Apparently, our wonderful NHS, the envy of the world, is in a right old mess. So says the independent report written by the independent peer Lord Ara Darzi after his independent and strictly apolitical review of the service. It may come as a shock to readers, but according to this scrupulously independent and impartial report, the main problem appears to be ‘chronic underinvestment’ since the year 2010, despite year-on-year real term funding increases from British taxpayers for that entire period.
As with most political publications, the report is more interesting for its omissions – for example, someone clearly forgot to mention that the independent Lord Darzi was a Minister of Health in a previous Labour administration and, until 2019, he sat in the House of Lords as a Labour peer.
I doubt many voters will be deceived by this choreographed political street theatre. As with the recently discovered ‘£22 billion’ budgetary black hole, most of the public will see straight through the spin. In political terms, Labour is attempting to ‘manufacture consent’ – first described by the influential American journalist Walter Lippman in 1922. Lippman described the process by which political elites construct the version of reality they wish the public to believe, by manipulating the press. The theory is based on Lippman’s premise that the modern world is too complex for any individual to fully understand. Hence selective presentation and interpretation of facts can be carefully crafted to justify predetermined policy choices by those capable of controlling information flow.
There is absolutely nothing in the 163 pages of Darzi’s report which is in any way surprising or novel. The publication is a data dense narration of well-known problems with few attempts to explain familiar glaring paradoxes:
Why does the NHS service consistently underperform on every possible metric despite huge budgetary increases?
Why does hospital productivity continue to fall, despite a 17% increase in hospital staff?
Why can’t patients access GP appointments in a timely manner, despite there being a 6% increase in the number of General Practitioners?
What explains the appallingly bad outcomes in cancer and cardiovascular diseases compared to every other developed world healthcare system?
What explains the disparity in post pandemic recovery between the NHS and our European neighbours?
According to Ara Darzi, these failings have nothing to do with poor management. Nor can they be blamed on the ever diligent and dedicated workers. The alternative reality presented by the former Labour Health Minister, suggests the problem lies in a £37 billion shortfall in capital investment because the evil Tories starved our precious NHS of taxpayer largesse. In Darzi world, as with the wider NHS, failures are always someone else’s fault.
Yet once the media froth has subsided on their futile attempt to blame all the woes of the NHS on the previous administration, Starmer’s ship of fools are left with a serious problem – the ball is now firmly in their court. As the self-proclaimed party of the NHS, voters will soon expect Labour to deliver tangible improvements in both performance and productivity – to quote Michel Barnier “the clock is ticking…”
Thus far, Labour have been long on generalities and short on specifics. Wes Streeting piously chants the word “reform” more frequently than Starmer refers to his father’s occupation (apparently, he was a toolmaker). To date, I’ve not seen a definition of ‘reform’ other than vague commentary about benefits of digitalisation, consistent with the prevailing delusion that ‘machine learning’ will save us from public sector profligacy and inefficiency. Irrespective of what the Health Secretary means by ‘reform’, there is a major obstacle to whatever plan he is hatching. I’m confident that the NHS workforce and their Healthcare Unions define ‘reform’ as consecutive above inflation pay rises, more working from home, part time contracts and enhanced pension entitlements.
And here lies the essential problem with the NHS. Despite the sanctimonious claptrap and aggressive hostility to criticism, the primary concern of the NHS is the welfare of its staff, not its customers. In economic terms, this is a variation of the ‘principal-agent problem’ –a conflict in priorities between the owner of an asset (the taxpaying public) and the person to whom control of the asset has been delegated (the NHS management and workforce). Taxpayers have no direct control and virtually no leverage over the professionals in the NHS. With a socialist government beholden to their union paymasters, this problem is set to worsen.
For example, when the incoming Labour Government immediately agreed a 22% pay rise for junior doctors, the Chairman of the BMA committee assured his followers that they could be back on strike to demand yet more money within a year.
The BMA General Practitioners Committee has advised its members on a range of “work to rule” actions designed to bring the NHS to “a standstill” and is threatening further industrial action in pursuit of an 11% annual pay increment. These two professional groups will not be the only ones extorting money with menaces from Starmer’s compliant administration.
The solution to the principal-agent problem is to directly align the interests of the manager/provider with those of the owner – in other words construct an incentive system which rewards the productive and penalises the idle. This would be my definition of ‘reform’ – a move towards a continental style mixed health economy, social insurance-based system which pays doctors per unit of work done, rather than our current upwards-only salary scale under which the inefficient are paid the same as the industrious.
Darzi, however, sees things differently: “Nothing that I have found draws into question the principles of a health service that is taxpayer funded, free at the point of use.” If he really is that myopic, the noble Lord needs to visit Specsavers. Of course, Darzi is neither short-sighted, nor independent. Stripping back the waffle and verbal padding, the single big idea in his 163 pages is the dissemination of digitalisation:
There must be a major tilt towards technology to unlock productivity. In particular, the hundreds of thousands of NHS staff working outside hospitals urgently need the benefits of digital systems. There is enormous potential in AI to transform care and for life sciences breakthroughs to create new treatments.
If I were being cynical, I might consider a state-run healthcare system with an annual budget of £165 billion a major business opportunity for large technology companies. Highly lucrative multi-year contracts backed by the British taxpayer would be a tasty prize, to say nothing of the massive amount of health-related data to be exploited.
A sceptical mind could imagine how such companies might go about lobbying persons of influence with a new government confronting an urgent political imperative.
Fortunately, we have an independent report expertly crafted by an independent expert to ensure that could never happen.
Consent manufactured.
The author, the Daily Sceptic’s in-house doctor, is a former NHS consultant, now retired.
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Why should life have meaning?
‘Consider the lily….’
The one who coined that phrase has the answer.
Consider the birds, do they have jobs?
They do all right for themselves.
Good luck to them, they’re very nice
All right then consider the lilies
Oh! He’s having a go at the flowers.
Taken from Life of Brian.
‘And there shall be a great confusion as to where things really are….’
‘And the young shall not know where lieth those things that their fathers put there only just the night before at about eight o’clock…’
Scientism and science explain very little.
Metaphysics, the immaterial, the spiritual, the human, objective truth, meaning…science has nothing to offer. Even on basic scientific matters it is usually wrong or corrupt.
The modern world is suffused with the material and the mechanical, but it has no wisdom, no purpose, no truth.
Christ, God, divinity, reality, the why, the when, the how of life and the cosmos, are all lost in the materialist fantasies of human error and blind egotism.
According to Wikipedia: “Science is a systematic discipline that builds and organises knowledge in the form of testable hypotheses and predictions about the universe.”
Seems like a reasonable definition.
I don’t see how science could possibly “tell us the meaning of life”. That’s not what science is concerned with. “The meaning of life” is surely something that is in the eye of the beholder and as such how I don’t see what or who could possibly “tell us” what it is.
Yes, that is the classical definition of science, when it had integrity, but science has been updated for political purposes, with horrors such as “conservation scientist”, “scientists are worried/concerned about …” and “Follow The Science”.
You come with nothing (of material value).
You go with nothing of material value so the meaning (purpose) of life must be beyond the material.
There is a Mount Everest volume of (many verifiable) accounts of Near Death Experiences that point unerringly to the reason we are here.
Once you understand this you can feel only pity and not hatred for those engaged in selfish and evil actions (here’s looking at you W.E.F and your ilk)
Given that, based on an atheist or scientific world view, we come from nothing, exist for a period of time as the result of millions of complex chemical reactions, then return to nothing it’s easy to see why some people think this world view has no meaning.
The most important reply to these people is that the world is the way it is whether you like it or not and hoping that there’s a god to give life meaning doesn’t make that god any more likely to exist.
In the absence of a god, if this is the case, it’s up to us to give our lives meaning, maybe by helping other people who, just like us can suffer or experience happiness, simply trying to do no harm, or just enjoying your brief period of existence.
Or as a friend once put it ‘We’re all just blimps (sic) on the oscilloscope of life’.
Many thanks for trying to cheer me up, David.
You call it should last
Every minute of the future
Is a memory of the past
‘Cause we all gave the power
We all gave the best
And everyone gave everything
And every song everybody siiiing
Live is life! ( na-naah-na-na-na )”
It can’t.
Scientia = knowledge, not wisdom, not understanding, not discernment.
That knowledge is useful, but continually evolves over time, constantly changes.
Ergo, science is not truth.
The humanist religion treats it has all the ‘nots’ above.
Life means nothing without a relationship with its creator.
Find Jesus this Christmas.
He is The Truth.
I usually find David Bell’s articles interesting and well written. Either I am experiencing extreme brain fog or this is not up to his usual standard of clarity. Sorry!
Ha ! Something meaningful at Christmas. Whatever next !
It seems to me that life is meaningful. It is only when we delegate sentient understanding to thought and knowledge that we acquire the continuity of time, and come to see life as integrated within that context. Then we have the conceptual problem of death, and invent a life hereafter to make ourselves feel better. The beginning of time is always now and death is the understanding of death and not the death of understanding
Science is only a system of representational meaning, and can only explore the representational universe. The system pursues efficiency while thinking about “meaning”
First define ‘Life’.
Then define ‘Meaning’.
Then we shall see if the ‘Meaning of Life’ is a reasonable item to investigate scientifically, or even spiritually.
This article reminds me of a study by Pfizer (https://www.pfizer.com/news/articles/how_genetically_related_are_we_to_bananas) that we are genetically related to bananas.
What an excellent article. It really summed up the two alternatives neatly. We’re either a collection of atoms that comes together in a certain way for a period of time before dissipating, or our life and everything has more meaning and purpose than we can even imagine. (And love is more than a chemical reaction). I feel David’s point that there’s nothing in between is very powerfully put. I’d even compare it to CS Lewis. David, rather cleverly, didn’t say which side he came down on but I hope the hint in the last paragraph indicates that he is celebrating the coming of Christ this Christmas.
Happy Christmas to Will and all my Daily Sceptic friends.