Criticise what happened and we'll desecrate your mother's grave

Three years ago, at the very moment that he was presiding over the abominations at Mid Staffs – and, as we now know, several other hospitals – Andy Burnham, then Health Secretary, was calling me ‘unpatriotic’ for pointing out the poor performance of the NHS in international league tables.

I mention it, not to have a go at the poor fellow – the rest of the country is already doing that – but to explore the connection between the tendency to shout down any criticism of the NHS and the number of British hospitals which are, as the Keogh Report put it, ‘trapped in mediocrity’. Any organisation that is treated as being beyond reproach is bound in time to become flabby, self-serving and producer-centred. It happened to the mega-charities. It happened to the United Nations. It would be surprising if the NHS were an exception.

In today’s Guardian, Simon Jenkins writes:

Lobbyists for the NHS have resisted reform by appealing to public emotion since its foundation. It has served them well – especially the consultants.
Indeed. Which is why the NHS remains stuck in the 1940s: an era of conscription, rationing, identity cards and unprecedented government control. It is why, while every other Western European country developed a mixed system of public and private provision, Britain clung to a state monolith. (This, incidentally, was the sixty-year old mistake I once criticised: the decision, wisely opposed at the time by the Conservatives and the BMA, to nationalise private, charitable and foundation hospitals rather than allowing them to form part of a pluralist system.) And it's why all the parties in Britain regard as normal a situation which only Communist parties in Europe support; no mainstream Social Democrats want to adopt a British-style system.

For a fair chunk of the British Left, a state-run NHS is beyond criticism. It is not a question on which different parties may reasonably disagree (‘Stop treating the NHS like a political football!’) Rather, it is seen, as in Andy Burnham’s formulation, or in Danny Boyle’s Olympic opening ceremony, as a test of patriotism. The same people who are quick to deplore the sentiment ‘my country right or wrong’ often take precisely such an attitude to the NHS. They don’t use those words, of course. What they say is ‘Instead of criticising the NHS, why don’t we all work together to improve it?’ But, if you think about it, it amounts to much the same thing.

Supporters of the status quo know that they have powerful human instincts on their side. We are, by nature, change-averse. We seem to be born that way (‘Would you like to try this, darling?’ ‘No!’) Our day-to-day encounters with the NHS are, as they jolly well ought to be in a country as wealthy as Britain, satisfactory, and we don’t want to seem ungrateful by complaining. While the OECD ranks our healthcare system poorly against those of other developed countries, it is by no means the worst in the world. And so we stick with what we know. Indeed, there is a respectable Burkeian argument that our irrational attachment to a familiar institution matters more than a strict calculation of what is the most efficient model.

The trouble is that a general attachment to the status quo has been twisted into a vicious, even violent, intolerance of any suggested alternative. When I pointed out that the NHS fared badly by most international comparisons three years ago, my since-deceased mother was harassed by Left-wing journalists. I suppose I should be grateful that her grave has not been vandalized – as happened to the mother of the woman who drew attention to the barbarities in Mid Staffs.

That, thank Heaven, was an isolated case. But listen to the language habitually used by those opposed to change. Consider the shrill, shouty way in which Labour MPs behaved in the House of Commons during the Health Secretary’s statement yesterday. A foreign observer would not have believed that this was a legislature assembled to debate tragic and unnecessary deaths.

Watch the video below, brought out in response to Andrew Lansley’s modest attempt to bring decisions slightly closer to patients. Or read the comments at the HandsOffOurNHS hashtag on Twitter. They don't constitute a reasoned defence of a state-run healthcare system. Again and again, they assert that ‘evil’ and ‘greedy’ people want to ‘privatise’ the NHS. No one specifies what is meant by ‘privatise’. Do they imagine that the Tories would sell shares in the NHS? Who would be mad enough to buy them?

But, of course, this isn’t about different policy options. It’s about preventing any serious discussion from beginning. And it’s precisely this intolerance of dissent that helped create the horrors at Morecambe, Mid Staffs and the rest. I know that's not how you meant things to work out comrades; but it's what happened.