Coffee House

Cameron’s opportunity to preach an NHS worthy of worship

5 February 2013

6:31 PM

5 February 2013

6:31 PM

Today MPs are debating a matter of conscience, invoking their personal religious beliefs as they examine the same sex marriage bill. The debate has largely remained remarkably respectful thus far. But tomorrow the Prime Minister will give a statement on another matter that stirs similar religious fervour: the NHS.

It will be David Cameron who delivers the government’s response to the Francis Report on the failings of the Mid Staffordshire NHS Trust, not the Health Secretary. The Prime Minister manages these occasions well: we saw that with the Bloody Sunday and Hillsborough statements.

British voters might, according to the latest census data, be losing their religion. But when it comes to the NHS, they remain faithful. Health policy is named by 36 per cent of voters as an important issue influencing their 2015 vote, below only the economy and immigration. And Labour currently enjoys a 16-point poll lead over the Tories on the NHS, with 34 per cent of voters naming Labour as the party they trust the most on the NHS, 18 per cent picking the Tories, and 32 per cent saying they trust none of the main parties.


Andy Burnham managed to get away with the line that the Tories were destroying the NHS with the Health and Social Care Bill because of the emotional response it elicits. Everyone – myself included – has their own story of wonders performed by this country’s free at the point of access health service. It is almost a miracle worthy of a religious shrine that this behemoth organisation exists in this country. Its icons provoke the same adulation as statues of the saints: Danny Boyle knew that when he wrote the health service section of his Olympic opening ceremony.

But this means that those who question this great religion of signs and wonders are denounced as heretics. The I ♥ the NHS avatar badges on Twitter accounts, those personal stories of the excellent cancer unit, the GP who spotted the irregular heart rhythm, all smother those heresies. The whistleblowers in the Mid Staffs case received hate mail. Even politicians criticising the NHS must caveat it with their own praise of its treatment of their mother or son. But take any group of doctors away from the heretics, and out come the same stories: the failings of hospital administrators, the wards they wouldn’t trust to treat their grandmothers because of the poor quality of the nursing staff, the disparity between the quality of care in different specialties.

So how can Cameron take the recommendations of the Francis report tomorrow as a catalyst for change? His party’s standing in the polls when it comes to the NHS could easily tempt him to take the easy route, simply telling MPs tomorrow that ‘lessons will be learned’. But this scandal demands more than that. As our leading article argued last week, there will be ‘an awful lot of talk about the need to “tighten up procedures”‘ and changes to targets, not overarching changes to increase accountability in the NHS. This is where independent providers have a role, not because they are intrinsically better than public providers (sometimes they are, sometimes they aren’t), but because they not only experience the anxiety of losing a contract as a result of poor performance, but encourage anxiety in the public sector providers too rather than the complacency that arises from being the only game in town.

On a political point, Cameron may not enjoy a poll lead on the NHS, but he can take heart from the polling on the standards in the NHS. YouGov’s polling at the end of last week found 45 per cent of voters thought standards of care in the NHS had got worse, with 26 per cent saying they’d stayed the same, and 18 per cent believing standards had risen. While voters were relatively evenly split between believing doctors and nurses were less caring today than they were 10 or 20 years ago, and believing they were as caring as they used to be, 41 per cent said ‘most nurses prioritise hitting targets over caring for patients’. Similarly, the report is likely to attack the trust’s slavish adherence to targets set by the Labour government: this is not a failing of the nasty anti-NHS Tories.

This gives Cameron a cause to be bold and to encourage faithful followers of the NHS not to lose their religion, but to shun blind belief in favour of proper scrutiny. That way the NHS can be something worth worshipping wholeheartedly.

Subscribe to The Spectator today for a quality of argument not found in any other publication. Get more Spectator for less – just £12 for 12 issues.

Show comments
  • Joshaw

    “But this means that those who question this great religion of signs and wonders are denounced as heretics”

    The response should be to ask whether bodies are piling up in France, Germany or the Netherlands. Don’t let them get away with simply harping on about the USA (which is not all bad – far from it).

  • Charles Hedges

    Imprison Sir David Nicholson (who should have been named in this shoddy article).

  • starfish

    The current situation is a failure of leadership – at all levels (political, managerial, medical)

    You notice that everyone in the NHS seems to be a a ‘manager’, no-one is a leader, no-one takes responsibility, promotes the correct culture

    There are too many power bases, too many egos to stroke, too little unity of purpose, a culture of secrecy, active discouragement of anyone who seeks to improve it

    It is all solvable

    There are numerous examples of large and complex organisations that have been turned around – the most obvious examples surround generation and maintenance of safety cultures in organisations that have lost their way, their sense of purpose and vision

    But when any attempt to solve it is attacked by Labour as ‘an assault on the NHS’ we will get nowhere.

    It will remain a festering sore, sucking in ever increasing levels of resources, with demoralised staff, poor care and outcomes

  • 2trueblue

    It all happened under Liebore. They wrecked the whole infrastructure and changed the ethos of the organisation. I am not interested in his preaching. I am interested in hearing the facts and then finding out how we get back to the a situation where the public can feel confident that their members of their family are in safe hands. Liebore talked about their investment of money. It was not all about the money, it was about maintaining standards of care. A short word that is the bedrock of the NHS, or at least it was until Liebore got at it for 13yrs.
    To them it was all about the money, big new contracts for the doctors, gauranteeing things that they did not understand, building hospitals on ‘contracts’ that made money for the providers and left the clock ticking with huge rate of running costs. The list is endless but it all starts with one simple word CARE. A small word that encapsulates what we all expect to receive from the NHS.
    I have no idea how staff on wards leave patients in their care lying in dirty beds, thirsty, hungry, ignored. The fact that it was so widespread is the shame all at that establishment should feel and pay for.

  • anyfool

    The NHS has for a long time lacked an ethos of care, it is mainly a construct that has been hijacked for ideological reasons by Labour and the Unions.

    It seems that since the 60s it has lost its way, no one is accountable, no one has responsibility, no one is held to any reasonable standard of skill and most of all no one seems to care starting from the bottom to the top.

    Almost anyone with long term experience of treatment will not be surprised at the thousands upon thousands who have perished at the hands of these heartless carers, Staffordshire is the tip of the iceberg.

    They get away with it because they by and large bury their mistakes and as quite a lot of older patients sometimes have only intermittent visits or non at all, there is no one to even speak on their behalf.

    Its decline has deteriorated badly since the Labour party joked that we had 24 hours to save the NHS, what they actually meant was save the cash cow for it and the union members, care was the last thing on their minds then and now.
    Yes there is small sectors that are excellent but that is the exception rather than the rule.

  • the viceroy’s gin

    “This gives Cameron a cause to be bold and to encourage faithful
    followers of the NHS not to lose their religion… That way the NHS can be something
    worth worshipping wholeheartedly.”


    It is perverse how casually you Speccie teenagers and your Cameroonian heroes first discount and minimize religious argument and social conservatism in the first instance, but then suddenly invoke religious fervor and a call-and-response appeal over secular institutions as the NHS.

    Perverse. That is the only way to describe it. Skin crawlingly perverse. It is perversity of language and politics, and a simultaneously perverse undermining of religion and religious belief.

    You should be ashamed.

    • Tom Tom

      If they would embalm Cameron I might be inspired

  • Smithersjones2013

    My own experience of the NHS is that they are appalling at diagnosis, competent at treatment (if they diagnose you correctly in time), poor in their aftercare and their ‘hotels’ get no stars at all (the food is swill). They also spend far too much time browbeating the electorate about their lifestyles.

    • Tom Tom

      I am still living with the consequences of their disastrous approach to one of my parents 26 years later…….it is an abattoir run by poorly-educated technicians sponsored by the pharmaceutical industry

    • John Smith

      Strange, I have found the technical side quite good but the care and administration abysmal.
      Ask most people about their local hospital and they will know how good or bad it is. Pity they cannot use their choice to help us all get better health care ..

    • chan chan

      For many months, my father’s GP told him to go home and stop wasting his time coming in with a chest infection. My father went back yet again, and the locum doctor sent him immediately to see an oncologist at the local hospital.

      As we sat in the waiting room, I was directly opposite a poster that listed ten symptoms of lung cancer. Even I could see my father had all of them, and shortly thereafter, the oncologist confirmed he had lung cancer. He died three months later.

  • niav

    I don’t have any good stories about the NHS. I think they’re mediocre at best, awful at worst. I try and limit my exposure to the NHS as much as possible, for I haven’t seen such bored, demotivated staff anywhere else outside government bureaucracy. Except here it’s a more sensitive issue.

    Frankly, the thought of my kids having anything to do with the NHS fills me with anxiety.

    • Russell

      NHS staff are motivated, unfortuately not in healthcare, but about their pay, pensions and working conditions. The many, many staff in my hospital are mainly obese and obsessed with sitting in front of computers as opposed to looking after patients.
      How many staff/nurses were prosecuted for failing to provide care resulting in death of patients at Stafford?,,,None.
      How many staff/nurses were sacked for failing to carry out the most basic standard of care to patients resulting in their deaths?…..None

      Same in the Teaching system…failing to provide adequate standards of education to our children (Basic reading and writing and maths skills)

      Labour are 100% to blame for the tragedy in these two areas of public services, along with every other area of public sector service.

  • andagain

    Andy Burnham managed to get away with the line that the Tories were destroying the NHS with the Health and Social Care Bill because of the emotional response it elicits.

    That may not show a belief that the NHS is the best possible health system. Just a belief that the Tories would like to eliminate the current health care system and replace it with nothing. They may see a choice between an inefficient system run the way Labour likes it, or nothing at all.

    • 2trueblue

      A Burnham spent the NHS into oblivion with his PFI funded hospitals. It was under Lieroe that the standards lowered whilst they threw money at it. Liebore have no concept of what real care is, they left us with an NHS that did not care for us, increased child poverty, single parenthood, teenage single motherhood, youth unemployment, the gap between rich and poor, all grew. I find it really hard that Liebore can walk away from what they did.

  • Smithersjones2013

    Cameron’s opportunity to preach an NHS worthy of worship

    Beware of political public sector sacred cows they are just an excuse of politicians to waste money!