I can’t stop watching Harry Smith

Anyone following the progress of the Labour Party conference last week will probably have heard of Harry Smith. As he has done in articles before now, Harry Smith successfully articulated what the NHS is for, and why it was set up,  with more clarity and meaning than any politician I have ever witnessed. True, he wasn’t charged with presenting any solutions to the finances or other pressures on the NHS.  But he did point out very clearly that life before the NHS (and the welfare state) was harsh, inequitable, and sad for very many people, and that the core values of the NHS which brought relief to that suffering are now at risk. I can’t possibly express it any better, I would suggest you watch his speech if you haven’t already.

Move forward a week and David Cameron’s commitment to the NHS had nothing to do with sparing people from the pain and injustice of a life where dying cancer patients had no access to morphine. Or  where even today children born one side of a fence are expected to die a decade or more earlier than those born on the other side of it.  His contribution to the politics of the NHS was definitely in the ‘policy nugget for potential voters’ camp, with the promise that people will be able to see their GP seven days a week “at a time that suits them and their family”.

His promise does raise a number of rather vexing questions. Like how to manage the GP workforce to meet this demand (which includes the need to train up rather more of them than we’re doing at the moment and the fact that many are highly stressed simply trying to meet today’s obligations). Like how referring people to other bits of the system on a weekend day will help them if no attention is paid to the problems elsewhere in that system. And like the fundamental problem that many of the people who most need better access to healthcare either don’t know when or why they need to go their GP,  can’t find one to go to, or need support they just don’t have to adopt lifestyle changes that would improve their life chances.  Leaving all these – and many other – questions aside for the moment, Cameron’s announcement is yet another firing round in the ongoing commodification of the NHS.

Harry Smith (and Andy Burnham, who also does this pretty well) succeeds in describing the NHS as a marker of a compassionate, altruistic society (which, incidentally, is the kind of society I’d like to live in: I imagine you would too).  Cameron and his helpers, on the other hand (though this criticism isn’t only directed at Tories), appear to think of healthcare – public or private – as a ‘right’. As in having a right to receive a certain standard of service. And to which, by implication, some people (the hard-working ones) have more right to than others.  The message that the NHS is there for people ‘when they need it’ seems to be turning into ‘when they want it’. Need isn’t the same as want, as most parents will probably have said at some point. Reinventing wants as needs for electoral convenience won’t stop that child on the wrong side of the fence dying a decade earlier than the child on the other side.

Harry Smith belongs to a generation that understands what life was like before the NHS, and why it was needed. I, on the other hand, belong to a generation which expects it to be there.  That expectation brings the risk of complacency. Add to that complacency a misplaced focus on ‘rights’ not ‘needs’, and the true value of the NHS can get lost.  Earlier this year, the losses and sacrifices of people of Harry Smith’s generation and the one before were being remembered across the country in commemorations of D Day and the start of WWI. But we seem a bit short on learning the lessons of history. Perhaps all our politicians should start by watching Harry Smith.

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