AND ANOTHER THING
Swallowing the big Health Service lie
PAUL JOHNSON
The National Health Service issue is widely believed to be Labour's strongest card in this election. It ought to be their weakest. Mr Kinnock stands for the preser- vation, in amber, unreformed and intact, of what has become the largest and most expensive bureaucratic monster in all British history, employing over a million people — more than half of whom have nothing to do with medical care — and absorbing colossal and ever-growing sums of our money. In the days when I went up to Manchester regularly, I always peered into a large building I passed on my right, immediately after leaving the station. It was part of the NHS and to me it epitomised everything that is wrong with our Sacred Cow. It was full of people sitting behind desks, and pretty well paid by the look of them. But if you were to go in and ask to have a cut finger bandaged, nobody would be able to do it. They were all — hundreds of them — 'administrators'.
After decades of cowardice, the Tories at last plucked up courage to tackle this prof- ligate absurdity, legislating to allow doctors and hospitals to release themselves from the bureaucratic nightmare and run their own finances. It is one of the best things they have ever done and, despite a barrage of lies from Labour and its friends in the media, is working well. Mr Kinnock is pledged to reverse it and go straight back to the old, inefficient, expensive mess. He has no choice of course. Those who own the Labour Party give the orders. Over the last decade, power within the party had swung decisively from private-sector to public-sector unions. I hope it has escaped nobody's attention that three of the most notorious of the latter, Nalgo, Nupe and Cohse, are to join forces and form what will be the most formidable union in Britain, 1.4 million strong, dwarfing the old giant, the T&GW. It will be by far the biggest sin- gle shareholder in Labour Incorporated and will have the loudest and greediest voice in its decisions. And, since most of those million NHS employees will belong to it, its message to Mr Kinnock will be plain: keep the Sacred Cow unchanged, fat and well-fed. Labour says it plans to pour huge sums of public money into the NHS, to 'improve the standards of health care'. The money will doubtless be provided but the new super union will decide where it goes — on higher wages, shorter hours, `better conditions' and the restrictive prac-
tices of its members. Patients will be no better off.
Indeed they will almost certainly be worse off. For old-style NHS hospitals are, to a great extent, run by the unions. Where once fierce and dedicated matrons ensured absolute cleanliness, strict discipline and, not least, bustle, shop stewards and con- venors create an atmosphere of egalitarian squalor and sloth. Immediately you enter one of these places, you notice the signs: passive, hopeless people sitting on benches, being ignored by plump, 'caring' ladies chattering about this and that behind their counters and officious glass screens; a gen- eral air of lassitude, manna and indiffer- ence; bits of paper stuck up everywhere with sellotape, inviting you to demos and marches; the almost palpable atmosphere of a state-financed, union-run concern where no one can be fired or even made to work. Occasionally, a frantically busy doc- tor or nurse rushes through, disturbing the demotic, dusty calm.
When the unions stir themselves, it is to obstruct. The old Spanish customs of some NHS branches rival even those of the print unions, now happily abolished to every- one's benefit. This week I got a letter from a radiographer who spent her life working in NHS hospitals: she gives three typical incidents, repeated daily all over the coun- try where the unreformed NHS flourishes. In one famous London hospital where she worked, the dark-room walls had to be washed down, a `specialist' task allocated to the appropriate union members, 'qualified' painters. Instead of taking one day, they required three, including long lunch-hours, coffee and tea-breaks. While they were thus engaged, no X-ray developing could be done. Exasperated by the growing back- log of films to be developed, the radiogra-
pher and her staff took advantage of the painters' extra-long lunch-break to finish the job themselves, and had the dark-room humming again by the time the men returned. Consternation — all painters in the hospital downed tools — strike threat — days lost — anxious meetings with man- agement — apologies all round.
On another occasion, she had two elderly patients, over 70, for X-ray when a thun- derstorm and tropical downpour broke. As the next patient was a 'sitting ambulance case', and as the two old people lived on the route the ambulance had to take, she asked the driver to take them with him: he refused her entreaties. So she transported the old folk in her own car. The next day, following an indignation meeting, the entire ambulance staff of the hospital held a one-day strike. A third episode involved a battle with the Purchasing Department of the NHS over buying a bit of equipment: the model she wanted was not on the offi- cially Approved List, but it suited her pur- pose best and was £100 cheaper. When she went ahead and got it there was an almighty row with the bureaucrats and a formal inspection by two 'administrators'.
Compiling lists and inspecting is, of course, how they justify their existence, and the unions intend to keep it that way.
These are humdrum little matters but it is precisely because they are constant and ubiquitous that the unreformed, union-run NHS is so expensive, functions so badly, and allows case-lists to accumulate. Putting in more money, without reducing union power and removing restrictive practices and bureaucratic structures, merely adds to the waste.
Indeed, administrators and non-medical staff, with too little to do but a burning sense, inculcated by their unions, of their own indispensability, actually impede the work of doctors, specialists and nurses. It would not surprise me if cutting the million NHS work-force by half actually improved its efficiency: that is certainly what hap- pened in British Airways and British Steel, two once-nationalised industries which have been successfully reformed. The real criticism of Tory health policy is that changes introduced are tardy and timid. But how to get this truth across? I usually trust to the good sense of ordinary people to unravel complex political issues and make sound judgments. But on the NHS they have swallowed the Big Lie.
Previous page
