BY PAUL T HORGAN
Surely one of the most cloyingly cringeworthy sights on British Television this year has to be the BBC’s Newsnight hosting a children’s choir marking the 75th anniversary of the creation of the NHS. All the young singers were clad in identical t-shirts as if they were part of some staatsjugend organisation. Some bureaucrat must have seen the 1980s music act St Winifred’s School Choir performing their chart single There’s No-one Quite Like Grandma and had a light-bulb moment to update something that was actually as unwelcome in the pop charts as the No.1 single Shaddup Your Face was to Ultravox fans in 1981.
The NHS is a political organisation. The United Kingdom is run for the benefit of the NHS rather than the reverse. It is a monolithic socialist edifice, whose survival is guaranteed by a persistent media campaign of fear that the only alternative would be an American-style private medical system funded by insurance, rationed using Health Management Organisations (HMO) and which would only be available to those who could afford to pay bills that would run into tens of thousands of pounds.
This fear campaign, perpetually promoted in part by Labour to gain votes, ignores the fact that there are more than two developed countries on the planet and thus exhibits wilful blindness over healthcare systems in the EU, which contain strong contributory elements, private services, and use compulsory insurance along with state provision.
The irony of the fear campaign is that our taxes in this country essentially pay for what is in effect a state-owned and-run health insurance system whose care is rationed just as much as it is in the USA.
The NHS has a waiting-list of over 7 million patients waiting for treatment, and these people are being denied care as much as they would be in the USA. However, the restricted availability of health services in the UK is not due to a visible HMO that is rewarded for cutting costs to the bone, but by a concealed HMO constrained by perpetual shortages of resources, paradoxically despite the increasing amount of ring-fenced taxpayer cash pumped annually into the NHS.
The major proponent of the fear campaign is not actually the Labour Party but the BBC, through the abject failure of the state broadcaster to inform or educate the public by considering or discussing any healthcare systems other than the UK’s or the USA’s, and using the latter only in terms of ringing denunciation, where the word ‘American’ is employed rather like an expletive.
And this makes a degree of sense. The BBC is a statist organisation, and thus its statist ideology extends to unflinching support of the NHS, hence the propagandistic exploitation of children on a flagship news programme. This monolithic statism compares with the slave states of the USSR created in Eastern Europe after the Second World War, which also seemed impregnable. However all these regimes eventually collapsed.
And it is the nature of the collapse of one of the Soviet-backed Marxist dictatorships which may suggest how both the BBC and the NHS may fall.
The condition of East Germany was the worst possible advertisement for socialism in general and communism in particular. Here was a monolithic totalitarian state that used all the methods of repression associated with state socialism, the creation of political offences, the banning of free speech, secret police, informers, routine unregulated interception of communications, psychological warfare on potential or actual dissidents, propaganda, etc. But that was not the worst aspect of the state, compared with other countries held in bondage to communism. It was that emigration was generally illegal and any attempt to leave was a de facto capital offence, as border guards were allowed to shoot on sight anyone trying to escape the country. The reasons behind this policy of extrajudicial killing had to do with the survival of the socialist state.
By 1960, the 11-year-old East Germany was facing national collapse. The terrible conditions of life in the country, compared with West Germany, were very clear, and East German citizens were regularly crossing the border for a new life in the West. The kind of people voting with their feet were the young and well-educated, and the loss of human resources placed the dictatorship into an existential crisis. Had nothing been done, the skills shortages would have further paralysed the economy, leading to governance withering away as the country could not function with only an increasingly unskilled and elderly populace available to do the work.
The erection of the Berlin Wall in 1961 and the criminalisation of emigration to halt the flow demonstrated for all to see how disastrous and dangerous was a country run according to socialist principles. This action, and the Soviet invasion of Czechoslovakia in 1968, sounded the death-knell for any popular political credibility communism held in Europe, Eastern or Western. East Germany was officially a country-sized prison, and its citizens and the wiser world knew this.
Successive Soviet leaders ensured East Germany remained this way until Mikhail Gorbachev became Soviet leader in 1985. His reforms and liberalisations led to copycat actions across the USSR’s slave states. In East Germany, the exodus, stifled for almost 30 years, resumed as Hungary opened its borders to Austria, creating an escape route for tens of thousands of people. The leadership of East Germany eventually closed all of its borders with other communist countries, as people stopped showing up for work because they had left the country. When the East German security forces refused to open fire on the protesters in the demonstrations that had started at the beginning of 1989, the end was near. The Berlin Wall was opened up in November 1989, and East Germany was absorbed into West Germany less than one year later.
It is the decline and fall of East Germany that suggests how both the BBC and the NHS will be replaced by something better. In the case of the BBC, hundreds of thousands of people are simply not buying TV licences any more and this is a growing trend, resulting in the BBC getting less money. The BBC was granted by the government a monopoly on selling to people the right to receive broadcast television through an annual household licence. However this monopoly is increasingly meaningless as it does not cover internet-delivered video on demand unless it is of a live broadcast. The BBC has a legal right to check a household’s internet use to see if this includes live streamed video, but there is no evidence that the BBC uses this legal right.
The TV Licence is now little more than a licence to watch live sports, as there is otherwise little pressing need otherwise to watch any television as it is broadcast. The only other need to have a TV Licence is for the right to watch the BBC’s streamed or live video output, and there are few reasons to do this when the BBC is now just one content provider amongst many.
The quality of the BBC’s output has decreased by comparison to its new competitors as the corporation is increasingly in hock the leftist ideology of the kind that has uniformly-attired children singing a hymn of praise to the NHS on a news programme.
As fewer British households pay for the TV Licence, so the BBC’s income will fall. Programme quality will decline creating a death spiral, rather like the exodus of its citizens in 1989 heralded the collapse of East Germany. The BBC’s management wish to avoid this scenario by raising funds with a tax on broadband use. If this was ever approved by an incoming Labour government (it would be impossible for the Conservatives to agree to this), then the BBC would have to be far more accountable to its new taxpayers with regard to editorial policy and output. Put simply, no taxation without representation.
Even if only part of the broadband tax went to the BBC, then the corporation would in effect be a branch of the state, somewhat like the NHS, rather than an arms-length corporation incorporated under a Royal Charter. BBC staff would become civil servants. At present the BBC is actually a commercial organisation benefiting from this state-granted monopoly based on activity increasingly made discretionary by advances in communications technology.
Taxing broadband and using some or all of the funds to finance the BBC would remake the corporation as a government department. Ministers would become responsible for questions regarding the quality of programme output and the BBC’s management, a new responsibility it is unlikely they would want, especially if the BBC put out questionable content, or if more of the BBC’s staff or contractors were caught raping children.
So the broadband tax which is being talked up at present is a non-starter if it made MPs into state pornographers or the friend of paedophiles by a direct financial link. Instead the BBC will have to move to a subscription service. If opponents of the subscription model state that the BBC could not survive in this marketplace, then this is a tacit admission that the TV Licence as it stands is not worth the money. People continuing to abandon the TV Licence will be the direct cause of the BBC’s inevitable demise unless the revenue model is changed, or the BBC ups its game, which it seems unable to do.
An exodus will also drive change in the NHS. Rather than a series of crippling strikes by employees who will inevitably return to work, or patients going private, it will be the exodus of qualified employees finding work elsewhere in the UK or overseas. Australia is already enticing medical professionals with attractive job offers, and if the departure of vital staff continues, then the NHS cannot help but collapse, unless the government decides on some kind of medical Berlin Wall, and no government will do that.
The issue here is that the revenue model of paying for the NHS exclusively from taxation or government borrowings does not direct a sufficient percentage of the UK’s GDP into medical services compared with an EU-style insurance-based contributions model, resulting in an Eastern Europe-style shortage economy causing waits for treatments and GP appointments. When the money arrives in the NHS, it is questionable as to whether it is spent efficiently. There are numerous instances of the NHS hiring ‘Diversity Officers’ for over £40,000 a year in salary, and these may only be hired because otherwise the spending authorities would have a budget surplus, and this would suggest the authority could do with less money, and no state organisation of any kind whatsoever would ever admit to that.
There is also the issue that the NHS is the heath sector’s dominant employer and as such distorts the labour market for health employees. Private provision would allow innovation and also a free market in jobs and salary, and would likely curtail the mass exodus of hard-to-replace staff as there would be more money to pay them to stay in the UK. It is possible that a new business model would permit the training of more professional staff as more money went into health care.
So, it is not policy that will drive change in these organisations, but people walking away from them for good. Fewer people paying the TV Licence cannot help but lead to the decline and fall of the BBC. An absence of medical staff will force the revenue model for health care that is free at the point of need by finally making it actually available though a contributions-based system. At present there is a waiting list of about 7 million people for NHS services. By any standard the NHS has failed, and like East Germany, collapse cannot be too far behind.
Paul T Horgan worked in the IT Sector. He lives in Berkshire.