When actors talk about national health systems

Why can't we have reason, not noise when people talk about Britain's NHS? Why can't we talk honestly about the fact that other civilised countries don't follow the bureaucratic NHS model, yet may even have better standards of healthcare?

Danny Boyle's romanticised NHS
Charles Crawford
On 9 March 2015 08:13

Actor Michael Sheen makes a 'blistering' speech about the UK National Health Service. Hurrah! If only our milksop politicians would have a bit of that passion and sincerity!

Or not.

Here is the speech.

It's a fine example of a good but very bad speech. Rather like the ill-fated Neil Kinnock speech in 1983:

Labour supporters gush that this unambiguously attention-catching oration was one of the finest ever made in British politics:

"If Margaret Thatcher is re-elected as Prime Minister on Thursday, I warn you. I warn you that you will have pain – when healing and relief depend upon payment. I warn you that you will have poverty – when pensions slip and benefits are whittled away by a government that won't pay in an economy that can't pay... I warn you not to be ordinary. I warn you not to be young. I warn you not to fall ill. I warn you not to get old."

Well, this scores strongly on thudding rhetoric. But it scores even more strongly on nonsense.

British voters have a keen ear for noisy cant. They know that Labour, Conservative and now coalition governments alike do not – and cannot – bring in apocalyptic changes. For the most part they boss us around and tweak things. Frantic Kinnockite warnings that the End is Nigh make no sense, so anyone proclaiming that comes across as losing the plot (and indeed the election).

Let's look at this Sheen version from the point of view of technique. It starts boldly as all speech should:

In 1945 Aneurin Bevan said: ‘We have been the dreamers, we have been the sufferers, and now, we are the builders.’ And my God, how they built. And what they built.

Every bit as much a wonder of the world as any architectural marvel, or any natural miracle … The National Health Service. A truly monumental vision. The result of true representation. Of real advocacy. A symbol of equality, of fairness, and of compassion.

Fine. Snappy short sentences. Not much grammar. They let the speaker add lots of rhetorical pauses for emphasis, or join thoughts together impromptu.

In his book In Place of Fear, Bevan said: ‘The collective principle asserts that no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.’

‘No society can legitimately call itself civilised’: now that begs the question, what sort of society do we want to be?

What is our vision for ourselves? What are the qualities and the principles that we aspire towards, and choose to defend?

Fair enough as an idea. Emphasis/structure through lists/questions.

Because it is a choice. Do we want to be a society that is fractured, divided, disconnected? Do we want to be a society that is suspicious and mistrustful of its own people? A society that is exploitative, that sees people as commodities, as numbers. Mere instruments of profit, to be used while they have use, drained of whatever they can offer, and when they are seen as no longer useful, just abandoned, cut adrift.

Preferably unseen and never again heard from.

Or … or … do we want to be a society where each person is recognised? Where all are equal in worth and value. And where that value is not purely a monetary one.

A society that is supportive, that is inclusive and compassionate. Where it is acknowledged that not all can prosper. Where those who are most vulnerable, most in need of help, are not seen as lazy, or scrounging, or robbing the rest of us for whatever they can get.

Where we … we do not turn our backs on those facing hard times. We do not abandon them or exploit their weakness. Because they are us. If not now, then at some point, and inevitably, they are us.

By now you're getting the idea. You MUST be compassionate and inclusive. Or else! To be precise, if you don't accept the Sheen point of view you are treating people as commodities. You're cruel and heartless!

This is what I believe to be Aneurin Bevan’s vision of a living tapestry of a mixed community, as he said.

What's a vision of living tapestry? Maybe the person who has such visions is a bit .. dotty? Best avoided?

At a time now, when people mistrust politicians as being too professional, too disconnected, no longer representing the voice of the people they have been elected to serve but more likely to represent the voice of wherever the money is. No longer standing for anything meaningful, or inspired by strongly held beliefs.

At a time like this, a man like Aneurin Bevan seems like a mythical creature.

Like a unicorn perhaps. Or perhaps more fittingly, a dragon.

On the page some of these sentences look confused and incomplete. When delivered they'll have sounded fine (enough). A good example of how a speech is not a written text. It's all about spoken words and mood/tone/energy.

This was a man who had no fear in standing up for what he believed in. And he made no bones about how he felt. This was a man who publicly stated:

No amount of cajolery, and no attempts at ethical, or social seduction, can eradicate from my heart a deep, burning hatred for the Tory party.’

In today’s political climate, where politicians are careful, tentative, scared of saying what they feel for fear of alienating a part of the electorate; where under the excuse of trying to appear electable, all parties drift into a morass of bland neutrality; and the real deals, the real values we suspect, are kept behind closed doors – is it any wonder that people feel there is very little to choose between?

Bevan said: ‘We know what happens to people who stay in the middle of the road. They get run down.’

A large part of democratic politics is all about building consensus. Saying that you ardently hate another side shows loss of self-control, and insults the middle ground who quite like some of the other side's ideas.

There is never an excuse to not speak up for what you think is right. You must stand up for what you believe. But first of all – by God, believe in something.

A curiously fascistic idea. Believe! In something! Anything will do! It's the intensity of your belief that counts, not the substance. See also Islamic State, Al Qaeda, Putin, Hitler and so on.

No one says they want to get rid of the NHS. Everyone praises it, across all parties. It is about as powerful a symbol of goodness that we have, so it would be too dangerous not to. But for decades now, there has nevertheless been a systematic undermining of its core values.

This is beyond party politics. The Labour government arguably did as much damage to the NHS as any Tory or coalition-led one.

Ah. Now you're actually addressing the issues, not making a loud noise. Why have Labour too undermined the NHS's supposed core values and all that Symbolic Goodness? Makes no sense, right? Maybe the existing model has, ahem, some significant problems?

This is about who we want to be as a nation, and what we believe is worth fighting for.

Too many people have given too much, and fought too hard, for us to give away what they achieved and to be left with so very little.

Left with so very little? What?

Are we talking about the same NHS? Look at its own website, Michael:

When the NHS was launched in 1948, it had a budget of £437 million (roughly £9 billion at today’s value). For 2015/16, it was around £115.4 billion...

The NHS employs more than 1.6 million people, putting it in the top five of the world’s largest workforces together with the US Department of Defence, McDonalds, Walmart and the Chinese People’s Liberation Army.

The NHS in England is the biggest part of the system by far, catering to a population of 53.9 million and employing more than 1.3 million people. Of those, the clinically qualified staff include 40,236 general practitioners (GPs), 351,446 nurses, 18,576 ambulance staff, and 111,963 hospital and community health service (HCHS) medical and dental staff.

The NHS in Scotland, Wales and Northern Ireland employs 159,748; 84,817 and 62,603 people respectively.

Aaaargh. It's wasting away! Help!

To those who have discarded all principles, save that of profit before all else; to those who have turned their backs on the very idea of a truly democratic society, and aligned themselves to nothing but self-interest; to those who have betrayed the vision of equality, and justice, and compassion for all – that vision that provided the crucible from which came forth the National Health Service – I say to you, as Aneurin Bevan said in Trafalgar Square in 1956: you have besmirched the name of Britain; you have made us ashamed of the things of which formerly we were proud; you have offended against every principle of decency and there is only way in which you can even begin to restore your tarnished reputation.

Get out. Get out! Get ... out!

Haha a rambling sentence of 124 words. But a lively intriguing conclusion.


Just awful.

The reason that even Ed Miliband does not emit something like this is that it is just too stupid. Irresponsible. Essentially dishonest.

Any honest speech about the NHS ought to include some of the practical compromises that were made to set it up. There always were large private enterprise elements in the way it worked. There had to be, if the UK was not to slump into all-out communism. And how did that work out for the health of the Russians?

An honest speech will accept that from those early days the NHS has grown, above all in process and complexity. An honest speech will look at the ratio of doctors/nurses to administrators, and wonder how those relationships are evolving in the wrong direction.

An honest speech will note that other civilised countries do not have an NHS like ours, yet you don't see people dying like flies in the streets. Why not? Are not other ideas something to consider?

An honest speech will say that if it's unacceptable that some corporations and banks are 'too big to fail', why does that not equally apply to state-funded bureaucracies. Don't huge unwieldy things have lots of negative features in common, wherever they are?

An honest speech will ask why the NHS is killing thousands of people a year through incompetence and neglect. Srebrenica after Srebrenica. Far more people that way than die in terrorist attacks. Under the evil Precautionary Principle all sorts of items are banned lest they pose the slightest risk. Should this not apply to the NHS too?

Above all, an honest speech will talk about the transformations occurring in technology and how all sorts of investigations and procedures can now be done utterly differently.

Why do we need anything like the heavy, over-centralised, over-processed systems we now have, when new decentralised arrangements will be cheaper and better?

Why go to the doctor when your watch can send the doctor a stream of vital data? Maybe in the future the main role of a doctor will be to tell you that you are getting sick and help you avoid that, not treat you when it happens?

All that could be in a short powerful and thought-provoking speech delivered with passion. Even belief!

But it would mean thinking, not emoting.

Reason. Not Noise.

Charles Crawford is a Contributing Editor to The Commentator. A former British Ambassador in Sarajevo, Belgrade and Warsaw, he is now a private consultant and writer. Crawford's piece has also been submitted to Pundit Wire. His website is www.charlescrawford.biz. He tweets @charlescrawford

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