Crimethink

Dear Reader,

Why is it that in the UK there is considerable opposition to privatising the NHS?  The answer is simple:  It is unthinkable that there should be no NHS.  No one can conceive of how mass health care could function in its absence.  It is as if the ability to conceive of a UK without the NHS has been somehow intellectually excised and cauterised.

This reminds me in a way of George Orwell's Nineteen Eighty-Four.  There, the all-powerful Party systematically destroys words such that it removes all coherent conception of any thought regarded by the nomanklatura as undesirable.  Orwell provides an excellent example of how this works.  In his dystopia, the text of the American Declaration of Indpendence can only be conceived of as the word 'crimethink' and nothing more.

Here in the UK, abolishing the NHS is also regarded as crimethink.  The coalition of vested interests and their political mouthpieces through a compliant media decry all attempts at moving health care into the private sector.  They do it by scaring people and pointing to life before the NHS and the quality of heath care in the 1930s.  A Channel 4 documentary series charting the history of the NHS, made in the late 1990s, justifies its creation by anecdotal evidence of women roaming the streets with untreated prolapsed uteruses, a highly graphic illustration, but not in and of itself a justification for the billions expended annually.

So here is this Blog.  The purpose is to break through the barrier of crimethink into a brave new world of concepts and ideas.  Abolition of the NHS is possible.  It can be done in a way that increases quality of care and also ensures that the poorest in our country receive the treatment they need.

All its needs is for enough people to believe that the privatisation of the NHS is possible.  And it is.

Why does there have to be a spread of this belief?  At present the NHS is a political football, used by Labour and the Unions to justify their existence.  People vote Labour to defend the NHS.  To the Conservatives, getting rid of the NHS is a vote-loser.  So here we have the paradox of a huge state business which is continually reformed as the political elite fear the electoral consequences of its abolition.  If those consequences were properly sold to the elctorate, then its abolition could take place.

Fir instance back in 1977 it was generally accepted that Britain was only governed with the consent of the unions.  The state owned and ran a dazzling array of industries and utilities as part of Labour's attempt to command the heights of the economy.  It was inconceivable in the mind of the general public that this could change.  Yet one decade later the power of the unions had been smashed and by the end of the 1980s the bulk of state-owned businesses were be in private hands.  All of these measures were strongly opposed by Labour, yet when they returned to power, no attempt was made to reverse them.  This was because the voters now understood that privatisation was a good thing.  By 1997, the only big businesses that remained under government control were the Post Office, London Underground and the NHS.

The NHS?  A business?  Yes, it is.  That is the concept that people have to realise.  It has all the characteristics of a business, but it is completely owned by the state.  Something else that people in the UK find difficult to accept is the the provision of health services can actually be a business.  The concept of someone making a profit out of someone else's illness seems repugnant.  Yet the businesses that develop the pharmaceuticals make a profit, as do the firms that build the hospitals, manufacture surgical equipment, uniforms, provide energy, vehicle fuel, the vehicles themselves and a host of other elements that make up the NHS and all of these are vital to help someone who needs health care.  They certainly do not provide these things for free.  NHS employees are not provided simple bed and board in return for their employment.  The fact that they are able to have spare money after providing basic living expenses indicates that there is a profit there too.  So why can't the NHS itself run a profit?

The answer is that it actually does.  A budget surplus is a profit.  But if a department always runs a surplus then its future budgets will be cut.  So the money is always spent (and sometime over-spent) somehow.  If it is not spent on front-line services then a pay rise to administrative staff will see you through.  Or, in the case of Mid-Staffordshire NHS Trust, payoffs to senior staff forced to leave after their incompetence caused the premature deaths of hundreds.

The state sector is notoriously inefficient at allocating resources and getting a return on investment.  But these are things that the private sector excel at.  If a given business did not, then it would not survive and it would be replaced by another business that could.

Perhaps it is hard for people to accept that the delivery of health services can be a business or indeed make a profit, but then that is why we are saddled with the NHS.

As soon as people can understand the benefits of getting rid of the NHS then popular support for this will drive its demise.  This Blog will try to provide the arguments that will allow people to get past the thought police embedded in their heads that labels abolition of the NHS as crimethink.

Sincerely,

Paul T Horgan

My next post will look at why abolition of the NHS is regarded as crimethink in a society dedicated to intellectual freedom and debate.