NHS Reform, the bill "no one voted for"? No, not really.

[matgb]

Jennie links today to an article on the OpenDemocracy website about the BBC coverage of NHS reforms. I'm afraid I didn't finish reading it. I generally have a little rule, if I'm reading something that claims to be factual and come across something that's egregiously annd blatantly false, I find it hard to take anything else it says seriously, if it gets something wrong that I know to be wrong, how many other things wrong are there that I don't know about?

If the article is headlined two years of censorship and distortion , then I expect it itself to not distort facts. That's fair, right? So, here's the the first substantive point the article makes:

1) Legitimacy – the bill no one voted for

In the run up to the 2010 general election, David Cameron frequently pledged that under a Conservative government there would be “no more top-down re-organisations” of the NHS.

Note, no citation there; he only actually said that once that I'm aware of, in a speech (a long time before the election as well). But how many times have you heard politicians and activists and campaigners opposed to NHS reform parrot that line out?

It's a lie. It's not true. Anyone saying it is either willfully distorting the facts or hasn't bothered to check them.

Y'see, Page 45 through 47 of the Tory 2010 manifesto^pdf includes such things as

We have a reform plan to make the changes the NH S needs. We will decentralise power, so that patients have a real choice.
...
We need to allow patients to choose the best care available, giving healthcare providers the incentives they need to drive up quality.
So we will give every patient the power to
choose any healthcare provider that meets NH S
standards, within NH S prices. This includes
independent, voluntary and community sector
providers.
...
We will strengthen the power of GPs as
patients’ expert guides through the health
system by:
• giving them the power to hold patients’
budgets and commission care on their behalf;
• linking their pay to the quality of their
results; and,
• putting them in charge of commissioning
local health services.

Centrepeice of the manifesto. Couldn't be clearer. That article starts with a lie, and then builds on it, therefore I gave up.

Saying "I disagree wtih this" is fine, in 2010 I was out there campaigning heavily against them, but saying "no one voted for it" is a blatant lie. 44% of voters in my constituency voted for a candidate backing these reforms. 39% did nationally.

The Big Lie is beginning to spring to mind about this one.

Wouldn't it be nice if the opponents of measures would actually argue their case? Y'see, I don't know what to think about the Govts NHS reforms, but when those opposed spend more time lying about them, distorting facts, scaring people, and similar than they do actually addressing the substantive issues, it doesn't make me think they've actually got valid arguments. If they did, why lie all the time?

How about you?

Comments

[hano]

Thing is, how many people actually read manifestos in detail these days? I did but I'm unusual like that. Even then, I'm pushed to remember what it actually said in detail. What I, and I suspect most people remember is the posters saying 'I'll cut the deficit not the NHS.' You can see it here (along with my favourite of the popularly edited versions here. Go Hackney.) The beauty of the (real) posters is that they project a message that the NHS is safe in their hands without actually explicitly saying so. It's a suitably vapid slogan that can meant anything you want it too mean. And you can bet several million votes at the next election that voters in 2010 chose to interpret that as 'the Tories won't privitise the NHS'. It's rather like reading, or rather not reading, the small print of a software company's terms and conditions before clicking accept. Then not understanding why people get pissed off when you point that out. All of which is standard electoral politics, it's not as if the Tories are the first to use such tactics to win elections.
It'd be interesting to see how many of the 39% who voted Tory explicitly endorsed page 45 through page 47 of the manifesto and whether they'd actually read it in detail.

[niaccurshi.blogspot.com]

Who wouldn't agree with it?

"We need to allow patients to choose the best care available, giving healthcare providers the incentives they need to drive up quality."

Hmm, better quality healthcare, and I have a choice to get "the best care"? Brilliant!

"So we will give every patient the power to
choose any healthcare provider that meets NH S
standards, within NH S prices. This includes
independent, voluntary and community sector
providers."

Fantastic, this aligns with my personal beliefs/politics/special needs that a one size fit all approach doesn't!

"We will strengthen the power of GPs as
patients’ expert guides through the health
system by:
• giving them the power to hold patients’
budgets and commission care on their behalf;"

Uh... ok, well GPs are smart people who I trust, so it can't be a bad thing to let them control what money is spent on

"• linking their pay to the quality of their
results; and,"

Sounds fair, no pay for bad GPs!

"• putting them in charge of commissioning
local health services."

*scratches head* sure...doesn't sound bad?

---

So... aside from whether people have actually read the manifesto or not, those who have will barely know what they're actually voting for anyway.

Something as complex as NHS reform simply can't be agreed with or not up front, and there's a definite argument that not enough public scrutiny was put on the NHS changes to either have people confirm their support or opposition.

But whether you dislike the reforms or not, they are what a government of power voted in believe will improve the service for the public.

Perhaps with the same sentiment as Mat, my frustration on NHS reform debates was that there was no coherent opposition to it. Sure, lots of protests against privatisation of the NHS, lots of (wrong) protests about the NHS suddenly ending it's free service...but actual reasoned discussion about the dangers of the bill were few and far between, and almost exclusively held outside the realm of the mass media. If Labour and those against the NHS changes really cared they'd have made a case against the flaws in the bill, as those who were invovled in the consultation stages did, and do the proper job of amending and taking control of the bill. Instead there was much stamping of petulant feet, and an easy passage was made for the bill.

At the end of the day I feel opponents of the bill wanted it to be passed, so that they had a new rod for Tory backs...political opportunism before the needs of the country that *could* have quite easily got an even more improved bill than we got.

[andrewhickey.info]

Exactly. It's heartening to see a few other sensible people like you and Mat saying that pretty much everything said about the bill by its opponents has been wrong. It sometimes feels like I've been living in a different universe from everyone else.

[rmc28]

I found the anti-NHS-reform arguments so repellent I was surprised to find myself, eventually, speaking against it.

[gominokouhai]

Exactly. How many of those 39% read the manifesto, compared with the number of them who saw the poster?

[matgb]

It'd be interesting to see how many of the 39% who voted Tory explicitly endorsed page 45 through page 47 of the manifesto and whether they'd actually read it in detail.

Not many. But...

A big chunk of people were going to vote Conservative anyway, (just as there was for Labour, and a smaller one for the Lib Dems).

But, when I was out doorstepping in my seat (bellweather marginal, considered one of the predictor seats, demographically close to the nation as a whole, etc), I found that the committed, partisan voters were the least likely to read the manifestos.

the swing voters, the undecideds, the "we voted Labour last time but are thinking it's between you and the Tories this time" voters? A lot more of them had read the manifestos, sometimes in detail. I had to go read up, then get back in touch with one lady who had read in close detail the pensions policy and had some very specific concerns.

Sure, most don't read manifstos. But... Most pay attention to the campaign, to the mood music. Thos who're actually undecided, the ones that actually determine the result, many more of them do, in my experience. Not the majority, I think, but even then they pay attention to debates and similar.

If the proposals were so bad, why weren't Labour politicos making as much hey with it in the campaign as they did afterwards?

(OK, we know that's mostly because Brown was useless and some of them were in favour of this sort of thing anyway while in power, but...)

The manifestos determine the campaign mood, to a large extent.

Whether lots of people read what they were voting for is less relevent than that they did vote for it, which is actually quite important.

[(Anonymous)]

"It'd be interesting to see how many of the 39% who voted Tory explicitly endorsed page 45 through page 47"

I would argue the view of anyone who voted for a party without reading their manifesto, doesn't deserve to have their view heard.

[http://www.nickbarlow.com/blog/]

I think you got further than me - when an article purports to be about 'BBC coverage' but then bases its conclusions on just looking at what's on the BBC News website, it's not something to give too much credence to.

[matgb]

Well, yes, there is that, but I thought I'd give it a further go, OD is normally a pretty good site, that article is on a bit I don't normally read, and I wonder if there's a reason for that.

[sir_guinglain]

Well said, and shows what can be exposed with a little research.

[matgb]

What bothers me the most is that it's been trotted out on shows like Question Time while senior Tories are sat there. Puncturing that balloon is such an open goal, why didn't they do it?

I mean, "Tories are Useless" can be a response to that question, but not all of them are.

The thing is.....

[daweaver]

There's a rather smoking gun in that most obscure document "The Coalition: Our Programme for Government", section 22, bullet point 2:

"We will stop the top-down reorganisations of the NHS that have got in the way of patient care. We are committed to reducing duplication and the resources spent on administration, and diverting these resources back to front-line care."

True, this isn't a "frequent" pledge, having been made in precisely one place. Nor was it made in the run-up to the election; my copy of the programme for government was downloaded on 20 May, a full fortnight after the vote. And the full quote is explained further by a theme in the Conservatives' election campaign, against the target-setting culture of the Labour era. The Conservative position was that administration-by-number generally didn't improve things, and was occasionally damaging to health. (obAdamCurtis: More on this theme in episode 1 of The Trap: Whatever Happened to Our Dreams of Freedom? (2007))

Like the original poster, I'm unsure about the changes to the NHS, not least because the enabling Act turned into a complete dog's dinner that is going to make good money for lawyers. Nor was I convinced by the arguments offered by the opposition: the only coherent attack I saw on the plans (as opposed to emotional posturing) was MD in Private Eye.

For historical reasons, Labour tribalists fetishise the NHS as "their" creation (blah blah Beveridge independent-Liberal historical inconvenient fact waffle). From what I can tell, Labour tribalists wish to ossify the NHS as it stood in the late 1960s, regardless of advances since. Rather than debate the merits of the proposals, and actually come up with concrete counter-proposals, they chose to scaremonger and mislead and lie. It's almost as if they knew they couldn't win the argument on facts.

It strikes me that only Labour would have the social capital to successfully bring about fundamental change in the NHS (such as, a move to a social insurance system broadly along the Irish or Dutch lines). Similarly, only a Conservative-led administration would have the social capital to bring about same-sex marriage and make it stick.

More widely, "No one voted for it" is a lie used by Labour tribalists about the present coalition government. This ignores the voices of the Liberal Democrat parliamentary party, federal executive, and conference representatives, all of whom quite clearly did vote for the present coalition in its present form. By my reckoning, about 1000 people expressed clear assent. Compare against people who vote for individual Labour councillors, or union grandees.

The pressure group does make one valid point concerning the BBC. The corp is absolutely hideous at publicly documenting contributions to its news coverage. Compare the running order for The Quotidian Today Programme - a brief description of some items - with its Australian counterpart, RN Breakfast. Similarly, finding out who was on Radio 5 is far less easy than who was on ABC Newsradio.

My understanding is that the BBC does keep such information in-house, but it's not on public-facing websites. I also understand that the Beeb is willing to assist with genuine research enquiries.

Re: The thing is.....

[matgb]

Completely agree. The coalition agreement contains the phrase, but that post-dates the election, and thus gets attacked regularly as somethign no one voted for.

Turnout at the special conference was more than 100 BTW, IIRC closer to 2000, but no one counted who was and wasn't a voting rep (the old IT couldn't do that), but the vote on the day was clearly virtually everyone in the hall.

[missedith01]

http://www.nhsconfed.org/priorities/latestnews/Pages/Conservatives-set-out-NHS-vision.aspx

[matgb]

Which pretty much states the manifesto plans 6 months before the GE as well, but does seem to contradict with the top-down moratorium.

Hmm, was that the speech that he used the phrase in? Because I've also seen them say "it's not top down, it's bottom up" or similar.