Health Policy Insight
Healthcare management online analysis and intelligence
The home of UK health policy

Editorial Thursday 4 January 2018: The Conquest of the NHS is in full swing

Publish Date/Time: 
01/04/2018 - 18:28

The historian Robert Conquest is famous for his 'three laws of politics':
1. Everyone is conservative about what he knows best.
2. Any organisation not explicitly right-wing sooner or later becomes left-wing.
3. The simplest way to explain the behavior of any bureaucratic organisation is to assume that it is controlled by a cabal of its enemies.

He was also the author of 'The Great Terror' an acclaimed book on the Soviet purges of Stalin, a later update of which Kingsley Amis remarked should have been retitled 'I Told You So, You Fucking Fools'.

Between Conquest's Third Law and Kingsley Amis' suggested revised title, we have a near-perfect summary of where the NHS finds itself, to the considerable surprise of absolutely no-one who's been paying attention.

The Conquest of the NHS is in full swing.

Waiting times are soaring - as experts predicted. Non-urgent electives have been cancelled for a month.

But some interesting things are also happening.

Prime Minister Theresa May's former special advisor Nick Timothy wrote a staggeringly sensible article in today's Telegraph, calling for proper, five-year NHS funding settlements and a Royal Commission on the future of the NHS.

Timothy describes the Coalition's NHS reforms as 'disastrous'.

Lib Dem leader Norman Lamb started a conversation with Mr Timothy on Twitter about this, and it didn't even seem surreal. (Norman Lamb of course backed the Lansley reforms, so that should be quite a chat.)

Elsewhere on Twitter, Nick Macpherson, former permanent secretary to the Treasury (AKA Munchkinland), who has formerly tweeted about the need for Simon Stevens to step down for daring to express a view on NHS funding; the same Nick Macpherson who elsewhere on Twitter had described the NHS as a bottomless pit, came up with the rather more reality-based suggestion that "Need a grown up debate on long term funding of NHS. I would suggest a hypothecated tax to be renewed every 5 years & an end to "triple lock".

It is almost as if the argument Simon Stevens has been making on funding is in the ascendant.

That will solve no problems in the short term.

Twitter is alive with A&E clinicians fulfilling their duty of candour by describing what is going on in A&Es across England (and also in higher-funded Wales and Scotland ...).

It's real, and the NHS staff keeping things as safe as they are able deserve huge thanks and respect. That thanks and respect, immediately, is all we can give them.

There will be a need for a hairy-arsed 'getting through the day'-type plan in every locality. I'll write more on this shortly.

But fans of irony might enjoy one more Twitter moment, from the possibly-outgoing Health Secretary Jeremy Hunt, who in a display of terrifying political tone-deafness wrote "Tony Blair's memory is as selective in office as out of office: does he not remember his own regular NHS winter crises? Perhaps he was too focused on joining the euro to give his full attention to the NHS...".

Well. And well some more.

Perhaps Mr Hunt has delighted us as Health Secretary for long enough.