Why do we clap the NHS, yet take the success of the private sector for granted?
We are oddly conflicted in our attitude to the NHS. We tell ourselves that it is the best healthcare system in the world, yet we simultaneously moan that other countries are coming through the coronavirus crisis with lower mortality rates. “Why can’t we be more like Germany,” we ask (or South Korea or Singapore or whichever country is doing well that week). But we refuse to countenance the obvious implication, namely that we might learn from how others run their healthcare systems.
When The Guardian interviewed the man it called “Germany’s leading coronavirus expert”, Christian Drosten, it asked what he thought of Britain’s performance. His reply was telling. “Public Health England was in a position to diagnose the disease very early on – we worked with them to make the diagnostic test – but roll-out in Germany was driven in part by market forces, which made it fast, and that wasn’t the case in the UK.” Quite.
The BBC engages in spectacular daily contortions. It rages about the supposed failures of the system – lack of ventilators, lack of protective kit, lack of testing. Yet it treats NHS interviewees with the kind of deference it usually reserves for children.
The contradiction was especially painful in last week’s Panorama, which invited a number of doctors and nurses to lambast the Government for its failings. It soon emerged that every interviewee – every single one – was a Labour activist. While that does not devalue their medical work, it does contextualise their opinions.
The entire premise of the programme was bizarre. Its title was “Has the Government failed the NHS?”, as though a bunch of spivvy Tory MPs were undermining the performance of hospitals for some unexplained reason – perhaps from sheer sadism. In fact, what few residual powers ministers had over the NHS were largely removed in Andrew Lansley’s 2012 reforms. The NHS is now self-governing, which is what voters say they want.
If there really was, as Panorama suggested, a culpable failure to provide NHS workers with enough masks and gowns (rather than just a general global shortage) then blame lies with the organisations that have responsibility for procurement, namely Public Health England, its equivalents in the devolved nations and the NHS itself. But the programme-makers never once acknowledged who was in charge, instead blaming every supposed shortcoming on “the Government”.
At the root of our national doublethink is a mental conflation. Even before the current crisis, most of us had had good experiences with doctors and nurses. We appreciate what they do for us and – not having to pay directly for their services – we don’t want to sound ungrateful. That natural and laudable impulse topples easily into a general reluctance to criticise anything about the system in which they work.
I am as glad as the next fellow to clap our clinicians every week – including my lovely next-doorneighbour, who keeps complaining that she is embarrassed by the applause, since her hospital has been quieter than usual. As I bring my hands together, I think of all the other workers whose services we are relying on – all the chemists and drivers and shelf-stackers and call-centre staff.
Businesses have adapted heroically and unfussily to the closures, laying on extra services, providing for elderly and self-isolating customers, ensuring that there are no shortages. And you know what? We take it for granted. Deep down, we always knew that they would meet the challenge. Our unspoken confidence in the private sector is perhaps the most telling thing of all.