Criticising the NHS hurts more than a little bit

Sajid Javid faced a demanding day and a tough crowd. Like William Shatner, propelled into orbit aged 90, he’d boldly gone where few had gone before – picking a fight with GPS.

The Health Secretary was unveiling proposals urging GPS to “respect preferences” for face-to-face care, with new league tables showing which surgeries had offered the most.

Naturally, that persuasive chequebook made a reappearance too – they dangled the possibility of an extra £250million in funding on top of the £12 billion already set aside for GP services, but only if targets for face-to-face appointments were met.

“It is disappointing to see there is no end in sight to the preoccupation with face-to-face appointments,” fumed the British Medical Association, recasting in-person meetings as some bizarre eccentricity or fetish, akin to morris dancing or necrophilia.

Count Mirabeau, the 18th century French statesman, reputedly quipped “where some states have an army, the Prussian Army has a state”.

Based on its current spending patterns, something similar seems to be afflicting the UK – only with the NHS in charge instead of Prussian military might.

The British state increasingly resembles a health service with a few other functions belatedly tacked on, and a prevailing culture of reverence towards those working in it. All of this gave the Health Secretary a gruelling media round.

Interviewed by ITV'S Good Morning Britain, Javid stared into the camera and blinked, glassy-eyed, before launching into a paean to general practice. “I wanna thank GPS for the phenomenal work they’ve done, especially during the pandemic, but of course everything they continue to do.” Yet after he’d delivered this same monologue word-for-word in his next media hit, his rabbit-in-the-headlights impression had almost veered into hostage video territory. (“I am not being mistreated!”, his glazed expression seemed to say).

Commanding an average salary of £100,000, it’s fair to say that by most people’s benchmarks, GPS aren’t exactly getting fleeced for their efforts. Yet interviewers pleaded piteously on their behalf.

“A lot of them are feeling threatened, frankly, by this proposal to name and shame them in league tables,” lamented Susanna Reid.

Kay Burley of Sky addressed Javid in hushed, reverential tones, like Trevor Mcdonald might use to describe the plight of Balkan refugee children. “They feel like they’re being battered by the government at the moment,” she said, “and they’re doing everything they possibly can.”

The Health Secretary certainly didn’t help himself. In a gift to headline writers everywhere, he pulled out of a planned appearance at the Royal College of GPS’ (RCGP) conference in Liverpool later in the day.

“Health Minister misses in-person appointment,” some said (arf arf!). Had he even bothered to ring and let reception know?

Up in Liverpool, the grinning college vice-chairman struggled to contain his glee at the last-minute cancellation. “Unfortunately this morning we do have one change to the programme. The Secretary of State for Health for England is unable to join us today, either in person or by video link.” The conference hall erupted into guffaws.

“This widespread vilification of hardworking GPS and our teams is unfair, is demoralising and it’s indefensible,” cried the RCGP chairman, to ringing applause.

It soon became clear that we’d been wrong all along. The real crisis wasn’t missed appointments, undetected ailments or the postcode lottery of care – it was the risk of people saying mean things about the NHS.

‘The real crisis wasn’t undetected ailments – it was the risk of people saying mean things about the NHS’