He’ll hold his nose.

One unamed “loyal senior Lib Dem MP” said: “I’ll hold my nose and vote for it [the NHS bill].”

That’s nice for him, whoever he is. He’s probably rich enough that he thinks he can do without the NHS. Perhaps he even thinks he can leave enough money for his children that they’ll always be able to afford private healthcare.

I read in Cake and Morphine’s blog a few days ago a hopeful assumption that if Tory MPs had only experienced the kind of shattering “lifestyle choice” of devastating illness or injury, they wouldn’t have voted in the Welfare Reform Bill.

But two or three years ago, Iain Duncan Smith’s wife had cancer. IDS took six months off work to care for her (and claimed thousands from the taxpayer while he was doing so). David Cameron had a disabled child, but Cameron doesn’t give a damn about the disabled children of families who aren’t, like himself, wealthy enough not to care what’s the price of services.

It doesn’t matter to Iain Duncan Smith that the NHS saved his wife’s life. She’s rich enough that she would be able to buy the very best healthcare wherever she lived. (The only American I know who consistently speaks positively of her country’s healthcare services is a very rich woman who has inherited wealth on both sides of her family.) There is no empathy in him, in David Cameron’s mind, for those too poor to matter: which is most of the rest of us.

From David Owen’s lengthy and solid critique of the NHS Reform Bill:

David Cameron should remember the words he spoke about the NHS during the election. Most of those who work in the health service were aware of his own late son’s illness and felt that when he spoke about the NHS not having any more top down reorganizations, he carried the conviction of someone who had real experience of what the NHS represented in British life. When he talked of his ‘Big Society’, many envisaged the ethos of the NHS would be part of that. During the 2010 General Election the NHS was not, as in previous General Elections, anywhere near as big an issue between the parties. Voters believed not only that there would be no more top down reorganisations but the Conservatives had absorbed the strengths and realities of the NHS. There was nothing from the Liberal Democrats either to identify them with these reforms. It is also noteworthy that the most recent assessment by the OECD3 in praising the achievements of the NHS drew attention to the fact that this was despite the adverse consequences of numerous reorganizations. Why are we having the mother and father of all past NHS reorganisations?

Robert Heinlein said once that when people ask “Why do they – ” the answer is always “Money”. I think that’s about as right as any facile Marxist analysis, but it’s certainly true in this case.

As the Telegraph itself notes, when private healthcare companies fail – and they are most of them looking financially shaky right now – this is much more of a problem than Woolworths going under.

“The issue,” says one industry insider, “is that the consequences of failure in the retail sector is that you lose your money. Whereas the consequences of failure in healthcare is far more profound. It is fair to question: what is the cost for society when one of these companies does fail?”

When a bank fails, the government has to step in and rescue the ordinary people whose savings were in that bank. This usually means saving the bank itself. When a healthcare company fails, the state has to step in and rescue the ordinary people whose lives are at stake – but unlike banks, where all that’s needed is tonnes of helicopter money, something any government in good standing can provide, saving people’s healthcare takes trained, experienced, professional staff. And you don’t get that just by calling the Bank of England and telling them a number.

It’s exactly those staff, the most priceless NHS resource of them all, who are speaking out against this Tory bill, from all parts of the political spectrum. Even Doctor Rachel Joyce, who stood as a Conservative candidate at the last election, and who holds to Tory ideology that “competition” is good in healthcare, says about the “reforms” of this bill:

The other major concern is about “integration”. Recently a BMJ paper showed how in just one decade, the death rate from heart attacks in the UK has halved. This reduction followed the publication of the National Service Framework for Heart Disease and the establishment of Cardiac Clinical Networks. I was in fact clinical lead for one such network for a few years during the time period studied. Working groups of doctors from hospitals, general practice and public health worked with managers and patients to transform services in particular for the crucial first few hours after a heart attack, and to make sure that all patients with heart disease were managed long term with the right treatments and investigations. This was true integration, where all parties reached a consensus on what needed to be done locally, and everyone understood and played their part in the care pathway. The easiest change came where there was strong clinical leadership and re-design of care was straightforward and evidence-based. The most difficult changes to bring about were where there were financial incentives against cooperation. Joined up services and coordination of care were vital. Health professionals are concerned that competition between providers will reduce cooperation, communication and coordination of care such as this, especially if there are perceived financial conflicts of interest.

Early in 2008, an American who had recently gone freelance, Daniel Durate, had no health insurance and started “dropping a lot of weight, going from 290 to 240 pounds”. He didn’t go to the doctor until he could no longer eat.

The diagnosis: Stage 4 stomach cancer. Medicaid paid for his surgery last April.

“Would you have been in a different place if you had health insurance?” asked CBS News correspondent Jim Axelrod.

“Totally,” Durate said. “I would have been able to go to a doctor like maybe last year.”

We have lots of good treatments for high blood pressure, diabetes and high cholesterol that can now prevent complications, that can now lengthen our patients’ lives, but we can’t do anything for our patients if they can’t afford to come to our offices,” [Dr. Steffie Woolhandler] said.

A 2009 study showed that 45,000 Americans die each year because they don’t have health insurance.

Yes, President Obama brought in legislation in 2009 to somewhat fix that problem. But he couldn’t go far enough to really fix the problem, because

most people who don’t like the healthcare reform bill, are disgruntled for the right reasons: the bill doesn’t go nearly far enough to provide healthcare coverage, to control costs or to regulate the avaricious insurance gangsters. This is the most tepid and insubstantial reform imaginable, something designed– unsuccessfully– to get Republicans to not make such a godawful ruckus. Well, it wasn’t only designed for that. It was also designed to please the Big Insurance Giants and other bad players in the Medical Industrial Complex who Obama and the Democrats are counting on to keep funding their political careers. Is that working, you ask? (Down With Tyranny / The Sideshow)

In the US, healthcare is a booming, profitable business. People who will die in unprofitable ways get shoved into the care of the state, which often can’t then do much more than try to make the dying time as painless as it can.

The 57 Liberal Democrat MPs in Parliament are in a bind. I appreciate that. They are trapped in a coalition which, if they leave it, will trigger a General Election probably before 2015. (Cameron has to call a General Election for May 2015, no later.) If they vote for this Bill, they are killing any hope of re-election and they are killing their party. Anyone who voted for the LibDems as a left-wing alternative to Labour, will know not to do that next time: anyone who voted for the LibDems as a kinder, nicer, more centrist alternative to the Tories, will know not to do that again. Nick Clegg represents the only South Yorkshire constituency, Sheffield Hallam, which has never been won by Labour: it would take an unprecedented swing from LibDem to Labour to unseat him, but in the 2015 Parliament, if he survives the winnowing, Clegg might preside over a party with fewer seats than the Scottish Nationalist Party.

This is an unpopular, unjust, and undemocratic Bill. David Cameron quite explicitly claimed he was not going to run anything like this once in Government, and he can hardly blame its origins on the LibDems, though their MPs are as much to blame for voting it in as the Tories are.

The question in each LibDem MPs mind must be: At what point do we stop? Where is the line drawn? There have been bad points before – tuition fees, welfare reform – but the NHS Reform bill is not merely not on the manifestos or in the coalition agreement, it cannot be justified by pointing to the pro-cuts ideology since it is shown to produce an NHS more expensive to run. The point of the NHS Reform Bill is not to create a better health service for thee and me, nor to cut costs, but pure and simple to divert a portion of all that money we collectively spend on our healthcare into the pockets of Tory Party financiers.

Those that plan to hold their nose and vote for it are doubtless thinking that their future political careers are already wrecked – or hoping that if their seats are safe enough to survive the 2015 deluge, no election will ever be as bad as that for the LibDems again. But every step they take down this course makes the eventual deluge worse, and this one – this destructive thing they plan to hold their noses and vote for – is the worst yet.

If you have a LibDem or a Tory MP you can write to them and urge them to vote against this bill at WriteToThem.

If a Labour MP … well, worth asking them, whatever their political masters are saying about compromising, to speak out against it.

Apparently Andrew Lansley is to be scapegoated for the NHS Reform Bill – the latest news from Downing Street is that Lansley has David Cameron’s “Full support”… just like Liam Fox:

Sylvester goes on to comment (not obviously reporting a source) that Mr Lansley “seems emotionally incapable of showing any understanding of other people’s concerns and intellectually unwilling to consider alternative ideas”.

It takes a remarkably unperceptive Number 10 operation to only just be noticing this. (Health Policy Insight, 7th February 2012)

Let’s not kid ourselves, though. While Lansley may be scapegoated for the unpopularity of the Bill, the idea of tearing the NHS apart and throwing the pieces to healthcare companies for profit, originated from the Prime Minister – it’s Tory party policy, unspoken until they were safely in power and sure of the LibDems. This Bill is not going away until the Tories are out of power. The best that can be done is to make it a ceaseless source of embarrassment to the Tories and to all the MPs who vote for it. Even if you see them holding their noses in the lobby.

Sign the petition, if you haven’t already.

Martin Rowson's NHS zombie bill


Filed under Healthcare

2 responses to “He’ll hold his nose.

  1. I would like to suggest a simple reform that would correct this imbalance – anyone taking public elected office should be barred for holding health insurance and from sending their children to private schools. Who could object to that?

    • I dunno. I just finished writing a post for tomorrow about Edinburgh Trams. The councillors who voted for this mess have to live with it as much as the rest of us do – but they still did it.

      Still, I like the idea.

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