Ideology not money is why affordable NHS healthcare is not a proposition

A few days ago Charles Adams and David Laws wrote a lengthy blog for Progressive Pulse in which they demonstrated why any UK government is quite capable of funding a world-leading NHS healthcare system. In so doing Charles and David did what many people do when confronted with the task of dealing with an important policy issue – they employed informed, rational thinking to come up with a well argued, feasible solution to the age-old question that all policy making seeks to address in one form or another: who gets what, when, and how. In this case, healthcare.

Sadly, sensible, rational, thinking that delivers outcomes that benefit the majority of ‘stakeholders’ has nothing to do with healthcare policy in the UK.  What drives government thinking and action is what underpins Tory policy making in many areas, such as housing, social care, economic policy, regulation and law-making, and Brexit of course – IDEOLOGY – specifically red in tooth and claw, free market neoliberalism driven on by people who can and should be described as zealots.

Of course, given the public’s belief in and valuing of the NHS the Tories cannot take the road that Republicans continue to pursue in the US in their attempts to dismantle Obamacare (after the failure of Republican moves in Congress the Affordable Care Act is now being dismantled or undermined piecemeal by Trump using executive orders). Thus, while many Republican politicians (having also taken a similar “turn” into neoliberal zealots – or ‘extreme partisans’ to use a phrase frequently used by US commentators) are happy to attack Obamacare and its real or alleged shortcomings head on, in the UK we have the dismantling and destruction of the NHS by stealth, lies and deception. Thus, deliberate underfunding supported by a series of related policies are all part of a grand strategy to destroy both the actuality and essence of the NHS – a strategy now probably three quarters delivered. And nobody has been better at designing and implementing this meta-policy than Jeremy Hunt and his many free-market accolytes and supporters at the Department of Health and within the senior echelons of management within the NHS.

In summary then, since the 2008 economic crisis, Tory (and Republican) politicians have maintained an ideological assault on anything – any policy, idea, or proposal – they associate with the period of social democracy that stretched from the end of the 2nd World War through to the late 1970s. Indeed, as their version of neoliberalism is far more extreme than that of Reagan or Thatcher, ideological zealotry has  taken us well beyond what were considered right-wing policies in the 1980s. Much is now made in some sections of the media and commentariat that with the emergence of politicians of the left such as Jeremy Corbyn and Bernie Sanders in the US (who are actually no more left wing than a 1970s social democrat) the age of neoliberalism is coming to an end. That may be so. But its death will be slow, and its zealots will cause maximum damage to all and sundry as they see the tide of history turn against them. History teaches us that this is what zealots do. Personally, I doubt the NHS that we once knew and loved will survive – it has already been turned into little more than a brand under which a multitude of commercial organisations milk the system for all it’s worth.

So, as with the existence of the so-called ‘magic money tree’, which appears when any neoliberal politician needs to fund a policy of their choice and then magically disappears when they don’t, let’s not continue to blame the demise of the NHS, or indeed the failure of policy in housing, probation services, elderly care, and the disaster that’s universal credit (and many more) on government’s lack of money. As Charles and David demonstrated in their earlier blog this is not the issue. But they failed to mention the real culprit – ideologically zealotry,  or extreme partisanship if you prefer the more polite expression.


  1. Peter May -

    Agreed. But what I can never understand is what purpose do the zealots think all this privatisation serves? What ills does it redress?
    Is it just as simple that they are zealots for personal greed?

    1. Charles Adams -

      It comes down to collective versus the individual. For public services, the collective is forced to participate, whereas for private you are free to choice. It is nonsense of course because in many vital cases there is insufficient choice for competition to work. There is only one bus operator on my route to work (owned by Deutsche Bahn). There is only one train company that will get me to London. Only one gas pipe and electricity cable into my house. All these things would be better run by the collective as the market is ineffective. In the knowledge sphere such as health and education the resource constraint is trained doctors and teachers and duplicating the service to create competitive is not a viable option.

    2. Debbie Tucker -

      It is pure greed, pathological greed – they are money addicts.
      Privatization allows those running the system to BILL THE GOVT ANY AMOUNT. Of course they do not tell us this in the sales pitch of lies. Now one of the new terms is ‘public-private partnership’, so beware of that, too.
      Billing the govt of a monetarily sovereign country (the UK, the US, Canada, Australia, New Zealand – countries that issue THEIR OWN CURRENCY) allows them to bill for massive exec salaries and millions and even BILLIONS in profits.
      Australia is seeing attempts at more of this privatization push, and people are organizing to stop it.
      The politicians and their owners/donors have lied about EVERYTHING in order to dupe us and enrich themselves.
      Taxes DO NOT FUND SPENDING, despite their big lies.
      THERE IS NO DEBT – another lie they have duped us with.
      A deficit is NOT a bad thing and should be LARGER in bad economic times.
      And so on – the lies duped us and gave THEM a smokescreen as they have used the country’s money to enrich themselves endlessly.
      I will link to professors of economics who teach about this. Also, for the UK, look up Ellis Winningham, professor of economics (he has a blog, is on Facebook, and does interviews a lot now with a group called Real Progressives you can find on youtube and Facebook). Many informative, revealing presentations by professors wanting the public to KNOW THE TRUTH.

  2. Ivan Horrocks -

    The purpose – if you can call it that – of privatisation is simply to remove services from the public domain, as anything ‘public’ is hated by right wing zealots. That’s it. One of the most egregious examples of this was the re-privatisation of the East Coast Mainline franchise in 2015. Recall that the previous franchisee walked away from the service which was then operated by a publicly owned company for five years, in which it returned a healthy profit to the Treasury and customer satisfaction increased. But lo, the franchise was handed on to Virgin and Stagecoach, and what have we seen since (fare increases, etc). There was no other reason for this than that the success of the state owned entity exposed the lie that all publicly run services are by definition inferior to those run for profit. And as the maintenance of this lie is a central plank of neoliberal zealotry nothing that exposes it for what it is can be allowed to proper. It’s as simple as that, Peter.

    1. Charles Adams -

      The publicly-owned East Coast Mainline was a miracle of excellent service and amazing prices, and still made a profit. They had to destroy it because it made all the other franchises look so bad.

      After Virgin took over, we had: wifi that did not work, the same announcement everyday that we are sorry the wifi has just developed a fault, charges for non-working wifi, smaller seat spacings, toilets that did not work, and prices going through the roof. I would avoid it if I could but they have a monopoly 🙁

      1. Sean Danaher -

        And the food is a lot worse and more expensive.

  3. Richard Murphy -

    I so agree about the East Coast Route, on which I am a regular traveller

    1. Ivan Horrocks -

      I’ve not see that, Sean, but that’s certainly consistent with other sources of information on the subject. And much the same applies in the US, where the percentage is not as low as here but is nowhere approaching a majority. But that’s how zealots operate isn’t it, whether in politics, religion or indeed as I found out years ago, vegetarianism 😉

      The sad thing is that with the help of certain sections of the media – and the bidding of its owners – the zealots’ agenda is pushed as if it were sensible and mainstream, and the reasons for not pursuing other options denigrated and lied about – as we all know happened consistently with the EU, austerity, why the 2008 crash happened and much else. Thus the great majority of the public remain ignorant of policy options that would almost always be beneficial to them (as with the East Coast Mainline) than those the zealots produce, leaving zealots to sleep confortably at night in the knowledge that they won yet another ideological battle (and sod the consequence and anyone who may suffer). Such is the mindset of a neoliberal zealot.

      1. Marco Fante -

        If they had the won ‘ideological battle’ then the public support for privatisation would not be so decisively low. It seems to me that (in ideological terms) they have stolen the loot but lost the war.

  4. Graham -

    Just to mention the NHS in Scotland is different.

    And have you read “Private Island: Why Britain now belongs to someone else” by James Meek? It’s an appalling catalogue, especially the way social housing was sold off, found its way into the hands of private landlords who now rent it back to the social sector at vastly inflated rents.

    1. Ivan Horrocks -

      Thanks for reminding me of that, Graham. In my enthusiasm to get something written I overlooked that. No I haven’t read James Meek’s book. To be honest, between what Private Eye publish, what I read in the assignments of many of my Masters students, and my own research, I don’t think I could handle much more of an insight and stay sane.

  5. Marco Fante -

    Is it ‘ideology’? If so I would have to accept that those morons genuinely believe in something (anything) and I am not quite sure that they do.

    I could propose an alternative suggestion in saying that their real motivation is to be found in a combination of acquisition (greed, if you like) desperation and the technological obsolescence of capitalism.

    In the 1970’s it first became apparent that “productivity” growth gained through automation though useful at first, resulted in a persistent excess capacity of labour (unemployment) and capital. The unrealistic expectation of ever-growing rates of return on industrial capital was consigned to history. The result as we all know was financialisation (rent-seeking and speculation) and an expansion into the developing world through “free”trade” (a last frontier and race to the bottom).

    But that’s not the whole story. There was another, smaller frontier and not all rent-seeking is done through speculation. There is monopoly / oligopoly rent-seeking as well and that’s what privatisation is all about. In a world where returns on investment are perceived to be low and all the low hanging fruit has been taken, the opportunity of seizing public monopoly assets is just too good to resist. Then there all those‘consultants and investment banker’s fees to be made in bringing the assets to market (or tender).

    There is a case to be made that privatisation isn’t really about ideology at all. It is a rent-seekers paradise simple and plain.

    1. David Laws -

      You’re absolutely right. It’s a multilayered subterfuge and the use of ideology (to deny space for alternative thoughts) is one such cloak of deception to achieve their (otherwise) naked ambition

      1. Debbie Tucker -

        Privatization allows the people running the system to BILL THE GOVERNMENT ANY AMOUNT. Of course, they do not want the ‘little people’ to know this, it would ruin their scam.
        The ‘money tree’ is the government, and the government – here in the US, there in the UK, some in Canada, some in Australia, and so on – has been increasingly infiltrated by the corrupt and pathologically greedy, the money addicts and sociopaths. THEY understand the ability of monetarily sovereign governments TO ISSUE MONEY WITH ALMOST NO CONSTRAINTS. They just had to lie and do a LOT of propaganda and schemes to dupe the masses. And they have done it.
        This ability to bill the government results (here in the US, for sure) in MASSIVE exec salaries and billions in profits. Profits GUARANTEED.
        Our privatized systems so far are: defense, federal prisons, healthcare insurance, and Medicare Part D, that I know of. They have a long list yet to get their hooks into.
        They convinced other countries back in the 80’s, because THOSE countries already had more public services to be able to ‘take’ than the US did, since our greedy effectively squelched most of the uprisings and demands for better lives over the past 100 years.
        The money addicts MUST be stopped.
        Intervention time.

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  8. Conrad Bower -

    I believe public ignorance of economic issues plays into the hands of the ideologically driven arguments of government regarding the NHS being un-affordable. Educating the public in economic issues is therefore essential to democratically defeating these ideologies. Which in my opinion Charles Adams and David Laws original article tried to do.

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