Making a Key Distinction in the NHS

There are two different narratives that are shaping the debate around the NHS at present. They are different stories, but they are becoming dangerously intertwined. I want to highlight the two stories and make a clear distinction between the two.

 

The first story is that there are some ways in which the NHS needs to be more efficient, work more smartly, integrate its services more effectively, cut some unnecessary waste, be more collaborative and ensure that the service it provides is as affordable as possible in a manner that is safe, learning, compassionate and continually improving. Some of this involves working with communities to help us live in a way (individually and corporately) that helps us to be more healthy and well, taking some strain from the system. It also involves some restructuring and rearranging of services to enable them to deliver care in a more streamlined way. This is a true story.

 

There is another story that is told that sounds like it has some similarities, but it is not the same story. This is the story that tells us the NHS is unaffordable, that it is failing and that we need parts of it to be privatized for it to survive. This is based on an idea that we have to balance our books, cut our cloth, tighten our belts and ‘live within our means’. This story is not true. It is not true because no country has ever lived within its means. Countries are nothing like households. Households are very simple. The economies of nation states are not. Households do not have banks in their back gardens that print money when things go wrong. Households do not give special privileges to rich friends, making life easier for them, whilst treating poorer friends like servants, taking away things they need and telling them are lazy and need to work harder, whilst blaming their problems on other friends who have moved into the area aka immigrants. Cutting public services and seeing the gap between the rich and poor grow ever wider whilst taking away the welfare that helps families in genuine need, cutting the services available to help them (pretending these are efficiency savings and not cuts) is a choice being made by our politicians. We are told there is no other choice, but this is not a true story. The NHS could be better funded (it is currently one of the most under funded health care systems in the entire developed world) and we could choose to manage the money of the country in an altogether different way! The NHS is affordable and the first story is helping to make this more true, but it needs greater investment, not the removal of vital services. Do not confuse the two stories.

 

 

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The Nazi Dog Experiment

Do you know the story of the Nazi Dog Experiment? The Nazis found that if they inflicted a group of dogs with pain through electrocution, 1/3 of them would lie down hopelessly and do what they were told. 1/3 would keep a fighting spirit no matter how much pain they were put under. The other 1/3 would start off fighting, but then once more pain was inflicted, they too would give up hope and submit to the inevitable.

 

I fear that this is now the state of those working in the public sector. Today has been horrible. You see, I am watching a nauseating sense of powerlessness and hopelessness begin to smother those in healthcare, social care, local government and education. The fatigue is palpable and it is deeply saddening.

 

We have seen the desecration  of our Public Health Service, leaving Clinical Commissioning Groups (CCGs) needing GPs to do much of the Public Health work, when they are already on the ropes. So GPs are now looking to partner with local schools. But every school in England is facing a 10% cut to their budget over the next few months. That means deep cuts to the kids who need help the most and it also means that schools now have no time, energy or resources to partner with local health services for the future wellbeing of the rising generation. A 10% cut to every school with no bail out help from local government as they too are being flogged. How is this not front page of every newspaper. What has happened to our press? Who is holding the government to account? There is something very sinister at work. A tiredness and hopelessness has set in.

 

But I will not be silent. Nor will I give up hope. The centre cannot and will not hold. We must throw off the oppressive yoke and we must throw off the shackles. I am still confident of this: top down hierarchy that eats up people like bread, holding power to itself through violence, law and debt has already lost. There is a better way. And we will see it and walk in it. It is the way of love. It is the new politics of love.

 

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