Last night, flicking through the TV channels after watching Andy Murray get pulverised by Nadal, the muscle-bound Spaniard, in the tennis, I watched in bemused fascination as ITV and the BBC both devoted quite a lot of air time to celebrating – that word was used repeatedly – the 60th anniversary of the National Health Service. There has even been a church service, attended by Prince Charles and the Prime Minister, Gordon Brown, to mark the anniversary of Britain’s monopoly provider of health care, an essentially socialist creation that is hardly emulated anywhere else in the world, and for good reason. None of the major objections to health care that is provided via tax and distributed “free” at the point of use were mentioned. Last night’s stories gave no balancing comments from skeptics or opponents of the NHS to counter the general feel-good presentations.
At the Institute of Economic Affairs, here is a rather more sober treatment of the NHS. As the US writer PJ O’Rourke once warned his countrymen about socialised medical care, if you think US private sector healthcare is expensive, just wait until it is “free”.
As I have mentioned coup before on this forum the greatest coup the socialists eï½–ï½…ï½’ pulled was anchoring postwar British patriotism to socialist institutions. Its the main reason for my extreme pessimism regarding libertarianism in Britain. As with the BBC, loyalty to the NHS is a lynchpin of national identity. “Does the damn thing work?” is strictly a secondary consideration. Fetishising institutions in this way is a fairly British failing. I know of no American tax funded organisation that is held in remotely similiar reverence. To MANY people rejecting the NHS while retaining their sense of national identity is as inconceivable as it is for mainland Chinese to reject Mao and the communist party and still feel chinese.
As long as the British public and media want Sacred Cows and collective identity rather than functioning healthcare nothing will get better.
JP,
You have picked-up on exactly what I feel. What bugs me most is that the NHS has somehow become apolitical. It’s become a given like Brits getting thrashed at tennis*. I find this truly bizarre and extremely disturbing.
*I also saw that match and I know little about tennis but I do know that Andy Murray just looks like some bloke and Nadal looks like he’s just walked off the set of 300. I was therefore not surprised it was straight-sets.
Here’s a fun little twist on it. The Guv has accused doctors of “stifling patient choice”. Despite being an Eyore resigned to my fate most of the time, I still have the capacity to be amazed at the blind delusionality of statists. They set up a system which eradicates choice by eradicating the market. They then try to re-impose or re-introduce the very aspects that the market would have provided but which they have abolished, a hopeless task, and then throw around blame for the absence of the very thing they abolished. Staggering.
What I find both interesting and bizarre is that the utter failure of the NHS in the real world seems to do nothing whatsoever to dent the loyalty that people feel toward the NHS in the abstract. People are steadfast in their passion for the idea of the NHS, even as they complain loudly about the inevitable practical consequences of that idea.
If ‘we’ as a nation MUST express our irrational devotion to something in order to sate our emotional need for collectivist identity, I would really prefer it to be something harmless and irrelevant like the England football team, rather say than a health care delivery system.
Off-topic – candidate for quote of the day :
“You cannot hope to bribe or twist,
Thank God! the British journalist
But, seeing what the man will do
unbribed, there’s no occasion to”
Quoted on http://biased-bbc.blogspot.com/2008/07/mr-motes-objection-independent-mep.html
Original source unknown (to me).
Since the NHS is just a year or two younger than me, perhaps I can begin to answer Jerome’s question.
When a young woman from a Glasgow slum, working as an upstairs maid, met and married a soldier who’d been born in a village in Ireland who’d joined the British Army to better himself, she secured for herself and her future children access to healthcare, (amongst other things).
When he was sent to France and later to Burma, the vagaries of war could have taken that benefit away from her.
When he returned from Burma, and I came along as her third, (surviving), child I was born in an Army hospital.
When my father left the Army, the three main things my parents wanted, more for their children than themselves, were a roof over their head, healthcare and education.
Though they both worked hard throughout their lives, they had little hope of achieving these things privately, but a council house, state schools and the NHS meant they could achieve them. No wonder they both voted Labour.
And, for the first twenty years, the NHS worked reasonably well. It wasn’t until the seventies that the cracks began to show and the politicians began their endless round of ‘NHS shake ups’.
In the early years nursing was a profession, even a vocation. Now it’s just a poorly paid job with few prospects.
In the early years the Hospitals and GPs were the focal points of the NHS. Now they’re just a drain on the multilayered administrative bodies where the real power, (and careers), lie.
I suppose the NHS was doomed from the start. Perhaps if the money raised from the puplic had been treated as insurance rather than taxation; perhaps if it had been kept out of the politician’s hands completely; (Ha! Fat chance. There’s votes in healthcare so pols are going to be round it like flies, as the US discovers ever four years.) Perhaps it could have worked.
I don’t know how to produce decent national healthcare, but for twenty years, the NHS got pretty close.
I worked in the NHS for 6 years in the sixties and I agree with Kevin that it worked better than it seems to now, but it was always doomed from the start.
The unrealist expectations, the elderly population, and the improving technology, together with the present lack of work ethic have conspired to make it so.
Perhaps the Swedish model where the workers in the clinics have a financial incentive to ensure that the clinic is successful and the patients well treated should be tried but this is so politically incorrect, and so against preceived wisdom that it will never happen.
There was a nice little post the other day at NRO about the Canadian version of NHS. It seems the chairman of the advisory commission that designed most of the system just gave an interview in which he says he’s changed his mind and now considers the experiment a failure.
He recommends privitization.
Oddly, this remarkable change of heart is being ignored by the MSM. Can’t imagine why…
The problem is that when you have a single monopoly provider, there is never any incentive to increase productivity, innovate or reduce costs.
Are there any Samizdatists who object to having both a private and public healthcare model working side by side, so to speak?
I object to a public model, period. I object to being taxed to pay for others’ health care services. I’ll pay for my own, and my family’s; everybody else should do the same. Those who legitimately can’t should have to rely on true charity (which is voluntarily given, not coerced through taxation).
Whilst some things look old at 60, some countries seem quite young! The United States is/are 233 years middle-aged. (Or is 4/7 the day of conception?)
America has brought a lot into the world, some of it good! Alongside some inspired rhetoric, it was also the US that invented income tax! (Described as a once-only measure, I believe.)
The major trouble with America now would be that it is so attached to the past, that it doesn’t want to change. Any libertarian revolution would have to overcome the belief that the system of government they now have is perfect. (Another American invention is the compulsory patriotism- other countries get by without such flag-fests!)
Still, it’s done a lot of good, and it is still one of the freest nations on Earth! But, as libertarians, we believe that it can be even freer!
As a pretty rabid free marketeer I’ve always being puzzled by the fact that the NHS (and British state education to) seemed to actually work until about 1974.
On our local TV the other day they were recalling the day the NHS started in 1948, when Nye Bevan is said to have handed over the keys of Park Hospital to the grateful serfs. No-one seems to have thought this odd: the hospital already existed, all that happened was that Labour nationalised it. The keys already belonged at Park Hospital before Bevan nationalised it and then handed them back. People sometimes talk as if there was no healthcare in Britain before the NHS, but the NHS was simply the nationalisation of what already existed. I don’t think a new hospital was actually built for the first thirty years of the NHS’s existence.
The problem of providing healthcare for all through an insurance scheme could have been addressed without nationalising all the medical facilities of the country, but that did not suit the Labour Party. We are now stuck with a piece of 1940’s socialist dogma which it seems we will never get rid of, because you can bet your arse Green Dave will not have the balls to do anything about it.
Park Hospital is now called Trafford General, and ten years ago, on the 50th anniversary, there was a big ceremnony there, with the Health Secretary and other assorted bigwigs. There is no such ceremony this year: the health trust, despite the billions spunked on it by NuLabor, is deep in debt, and has had to close wards and operating theatres. Happy 60th birthday to the NHS, the envy of the world that no-one else has ever thought to copy.