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Daniel Hannan is an MEP for South-East England, and a journalist, author and broadcaster. His most recent book is How we invented Freedom and why it matters.

Claims that the Conservatives plan to “privatise the NHS” are a familiar election ritual, like the Official Monster Raving Loony Party standing against the sitting Prime Minister. When ministers dismiss the charge, Labour politicians, predictable as pantomime characters, come back with, “Ah, well they would say that, wouldn’t they?”

“The Government keeps denying that it is privatising the NHS,” wrote Frank Dobson, the former health minister – in, er, 2006, when the prime minister was Tony Blair.

Privatisation is always imminent – it’s generally supposed to happen immediately after the next election – yet it somehow never takes place. The same phantom was conjured at the 2010, 2005, 2001, 1997, 1992, 1987 and 1983 elections. (“Private companies are to be enabled to asset-strip the NHS,” Michael Foot’s Labour Party assured us. “The NHS must pay full price to the private sector, which will be allowed to pillage NHS resources.”) Before that, when the word “privatisation” had yet to come into vogue, Labour railed against the iniquity of “pay beds”.

Labour never explains why privatisation keeps failing to materialise, despite Margaret Thatcher’s massive parliamentary majorities. Nor, indeed, does it explain precisely what form privatisation will take. Does Ed Miliband seriously want us to think that there is a scheme to break up the NHS and sell shares in it? Who would be mad enough to buy such shares?

The vagueness is, in truth, quite calculated. The phrase “privatise the NHS” deliberately conflates two separate things: first, the idea that patients might end up having to pay for their treatment – something that no British political party is proposing; second, the gradual extension of the more flexible commissioning arrangements introduced under the Blair government.

These internal reforms have mildly improved efficiency, though they stop well short of almost every European healthcare model, where state and private providers coexist within the same system.

Yet even these gentle ameliorations have been howled down as a conspiracy to sell hospitals to City spivs. The NHS is treated as something that ought to be above politics: unsullied, immaculate, eternal. As David Prior, chairman of the Care Quality Commission, put it, “The NHS became too powerful to criticise. When things were going wrong, people didn’t say anything. If you criticised the NHS – the attitude was ‘how dare you?’”

Having been on the receiving end of that attitude more than most, I’ve noticed that it comes from two quite different sets of people. First, there is a knot of hardline Leftists, some of them in public sector trade unions, who see it as their task to keep the system unaltered, a stance neatly summarised in their slogan, “Hands off our NHS!” These are the people who pour out furious abuse online, who organise protests, who harassed my mother after I had criticised the system, who hounded the Mid Staffs whistleblower.

Then there is the wider constituency: people whose personal experiences have been satisfactory, who have found NHS staff to be friendly and helpful, and who therefore see criticism as ungrateful. People in this second constituency have no ideological attachment to a state monopoly in healthcare. They simply remember that their doctors and nurses were, for the most part, good-natured, and that their treatment went well.

What has happened in our political system is that the second constituency has been passively co-opted by the first. The people who make the most noise are doctrinal. They are attached to the NHS, not because it works, but because it is the only part of the British state which operates on socialist principles: production according to ability, distribution according to need, ownership of all assets by the government.

The wider constituency is motivated, not by dogma, but by the natural change-aversion to which all human beings are prone. Milton Friedman called it “the tyranny of the status quo”.

I’m often struck, in the European Parliament, by the fact that no mainstream socialist party on the Continent proposes a state monopoly in healthcare on the British model. Only some Green and Marxist parties have such an agenda. It’s impossible to imagine that, had we stopped short of full nationalisation in the late 1940s, anyone would be arguing that we should adopt it today.

Still, we are where we are. In a democracy, voters are never wrong. A clear majority wants to keep the NHS as it is. Sure, you might argue that this desire is based on a misunderstanding. I’m often surprised by how many Britons believe that free treatment for the poor is a unique characteristic of our system. I’m surprised, too, by how easily pleased we are when simple things go right. When I get off a flight from Brussels, I don’t fall weeping to the tarmac, saying “I owe my life to British Airways”. Yet I frequently hear people say, “I won’t hear a word against the NHS, it gave my Auntie Nora a new hip!”

This is understandable, of course: it’s in the nature of healthcare that we should be emotional about it. Still, expecting minimum standards doesn’t insult our doctors and nurses, any more than, in my analogy, expecting minimum competence insults the BA pilots; rather, it compliments them. More to the point, it was the clinicians concerned who replaced Auntie Nora’s hip, not the arrangements whereby their services were procured.

Be all that as it may, though, people have made up their minds to keep the system as it is, which is why every party – including, after a brief wobble, UKIP – opposes systemic change. We might complain about failures at Mid Staffs or Basildon or Blackpool; but we can’t complain about failures in representative government. We’re getting exactly the system we’re asking for. So why pretend otherwise?

31 comments for: Daniel Hannan MEP: Stop complaining about the NHS. You’re getting what you asked for.

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