Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Saturday, 5 January 2008

Was the 1945 Conservative Manifesto a blueprint for Thatcherism?

It is customary at this time of year (though I plead guilty to being a little late) to look back on the year just passed and reflect upon some of the more outstanding events it witnessed. To many, of course, the Government's monumental train of failures and descent into PR hell shortly after Gordon Brown took the reins is going to be up there with the best of them. But whatever your opinion on the matter, all the kerfuffle about Lady Thatcher's visit to the prime minister late last year confirmed in stone what a lot of us have suspected for a long time [1] - namely, that a new consensus has come to pass in British politics. However, with the last real remnant of the old one celebrating its 60th anniversary this year (the NHS, to those not in the know), it seems an appropriate junction to look back and ask ourselves: why did it take so long? Perhaps more importantly: could we have avoided the wasted thirty years between Attlee and Callaghan?
It is to my mind that sadly, the answer is yes, we could.

I have in the past touched on the idea that, to get technical, Thatcherism was not so much a philosophy in itself (and much less an ideology, as many mistakenly claim), but a mission that came into being for the sole purpose of 'fixing' Britain. The fact that increasing divisions within the party and Margaret Thatcher's own inner circle seemed to be index-linked to their own success certainly lends credence to this view. But there is further supporting evidence in that the circumstances surrounding the Conservatives' 1979 election victory are not so dissimilar to those surrounding the writing of the 1945 Conservative Manifesto. The task ahead of both Labour and the Tories at the time was to develop ideas on how best to reconstruct an economically and, in many cases, physically destroyed Britain. It was a plan of action, an operation - a mission, so to speak. And it needed to be - financially, the nation was on its knees. From being the world's banker, Britain had emerged victorious from the war bankrupt and at the tender mercies of our American creditors (this debt was only fully paid off in 2006). Cut to 1975, and Britain was once more staring at the abyss financially - indeed it was to be only another year before we were again to be bailed out by an outside party (this time, the IMF). But that is not the only parallel to be made here - most striking is the actual content of the thing. It sounds a hell of a lot like Thatcherism.

Can this be? The nation's 'Greatest Briton' and its 'most unpopular prime minister since records began' proposing the same thing? The thought may not come as any great surprise to many on the right, but to the chequered mosaic of proud Britons that all claim Churchill as their own, it may appear somewhat alarming. Not least, I am sure, to the 'One Nation' Tories who served under Churchill and his protégés after the war, and subsequently fought Lady Thatcher's policies nail and tooth throughout the 1980s. But I challenge anyone giving the time of day to actually read the document in question [2] to deny its almost identical nature to said policies. It contained a now very familiar cocktail of liberal economics, a focus on the wealth-creating importance of entrepreneurs, individual responsibility and low taxation - all imbued with a strong emphasis on the vitality of family values, fierce patriotism, and a firm sense of Britain's historical role in the world at large. Indeed, as Lady Thatcher later proved, the 1945 Manifesto correctly identified that 'Only a Britain that is strong and ready to fight in defence of Freedom will count in the high councils of the world'. It was to be Britain's intolerance of Argentine aggression, her swift and merciless dealing of Islamic terrorism, and her resolve in confronting Communism on a worldwide scale under the Thatcher premiership that renewed our place in these 'high councils'.

Yet despite the many similarities in their beliefs and policies (more of which will be addressed below), there remains a huge divergence in the reputations of Sir Winston and Lady Thatcher. Indeed it would be difficult, certainly in many areas of Britain, for them to be further apart. The reason for this rather peculiar state of affairs lies in two fundamental differences in circumstance - and they speak volumes about how public opinion is formed this country. First, as we well know, Churchill was never able to implement his vision of British revival. In the evening of his years, and in respect to the wishes of a people that had endured so much, Churchill and his party chose not to reverse the Attlee reforms once they returned to office in 1951 - seeking instead to make the best of the new consensus that had almost annihilated them at the last election. Second, though almost identical to the Thatcher years in both policy and ethos, the 1945 Manifesto was a mission to rebuild. And this is the clincher - the Thatcher government did not have this luxury. In Oliver Hirschbiegel's seminal film Downfall, Adolf Hitler muses to his chief architect Albert Speer that the Allied destruction of Berlin had come as a blessing. It would be far easier, he said, to clear away the scattered rubble of Berlin for the new Welthaupstadt (World Capital) Germania than to tear it down first. Yet this is exactly what Margaret Thatcher had to do. From her first round as 'Milk Snatcher' in the early seventies to the closure of loss-making pits and the muzzling of union power a decade later, she bore the unenviable burden of being someone who was seen as taking things away. The idea that a prime minister can, for this reason, be so overwhelmingly unpopular yet simultaneously so successful may appear strange, but then nobody who signs into rehab is going to be under any illusions regarding its pleasantness.

To Churchill, Britain's greatness had been 'built on character and daring, not on docility to a state machine' - and this is very much how he intended it to continue. This 'spirit of independence' which we are now still struggling to re-introduce was something that Churchill sought to preserve 'at all costs'. Like Margaret Thatcher sometime later, Churchill saw as 'first essentials' a strong 'confidence in sound government - mutual co-operation between industry and the State rather than control by the State'. There was an instinctive affinity, reminiscent now of Thatcherism, with 'the small man' in business - Churchill recognised, as Lady Thatcher always saw in her father - that in pursuing his dreams, the entrepreneur 'adventures all he has...his independence of spirit is one of the essential elements that make up the life of a free society'. The Manifesto sought to drive home the legitimate concern that after the war 'other men may have jobs to go back to, but the businesses of some of these men are gone, or hanging by a thread'. There is even an early recognition of the inefficiency inherent in Britain's coal industry - a worrying reality that disappeared under the veil of denial manifest in Labour's nationalisation. Though for the next thirty years the industry’s perpetual decline was frequently cited as a result of under-investment, the 1945 Manifesto correctly identified state-owned coal as 'a wasting asset'. Citing the Reid report, the Conservatives observed how the industry had 'fallen behind some its competitors overseas' and that 'Adequate supplies, as cheap as possible, must be available to our homes [and] to our factories'. Margaret Thatcher's entire policy regarding taxation as well her own deeply-held suspicion of state power too, finds a very clear voice within the 1945 Manifesto. It identifies the state as having

...no resources of its own. It can only spend what it takes from the people in taxes...Britain is now a nation of taxpayers...[this] drastically restricts the ability of the ordinary citizen to satisfy his personal desires. It is discouraging to his enterprise and his efforts to better himself by doing a bit extra

In addition to this, the Conservatives naturally pledged to 'preserve the incentives of free enterprise and safeguard...industry from the dead hand of State ownership or political interference in day-to-day management'. Somewhat ironically, there are also many things proposed in the Manifesto that have, in subsequent realpolitik only been possible relatively recently under New Labour. These include, within the Conservatives' plans for a 'comprehensive health service' pledges to protect 'the patient's free choice of doctor' as well as voluntary trust hospitals that have 'led the way in the development of hospital technique'. In education, too, the Conservatives promised that 'parents will be able to choose the school they like and to play their part with the educational authorities in the physical and spiritual well-being of their children' - a policy begun under the Thatcher government and carried on under Labour. There were familiar calls, seen later in the sale of council houses and the extinguishing of inflation, to 'see property widely spread...we rejoice that the savings movement, which must go on, has now made almost everyone a property-owner'.

Sadly of course, this movement died a quick death under the welfare state for those it served most - the working class. With the self-reliance that saving fostered replaced now only by a vulnerability to creditors and debt, there is good ground to argue that it was the Attlee welfare state and not Margaret Thatcher's premiership that has effectively made 'the poor poorer'. It robbed them of the need for friendly societies, the need to plan ahead financially, and experience in the rewards that hard work and thrift can bring. It robbed them of the thing most precious and sacred to every human being - their very independence. Resistance to Thatcherite policies culminating in the 1984/85 miners’ strike may have given the illusion of traditional working class solidarity at work, but this had effectively been destroyed years earlier by the state reliance Butskellite consensus fostered. Take away the nationalised industries that allowed this reliance and the veil was lifted. Traditional working class values forged through blood, sweat and tears in the sweltering forge of nineteenth century life – thrift, saving, financial solidarity, family values – all gone within a generation. Nationalisation and distorted trade union power had steadily eroded these values by eliminating risk and flexibility from the workplace. The two became irrevocably tied, and so effectively perished together.

To my mind, out of the many failings of the post-war consensus, this has to be the most remorseful waste of all. Thirty years of precarious financial management (estimated at around £40 billion in 1982 from capital write-offs and grants alone - not to mention wasted productivity) was readily, if not painfully remedied by fiscal squeezes, tax reform, and privatisation - London is, after all, once again the banking capital of the world and leaders of the Labour Party now speak enthusiastically about globalisation and private enterprise. But the underlying tragedy, not so easy to correct, is in the human cost of those wasted years. By making the wrong decision in 1945, by taking the easy road, and - as even Keith Joseph confessed to doing - kidding ourselves that there were 'short cuts to utopia' only to realise the error of our ways at barely the eleventh hour, we have left behind us dire social consequences that have become deeply rooted in the national psyche. With broken homes, teenage pregnancies, benefit dependency, massive debt, and undisciplined children now endemic in this country, there is more than a touch of irony in having rejected a manifesto so strongly identifying Britain as 'a country built on family life [and] the love of home' - a 'precious asset to be defended at all costs'.

The now almost alien tone of this sentiment in the context of political vocabulary is why I will continue to support David Cameron’s policy encouraging marriage as an institution and an ideal. It stands always as the essential foundation from which everything else is built - financially, emotionally, and educationally. As we’re still clearing up the mess left behind by the post-war consensus, with many of the things that were taken for granted when the 1945 Manifesto were written now gone, sound economics are simply not enough. Cameron’s Conservatives are right to tackle the social agenda, and it by no means indicates that they are shifting to the centre ground - far from it. What it means is that like all good Conservatives, they are being pragmatic. Solid social values regarding family, citizenship, discipline and respect are essential to the functioning of a healthy free-market liberal democracy and this is why Labour, with its vast army of bleeding heart lefties, will never be the party to tackle it. We can say in all confidence that the economic war is won. Liberalism is triumphant across the floor. But if the values that Churchill identified as the source of Britain’s greatness are not re-introduced one way or another - if the social war is not now won - then we shall be facing some very deep water indeed.

Thursday, 7 June 2007

Is the NHS eroding our civil liberties?

Tuesday's Times reported on its front page a headline on the proposed 'Crackdown on middle class wine drinkers' that Boris Johnson has since kicked up a storm on his blog, as doctors have been renewing pressure on this already legislation-happy government into imposing higher taxes on alcohol sales and providing more 'safety' warnings on labels. It represents a fundamental shift in Whitehall policy towards drinking, which in the past has focused on underage and anti-social drinkers. It also represents an unwelcome return of that old familiar stench 'the man in Whitehall knows best'. With this change, policy no longer rests on merely enforcing the law and protecting the public from violent individuals - it is taking the very odious decision of protecting the public from themselves. Not content with deciding for responsible adults (and employers) when and where they may smoke, doctors and ministers are now seeking to control how much individuals should drink in their own homes for their own good. A Whitehall source told The Times that they wish now '...to target the older drinkers, those that are maybe drinking one or two bottles of wine at home each evening' before woefully adding that they simply 'do not realise the damage they are doing to their health'!

Now, although this writer is all in favour of shifting income tax onto indirect taxation, we all know this is not going to happen. This pernicious tax would simply add to the public's burden and is nothing short of a naked attack on individualism and personal responsibility - two things that are already sorely lacking in this country. For while the pen-pushers at Whitehall wither over their charts and statistics, the reality is that it is the responsible lower-middle income drinker that will suffer from this ludicrous piece of nanny legislation. It does not even hold the shred of authority that the smoking ban claimed - namely, protecting non-smokers from the passive smoke they do not choose to inhale - and yet the head of science and ethics at the British Medical Association still felt confident in her assertion that 'It is not the nanny state. It is about informed choices'.

But the truth is it is about neither. The root motive of this, and by extension all nanny health legislation, is money. More specifically, the ailing NHS's money. We have to ask ourselves seriously; why else should the man in Whitehall really be so concerned with our health? The Times reported in same said article that 'ministers wish to highlight the increasing burden that drink-related disease is placing on the NHS...estimated to be costing between £1.3 billion and £1.7 billion [a year]'. So there it is. In black and white. It's because it costs them money. Though technically it's our money. So instead of having the individual responsibility of drinking reasonably in order to avoid large personal medical costs, we must be chastised and taxed collectively by the state to make sure we're taking good care of ourselves and aren’t doing the terribly selfish thing of costing our neighbour money.

In this sense the health service stands out as the last socialist holy cow to survive the Thatcherite era. It is the last post-war institution to be maintained despite making zero economic sense, racking up enormous public debts, and by proxy eroding individual responsibility through more and more government legislation. British Gas, British Airways, British Rail, British Waterways etc were all privatised for these very reasons, and although Mrs Thatcher would very much have liked the NHS to follow, realpolitik of the time made this an impossibility far surpassing the 'troubles' of the Poll Tax. However, with Tony Blair's Labour government having 'alleviated' more and more of the health service through the Private Finance Initiative in the last 10 years, perhaps it is time for complete privatisation to be (very gently) put back on the table.

It needs to be addressed that - wonderful an idea as it was, and great things it has nonetheless achieved - the stark reality is that the NHS is unsustainable, that it has become a monster with an insatiable appetite for vast amounts of money that seem to go nowhere. It has proved itself unable to cope with the challenges of an ageing population in the aftermath of the post-war baby boom. While more and more medical care is needed and new treatment becomes more and more expensive, our population and ergo tax revenues decrease. This has placed the health service in a situation of perpetual decline, while the taxpayer is paradoxically forced to cough up more and more of their earnings for a worsening service. In business this would be called a diseconomy of scale. Added to this - as Whitehall are attempting to point out - the responsible drinker ends up paying for the reckless indulgences and misdemeanours of others.

On the other hand, privatising the health service would enable the government to massively slash income tax - giving the public the free choice of where to place their hard earned cash and removing the fiscal motive for Whitehall poking their nose into peoples' decisions. A private firm would in no way be worried about the strain placed on their resources by people who wish to drink more than they should, and the subsequent treatment would in fact be welcomed as good for business. The government would no longer have to worry about taxing the public into good health, nor would it feel the need to emblazon bottles of wine with large ugly health warnings because it would no longer be any of their concern. Such a huge reduction in the scope of government and of nanny statism - which is only ever a few moral panics away from police statism - can only be seen as a victory for liberty.

Of course, it would be a difficult campaign to fight - the health service is somewhat of a Pandora's Box in that when you're seemingly getting something for free, you're not going to want to give it up, even if it is in a terrible mess. Nigel Lawson is said to have called it 'the national religion' [1]. But in the campaign that will no doubt soon need to be fought, it needs to be addressed to the people that the problems the NHS is now causing outweigh its benefits in the modern day, particularly in regard to personal choice and responsibility. No longer should the prosperous, the responsible, the frugal, hard-working and law-abiding citizen be held back by paying for the reckless, the idiotic, the short-sighted, and criminal members of our society. This writer remembers very vividly being taught Aesop's story of the Ant and the Grasshopper at school, yet wonders what on earth is the point in teaching children such an important lesson if the Welfare State is going to be there to work for you just in case you decided to ignore it?

In June 1945 - campaigning against the socialist future of welfare and equality Attlee's Labour Party were proposing - Winston Churchill warned the nation that however benignly such a doctrine was conceived, maintaining it would nonetheless

...gather all power to the supreme party and party leaders, rising like stately pinnacles above their vast bureaucracies of civil servants, no longer servants and no longer civil...nip[ping] opinion in the bud. My friends, I must tell you that a socialist policy is abhorrent to the British ideals of freedom.

Churchill was laughed down at the time - with the utmost respect of course - as an old-fashioned reactionary conjuring up fantasies of totalitarianism to preserve the imperial Britain everyone else was fairly certain was coming to an end. Yet, in a time when the authorities are able to shoot dead an innocent man in a tube station [2], or break into an innocent Muslim’s home during the early hours and shoot him [3] - all for our own good, these words may demand review. The NHS is the last bastion of this socialist future Churchill warned against - it continues to place government in a position of over-reaching responsibility - and thus power - to interfere with peoples' lives for what it believes to be for their own good. As Milton Friedman observed, the worrying thing about this is that 'the power to do good is also the power to do harm...[and] even though the men who wield this power initially be of good will...those who control the power today may not tomorrow'.

This writer is not for a moment suggesting that privatising the NHS would somehow magically restore Britons' lost civil liberties or instantly reduce the scope of the state in our lives. Not at all. But it is the cold hard truth that it was this post-war craving for a strong, far-reaching and powerful government to enforce equality that got us into this mess in the first place. In the words of David Bowie's chilling homage to Nineteen Eighty-Four (released as Diamond Dogs in 1974) - a demoralised people wanting 'someone to claim us/someone to follow/someone to shame us - some brave Apollo' ended up with Big Brother. I doubt there are many in this country who wish to live up to that Orwellian nightmare, but they would do well to remember that - as every revolution has taught us - the road to hell is indeed paved with good intentions.