The Guardians front page informs us, yet again, the ‘soaring cost of long-term care threatens to ‘overwhelm’ the NHS. This follows hot on the heels of 3 years of dire pronouncements from Cameron and co on the viability and future of the NHS. The inevitable demise of the NHS is linked most often to the ‘demographic time bomb’, a phrase which succinctly stigmatises older people for ageing and justifies austerity measures and no end of initiatives from policy makers to introduce changes to meet ideological imperatives, rather than actually build on what has been a succesful economical healthcare system for over 60 years.
It’s time to drop the negative narrative which abounds whenever the NHS is discussed and embrace the positive contribution it makes to all our lives. Ministers and policy makers across all parties are not providing new and innovative thinking on the future of the NHS. Yes, Cameron, Osborne, Hunt, Gove and co really do think they are putting forward radical new plans, which appear to be centred around the ‘tyranny’ of choice and deeper privatisation of traditional public sector provision. This is not new , it’s a rehash of the same old neoliberal dogma beloved of Thatcher and Blair; transform health care into a product, and patients into consumers, ‘codify’ practice to make it ‘professional’ and ‘commoditize’ care to make it a deliverable ‘product’. Putting such narratives around practise makes problems in the NHS easier to talk about and resolve, i.e we need more training for carers, more training for leaders and managers, different providers, a mixed economy of care etc.
Many in government scream ‘consumer choice’ as if it’s the answer to every woe. However, for many the reality of choice is it’s a huge amount of hassle and the ‘choice’ is between equally dismal providers when all anyone really wants is one provider to provide a good service. My belief is the NHS is more than able to achieve this, yes reform is needed, however, the NHS is not just any old healthcare system, it is an expression of our values, our belief in a social institution based on equality and collectivity. It is also a proven alternative to free market competition. Lets not forget the reason for the existence of the NHS, it was founded on the failure of the free markets in a period of financial austerity – a time of new government and new political agendas.
Bevan said ‘Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community’
The NHS is not an indulgence, it tells the world something about us as a nation, it tells us something about ourselves. Reform is required, certainly, but please, lets just try to make sure reform builds on the success of the NHS, not just the narrative of austerity. We as a nation need to ‘own’ the NHS in our collective conscience, otherwise we will lose it to the medical equivalents of the energy companies and financial sector.
Is that what we really want?