Posted by Sam Fenny - Memes and headline comments by David Icke Posted on 8 July 2023

More of the Same Medicine for the NHS That Has Never Worked Yet

This week marked the 75th ‘birthday’ of our sainted anthropomorphised NHS. Observing the relentless barrage of propaganda from the BBC and associated media outlets I have been thinking about the nature of belief systems – how they are formed, sustained and manipulated.

Official lines loop endlessly on the public broadcaster – similar to leitmotifs in an opera or the chanting of a Greek chorus. Endless repetition of the foundational myth: universal healthcare, free at the point of use from cradle to grave, paid for by general taxation. Dire warnings of the threat of American style healthcare bankrupting patients with medical bills. And the excuses – always the excuses: ‘ageing population’, ‘rising demand’, ‘chronic underfunding’ and the rest. There is, as yet no evidence of intention or appetite for a significant change to the model of monolithic socialised healthcare in the U.K.

The pinnacle of absurdity must surely be the bizarre pantomime at Westminster Abbey on Wednesday. Royalty and the bien pensant beau monde gathered with 1,500 ‘NHS heroes’ to thank a presumed deity for bestowing chronically underperforming state-run healthcare on the nation. The Dean of Westminster went so far as to say that “the NHS was, and still is, a glimpse of the new heaven and new earth that is promised”. The poor chap may need to see a doctor – if he can find one. Irony is usually wasted on politicians, but I thought it telling that in the week Wes Streeting suggested we need to stop treating the NHS as a national religion, the leader of his party stood in a pulpit in Westminster Abbey performing a reading from the Bible in homage to the sacred institution. I’ve seen some nonsense in my time, but this was really through the looking glass.

The ‘birthday’ has seen the release of multiple reports, purporting to assess the state of the NHS and provide expert advice on how to repair it. Such reports are usually written with a prior agenda in mind – often with the intention of manufacturing ‘opinion-based evidence’ or to promote vested interests. Sometimes they are written to give the impression that a public body is ‘listening’ or has a plan. Occasionally the purpose is to deflect attention from embarrassing issues or to conceal prior policy mistakes. I find it noteworthy that reports published this week from different sources contain very similar substance. Surely coincidental.

The most eagerly awaited publication was the NHS long term workforce plan. Weighing in at 151 pages, this document is at risk of TL;DR syndrome (‘Too long, didn’t read’). Of course, this may be the intention. I’m always keen for readers to examine source documents for themselves, but in case they very reasonably have better things to do, I will summarise my thoughts below.

Before reading any report, the first thing I examine is the authorship or contributor list. The NHS workforce plan does not have one. There is a lengthy list of bodies ‘consulted’ but no names on the document other than that of Amanda Pritchard, the NHS CEO. This makes me wonder what (and who) the influences were on putting it together.

In common with most governmental reports, the document is slightly disjointed. Being written by committee, the various sections don’t fit together coherently. The preamble is packed with sanctimonious verbiage consistent with the religious positioning of the NHS. The text is long on aspiration but short on specifics – not entirely unreasonable given the unpredictability of the political landscape, but without specific deliverables, it is hard to quantify value. As the eminent 19th century historian Thomas Babbington Macaulay put it: “The smallest actual good is better than the most magnificent promise of impossibilities.”

Headline reporting has focused on the intention to expand the workforce. More medical school places, more nurses, more paramedics etc. Training courses will be shortened to push students into the workforce at an earlier stage. Competencies around prescribing for pharmacists and specialist nurses will reduce demand on GP services. Care will be moved out of hospitals and into the community. Public health will be improved to reduce obesity, diabetes and other chronic disease conditions. At the end there is a slightly bizarre section focusing on emerging technologies such as robotic surgery, AI, genomics, virtual wards, personalised care plans and so on. The lengthy appendices contain lots of detail in relation to the economic models used in generating the substance. I assume this is intended to reassure readers that there is some quantitative analysis behind the document – given the recent track record of governmental modelling I wouldn’t set much store by that. Maybe it will be different this time.

On the upside, the report is at least a recognition of workforce problems by the civil servants who run the system (I don’t think elected politicians have any significant influence). The proposal to reduce duration of medical training isn’t quite as crazy as it sounds at first glance – shorter courses are already successfully provided for graduate entrants with prior experience in areas related to medicine and there may be some benefits to be gained here.

What isn’t mentioned in any significant detail is the ongoing cost – if the workforce is rapidly expanded, the wage bill will also rapidly increase. Given that staff costs are the single biggest item in the NHS budget, it’s a reasonable inference that the taxpayer will be tapped for a lot more cash. Nor is there any mention of who will train these extra medical students and nurses – frontline staff are already pushed to the limit – I can’t see many of them agreeing to take on extra teaching commitments given current industrial unrest. Further, as another recently released report from the Institute for Government points out, NHS productivity has continued to fall in recent years despite huge increases in the number of staff employed.

Maybe it will be different this time.

Read More: More of the Same Medicine for the NHS

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