We Should Obsess About the Nation's Health, Not the NHS

The campaign via Twitter to force people to declare their "love" for the NHS is not one I shall be participating in. I do not "love" the NHS any more than I "love" other major national institutions like the Police or the armed forced. These institutions are not there to be "loved", they are there to provide public services, and if they do a good job they should certainly be respected. But "loved", give me a break. This is puerile politics at its worst.

Dan Hannan's remarks about the NHS in America were bound to cause controversy. The fact that he dared to criticise what has become a hallowed British institution on foreign soil has not gone down well with David Cameron and Andrew Lansley, and it is easy to see why. They have spent a long time re-establishing Conservative credentials on the NHS and among NHS staff. This hard work could now be undermined by the actions of someone they see as a renegade backbencher who holds no official policy portfolio in the party.

The Labour Party has naturally jumped all over Hannan's remarks, and who can blame them? But when we have to listen to Andy Burnham, the Health Secretary, talk about "Labour's NHS" it's time to pass the sick bucket. It's not Labour's NHS, the NHS belongs to those who pay for it.

This whole row illustrates the problem we have in this country. It is impossible to have a rational debate about the NHS because the moment anyone utters the most mild of criticism (and I accept Hannan's doesn't fall into that category!) or dares to suggest that the NHS actually isn't all that perfect, they are dumped on from a great height and accused of wanting to "Americanise" or privatise the whole system.

Until we accept that the NHS cannot possibly meet every demand made on it, and that we should be moving towards a mixed system of healthcare provision, the days of waiting lists, a lamentable dentistry service, postcode lotteries and withholding of disease curing drugs won't be over. The days of "public bad private good" and the reverse should be behind us. No other country in the world manages its health system in this way, but if you dare suggest that the private sector just might hold some of the answers you're just shouted down by all the vested interests whose very existence might be threatened. If you point out that every other European country has a mixed system which produces better outcomes you're accused of being a right wing zealot.

No, the NHS isn't perfect, and Dan Hannan has pointed this out using some fairly lurid language. But just to ignore the points he makes and pretend all is well is to brush it all under the carpet, which is exactly what the Labour Party wishes the media would do. Its record on the NHS is mixed to say the least. Yes, progress has been made. In 12 years so it should have been. But at what cost? Has the huge amount of taxpayers' money pumped into the NHS really produced the benefits and improved health we should have expected. No one could seriously answer 'yes' to that question.

I don't think anyone can seriously doubt the David Cameron's commitment to the NHS. It did wonders for his son Ivan, and he has demonstrated his commitment by consistently saying it is "number one priority" and that its funding will be ringfenced. Not only that, but he and Andrew Lansley have committed themselves (wrongly in my view, bearing in mind the state of our public finances) to real terms funding increases. No Labour politician has done that. Even sceptics would surely have to admit that the NHS would be, to use a famous quote, "safe in his hands". His commitment to the NHS does in part stem from his own family's experience and he is not alone in this, as this morning's 5 Live Breakfast Phone in proved. People do judge big institutions by their own experience of them. I, for example, have little confidence in the Police because every time I have some experience of them, it is a bad one.

Most people do have a good experience in the NHS, but those who have bad experiences tend to let them affect their view for longer. From a personal point of view I could not speak highly enough of the treatment I have received for my diabetes. But my experience with relatives who have had prolonged stays in hospital is sadly very different. We have a mental healthcare system which disgraces the concept of a civilised nation and almost non existent NHS dental care provision.

If you die earlier in Britain than you would in other countries. If you can't get dental care like you can in other countries, if the NHS won't give you the drugs you need because you have at some point paid for them, if the NHS wastes billions on bureaucracy, then you rightly ask why politicians aren't gripping the argument and coming up with solutions.

It is because we are trying to make a 1940s healthcare system cope with the demands of a 21st century society. We cling to the idea that healthcare is free at the point of delivery, while conveniently ignoring the truth that in many cases it isn't, and it never can be. And yet at the same time we prevent those who are happy to pay for their care from doing so without then being banned from having NHS treatment. Until we come to terms with the fact that a 1940s structure can never service 21st century needs, we're not going to get anywhere.

Andy Burnham says there is a deep hostility to the NHS within Conservative ranks. It suits his political agenda to allege that, but it is simply not true. There is a deep hostility to waste and inefficiency but there is no hostility to the NHS as an institution. It is not a total failure, but contains within it systems which are failing. It is the duty of politicians to point those out, react to people's concerns and come up with solutions. The trouble with the health debate now is that few people are even willing to have a rational debate without coming up with scare stories about cuts.

It's thoroughly depressing. Until we acknowledge that it is the nation's health we should be obsessing about, rather than an institution called the National Health Service, we won't get anywhere.

UPDATE: Dizzy has a blindingly good post on this subject HERE.

UPDATE: Little Ben Bradshaw tweets: "Cameron doesn't sack Hannan but does Tim Kirkhope - says all you need to know about "modern" Tory party."

Doesn't that tell you all you need to know about Bradshaw and the level of debate these pimples of cabinet ministers wish to have? Kirkhope wasn't sacked, and what exactly is Hannan supposed to be sacked from? He doesn't hold a front bench portfolio.