.jpg” width=”250″ height=”176″ alt=”cmc.jpg” />Next time you meet a nurse, ask him or her what the NHS reforms are about. Almost certainly the answer will be ‘I’m not really sure…I don’t really understand them’.
Next time you see your doctor, ask him or her what the NHS reforms are about. A few might know, and give their version, seen through their political prism, but from the rest, the answer will be: ‘Waterworks OK?’ Sub-text: stop asking me stupid questions I don’t know the answer to.
Email your MP and ask them what is his or her position on the NHS reforms, and nine times out of ten you will get his or her party’s standard issue response. Probe further, and it will become clear that he or she hasn’t the foggiest.
And don’t even bother to ask your mates, because sure as eggs is eggs, they won’t have a clue.
Now, if we stand back for a moment, this is quite extraordinary. The individuals who work in Britain’s largest organisation, the punters who run the country, not to mention the rest of us, are largely in the dark about what Dr No can only describe as the nuclear option for the NHS that has been put in front of us in the guise of the Health and Social Care Bill. The NHS is facing its Cuban Missile Crisis; and not even Dr Strangelove knows what is going on. Instead, an apathetic fog of confused indifference has settled on the land, a perfect fog, as it happens, from which to fire the missiles of NHS Armageddon.
And yet there are voices warning of the ICBM’s hidden in the Bill. Puppets-in-waiting Stevie and Mildew may bat for the other side, but there can be no doubt that the British Medical Association, the ‘official’ voice of the medical profession, has rejected the Bill in its entirety. The Royal College of Nursing, the ‘official’ voice of the nursing profession, has passed an overwhelming (99 to 1%) vote of no confidence in Lansley’s reforms. Crimson Pollock, an outstanding academic, and it is the force of her argument not the colour of her politics that matters here, has totalled the Bill several times over. Dr Clare Gerada, the divine Chair of the Royal College of General Practitioners, has repeatedly warned that the reforms will ‘destabilise the NHS forever’. No one, who bothers to look, can be in the slightest doubt that the overwhelming tide of professional opposition runs hard against this Bill.
And yet Cammers and Broken Arrow, and their back-bench buddies, time and time again trot out that doctors – because GPs have signed up to commisioning consortia – are in favour of the Bill. Never mind that GP’s are only part of one profession, and never mind that most have only signed up under duress, or if not under duress, on a what-else-can-we-do basis…
And this is the paradox of our modern degenerated democracy, a democracy defined not so much by a positive intent to rule well (albeit only in the interests of ‘majority’), as the single limited and ultimately negative notion that all that democracy stands for , all democracy is, in fact, is rule by a government that you can throw out every few years. We may know that we can dump them from time to time – but they also know that in between those times, they are pseudo-mandated oligarchs – and can do pretty much what they like. And so they do.
And unsurprisingly, many of us, faced with years of oligarchy, end up crumpled on the heap of indifference. GPs sign up to commissioning consortia (which is not the same thing a signing up to commissioning) because they see little option but to do so. Faced with the nuclear option cloaked in a baffling four hundred plus page amending Bill, now subject to over two hundred further amendments, many give up the ghost, and say ‘whatever…’, resigned to the inevitability of government getting its way. The vocal opponents, the voices Dr No listed earlier, are just that: vocal opponents, yet blind to the force of inevitability. There’s no point in understanding the Bill, let alone wrestling with it, because it is all going to happen anyway.
Bad mistake. Once nuked, the NHS – an institution which in many ways lies at the heart of, even defines, modern Britain – will never recover. Some might even say Britain will never be the same again.
So what is to be done? Dr No, you will be relieved to know, isn’t going to urge you to read all the Bill, and all the amendments. If he is honest, he hasn’t read every line himself. Instead, he suggests you consider one core question: why is the Secretary of State so determined to remove his duty to provide, or secure the provision of, a free at the point of delivery comprehensive health service? Once you have the answer to that one, the rest falls readily into place, and the nuclear option at the heart of the Bill lies plain for all to see. You might even want to tell your MP about it.