SINCE IT’S ONLY individual experiences that matter now, let me share with you my own encounter with the NHS early on Tuesday, when I took my sick daughter to A&E in an inner-city hospital. It was fairly quiet. There was the usual sprinkling of patients hanging around but the first nurse saw us within two minutes, after which we were shown to a private cubicle and attended to five minutes later by a doctor and a second nurse. Soon after that, we were transferred to a colourful children ’s waiting area full of toys where we sat for perhaps half an hour before being seen by a specialist paediatric doctor. All kind, all considerate, all highly professional. I was back home two hours after I left, with a significantly improved toddler.
Our exclusive experience with the NHS is available to Michael Howard for use at Prime Minister’s Questions next week if he gives me a ring. Equally, if Labour would like to put us on an advert under the heading “forward not back”, it would particularly suit my daughter who can, in fact, only walk forward and not back.
But I would no more assert that the fact that I got a good service means that the NHS is perfect than I would that Margaret Dixon’s case shows that it is in collapse. Labour’s focus groups have shown a public sceptical about Mr Howard’s use of Mrs Dixon and her shoulder. One woman said: “It’s all a farce. They are dragging people out of the woodwork, flinging them in front of the camera. It’s just scoring points.”
A Populus poll in The Times this week suggests that voters’ perceptions of the NHS are swinging Labour’s way. As the health service has improved, people have tended to view their own positive experience as an aberration and to assume that everyone else is still getting bad treatment. But now that is changing. People’s overall impression of the NHS nationally has risen sharply over the past year, while their personal experience of it is still improving bit by bit. Labour is winning the war of public perception.
The parties, as ever, are ambivalent about the public. On the one hand they understand the power of individuals to get across points that people will not listen to from politicians. Tony Blair’s “masochism” strategy is based on the understanding that if it’s an angry member of the public the Prime Minister is speaking to, voters will at least listen to the exchange and may see his point. On the other hand, members of the public can be pretty daft. With eight years at No 10 under his belt, Mr Blair knows this better than most. There is a wonderful vignette in an excellent book by Mr Blair’s former aide and speechwriter, Peter Hyman, which looks at the difference between formulating education policy in No 10 and delivering it at an inner-city comprehensive.
In 1 out of 10, Mr Hyman recalls a day with war in Iraq imminent, when Mr Blair came off the phone to George Bush to attend a meeting with the readers of Chat magazine. He enters a grand, pillared room at No 10. “Surging towards him is an elderly woman with her hand halfway up a furry dog glove puppet.” Jingles, the ventriloquist dog, starts nipping the Prime Minister’s hand. As he sidesteps her, another woman approaches to ask if she can read his palm, and tells him he is going to be involved in a major investigation into white bread production. Well, there’s still time.
With these experiences in mind, you can understand why Labour feels the need to parody the Tories’ health policy as “introducing charging” rather than engaging with more fundamental arguments about the reach of NHS reform. When the Tory party says that it will pay half the cost of operations for people who choose to go private, Labour contends that that means introducing charging into the NHS.
The argument of John Reid, Secretary of State for Health, runs like this: if the Tories take £1.2 billion out of the NHS (the cost of subsidising operations for those who would go private) and then they scrap all targets, as they say they will, then waiting times will get longer. Those who can afford to pay will therefore be more likely to go private, at half the cost, than they are at the moment. More and more private operations will mean fewer and fewer NHS operations, as the same doctors perform both. Therefore in effect you will have to go private too in order to get treated — and will have to pay half the cost. Hence, the Tories are introducing charges for basic operations.
The Conservatives respond that, yes, they do want to encourage more people to use the private sector in order to develop it as competition for newly liberated NHS hospitals — but that after the first £1.2 billion it will start representing a saving to the NHS as it saves half the cost of all those operations it would otherwise have funded.
There is plenty here for the parties to argue over — about whether Labour’s use of the private sector introduces any competition or simply represents a short-term measure to cut waiting lists but leaves the monolithic health service fundamentally unchanged, for instance. Perhaps the lady with Jingles would have a view on that.
But the campaigning reflects none of this. Both sides oversimplify the facts about MRSA. They select the statistics which “prove” their case. And they parade wild claims about each other’s record and plans.
The sloganeering does not do justice to an important debate about a fantastically complex insititution where so many individuals meet a vast and intricate organisation. Why was I at A&E on a Tuesday morning instead of seeing a GP, as I perhaps should have? Because the reorganisation of family doctor services meant that there would be no GP available for hours unless I attended a clinic a couple of miles away in a miserable backstreet in a dangerous part of town, and I didn’t have a car. So I chose to visit A&E in a big, bright, busy three-star hospital half a mile down the road instead.
The real problem with the NHS is not the hospitals or the managers or MRSA, and all the things that politicians argue about, but the inadequate family doctor service. Then again, that’s only my experience. I expect you have another.
