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Reforming the NHS and the laws of politics

Sunday, October 29, 2023 12:42

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Many years ago as a young local councillor, I discovered that politics is bedevilled by the sheer irrationality of our electors. London Transport (as it then was) proposed to make some perfectly sensible changes to the bus network in my area, and held a public consultation. A woman rose and made an impassioned speech in two parts:

(A) the current bus service was shit; and

(B) it mustn’t on any account be changed, in any particular.

I was very glad it wasn’t me in the chair, because I find it really difficult dealing with stuff like that ( – the same motive that caused me to recoil from being foreman of the jury on which I sat recently – and I was heartily grateful someone else accepted that solemn duty).

The public’s attitude to the NHS is the same, only on a truly monstrous scale. Here’s an extract from a piece in LabourList last week:

Normal people are very capable of holding contradictory views in their heads, especially in subjects about which they know little but feel strongly … paradoxes, which have regularly been witnessed in opinion research … are of profound importance as Labour thinks about how to frame its NHS offer running into the next election. They are:

- Everyone loves the NHS and yet in focus groups it quickly becomes apparent that absolutely everybody has a personal horror story about waiting lists or botched admin. These stories flow from them like a public policy fever dream.

- Everybody knows that the NHS is in desperate need of reform – and yet in focus groups almost nobody believes such reform will work. Getting people to imagine a high-performing NHS is very, very hard.

- Everybody knows that the NHS is in desperate need of investment – they see it with their own eyes every time they visit a hospital. And yet nobody believes it will make any difference to the service they are experiencing.

The piece goes onto say that “[Wes] Streeting’s speech at [Labour party] conference seemed to try to reflect these paradoxes and even solve some of them.“ He’s also recently told the Royal College of GPs that Labour “won’t entertain requests for blank cheques“, which is rather what they have in mind.

Assuming he & the rest of Labour are seriously preparing for power (as well they might), I very much hope this all means they have taken heed of Drew’s Laws of Politics #1: Never buy off anyone at a higher price than absolutely necessary. Virtually no voter will change their allegiance based on the precise nature of Labour’s NHS policy next year. But Labour could get itself into needless trouble by promising the earth, tempting though that must be. Now one might say: Satrmer is such an accomplished liar and shameless U-turner, he can say whatever he will and then renege on it as PM, just as quickly as he always has with any other pledge or promise he made to the Labour faithful since 2019.

Still, he’d probably rather not. Might Labour then be the first party to come to power with a bit of a free hand on the NHS? We do all really know it can’t go on like it is.

Source: http://www.cityunslicker.co.uk/2023/10/reforming-nhs-and-laws-of-politics.html

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