Why the Right is losing the NHS debate

That so many Conservative-leaning commentators (witness a recent blog by David Herdson over at PoliticalBetting) focus narrowly on the political ramifications of the Health & Social Care Bill betrays two facts about the modern right-wing commentariat, which in turn explains their problem over the NHS in the mind of the public.

First, so very little of the noise from right-wing circles focuses on the arguments for and again reform. There is ample evidence that the NHS in its current state is one of the most efficient of any developed health system and consequently the UK spends a lower proportion of GDP than numerous other western nations and yet health outcomes here are improving faster than in many of those nations. Additionally, both internal performance and patient satisfaction are improving (or at least they were until very recently). Yet none of this often makes its way into their thought processes - this aspect of the debate is rarely even mentioned. As this blog has argued before, it is a fact of the modern right that their ideological commitment to reducing the size of the state trumps any rational arguments as to what works best for service users. In this sense, their ideology is closer to a religion than a political theory.

Second, what is instructive about the modern right is how much they underestimate the fact that the central moral principles of the NHS  - that health care is a right for everyone, not a commodity like a car or TV available only to those that can afford it - have been accepted by the vast majority of the British public. The left-wing theorist Stuart Hall, in a recent interview with the Guardian, actually himself underestimated this when he declared that "The principle that someone shouldn't profit from someone else's ill health has been lost". In fact, this principle still carries a great deal of sway for many people beyond the left and centre-left, although in reality it has been chipped away at somewhat in recent years.

Then there is a final problem for the modern right, and an Achilles' heel in some regards. The NHS (and, in fact, the BBC) are seen as very British institutions. This gives them an appeal beyond the left, to those that value nationalism and have pride in British culture. In other words, the Tory Party has a central problem with regards to both these institutions in that in undermining them they will be seen as undermining British cultural institutions - difficult for a party that builds so much of its support from regular appeals to nationalism.