Kristian Niemietz: The Left’s horror stories about the health service are preventing necessary reforms

24 May

Kristian Niemietz is Head of Political Economy at the Institute of Economic Affairs.

The book When Prophecy Fails, first published in 1955, is about the psychology of Millenarian cults, formed around the belief that the end of days is just around the corner. More precisely, it is about how the members of such a cult react when the date of the predicted apocalypse comes and goes, and nothing special happens. How do those people respond to the total, unambiguous and undeniable refutation of their belief system?

A period of confusion and disorientation? Some honest soul-searching and self-examination? Shame and embarrassment? Do they turn on the cult leaders? Does the cult disintegrate?

The answer is: none of the above. The most common response is to double down. The cult members modify their story somewhat, and shift the date of their prophecy into the future. Far from feeling any sense of embarrassment, the cult develops a greater missionary zeal. Far from falling apart, it emerges stronger, and more cohesive.

Britain has its very own version of such a cult. It is built around the belief that there is a secret plan to dismantle the National Health Service, sell off its components, and replace it with a dystopian survival-of-the-fittest system, in which we will live in constant fear of being bankrupted by medical bills.

There are currently dozens of competing petitions, which have gathered hundreds of thousands of signatures, claiming that the latest health reform – the Health and Care Bill – is really a Trojan Horse for the privatisation of the NHS. But this is, of course, not the first moral panic of its kind. Three years ago, the envisaged UK-US trade deal was denounced as a Trojan Horse for selling sell the NHS to American healthcare corporations. More than 1.4 million people signed a petition to avert this imaginary threat, and according to one survey, nearly 60% of the public fell for it.

During the Cameron years, there was a large-scale moral panic around the Health and Social Care Act 2012, which campaigners believed to be – you guessed it – a Trojan Horse for the privatisation of the NHS. Several books were written about how the HSCA would kill off the NHS, with self-explanatory titles such as The Plot Against the NHS (2011), NHS SOS: How the NHS was betrayed and how we can save it (2013), NHS for Sale: Myths, Lies and Deception (2015), and How to Dismantle the NHS in 10 Easy Steps (2015). On the day the HSCA came into effect, socialist author Owen Jones wrote in his usual measured, level-headed style:

“[S]pare a moment for our National Health Service. Time of death: midnight, 1st April 2013. Cause of death: murder. […] The great sell-off of our NHS is already well under way. […] The NHS has been killed, murdered, assassinated by a Tory government.”

In Gordon Brown’s days, a reorganisation of primary care was supposed to act as a Trojan Horse for the privatisation of the health service. As the Independent reported at the time:

“GPs […] are set to pass a vote of no confidence in proposed health reforms which they claim will result in NHS privatisation. […]

The British Medical Association will deliver a […] petition, with tens of thousands of names, to Downing Street”

I could go on. In fact, I do go on, namely in my new IEA report Repeat Prescription? The NHS and four decades of privatisation paranoia, in which I document the very long succession of such supposed “Trojan Horses”. Going back to at least the early Thatcher days, every major and every minor health reform has been greeted by someone or other as a “Trojan Horse”, which allegedly contained a secret plan to dismantle the NHS. Needless to say, none of these Trojan Horses have ever contained anything – but that has never stopped the privatisation prophets from simply creating a new moral panic a few years later, pushing the date of the NHS’s predicted demise into the future.

Folk wisdom has it that if you “cry wolf” too many times, people will eventually stop taking you seriously. At least in this instance, that folk wisdom could not be more wrong. When it comes to conspiracy theories about NHS privatisation, crying wolf works every single time. Large sections of the broadcast and print media can be relied upon to provide the wolf-criers with megaphones. The medical establishment, in the form of the British Medical Association and the Royal College of Nursing, jump on the bandwagon more often than not, and so do the trade unions and frontbench opposition politicians.

One of the problems with this charade is that the ensuing hysteria then crowds out any sensible discussion about the pros and cons of the actual reform. If you go through old news archives about previous health reforms, you will find plenty of hysterical denunciations and angry denials, but you will learn very little about what those reforms were actually about.

Conspiracy theories about NHS “privatisation” are the failed prophecy that never dies. We need to start calling out the failed prophets on the 0% success rate of their prophecies.

 

Ryan Bourne: If you want to feed hungry children, don’t target food poverty. Aim to reduce poverty as a whole.

28 Oct

Ryan Bourne is Chair in Public Understanding of Economics at the Cato Institute. 

Covid-19’s initial economic impact fell disproportionately on those least able to mitigate it. An Institute for Fiscal Studies paper in July found that single parents, low educated poor households, and ethnic minority groups suffered the worst relative hit. Since then, workers in low-wage services industries such as hospitality, transport, and retail, have faced both the worst of unexpected job losses and uncertainty about their income.

With this unique shock, it is unsurprising that a welfare state built around previous experiences has exhibited failures in protecting against hardship. Falling incomes, especially for those without savings or access to government benefits, have consequences. The Food Standards Agency reports greater food bank use, self-reported hunger, and families eating out-of-date produce.

That context is why the Government faces intense pressure over extending free school meals during school holidays through Easter 2021. Given the uncertainty around the efficacy of other government support, you can see the temptation to follow the advice of Iain Martin, who proposes caving to Marcus Rashford’s campaign again. Give the “£20m, handshake with Marcus R on steps of Number 10 on Monday and Royal Commission into child poverty,” Martin tweeted.

That defeat might seem a small price to pay to end the optics of opposing meals for hungry children, regardless of any questions you might have about the realities, or the desirability of extending the government scheme. As Isabel Hardman writes, the belief that Conservatives are insensitive to “food poverty,” coming first in righteous anger over food bank use in 2010-2015 and now “free” school meals, has hung around the Conservatives for a decade, whether fair or not.

Martin’s short-term solution, however, neglects that campaigners won’t be satiated by extending out-of-term meal vouchers to Easter 2021. Rashford’s campaign’s ultimate aim, remember, is to implement the Dimbleby Review, which would double the number of kids on benefit-triggered free school meals by extending eligibility to every child from a Universal Credit household (an extra 1.5 million kids.)

Crossbench peer Baroness D’Souza is already pushing for out-of-term meal vouchers to become a permanent feature. Combined, that would be billions of pounds, year on year, not tens of millions.

Come next year, no matter the labour market’s health, the Government will face the same criticism. If much of austerity taught us anything, it’s that even when acute need passes, wrapping up programmess will renew accusations that Conservatives “want to starve kids” by “snatching” their lunches.

Milton Friedman’s warning that “there’s nothing more permanent than a temporary government programme,” in part stems from recipients’ aversion to losses. A Royal Commission packed with do-gooders who examine food poverty in isolation will bring further demands for spending and diet control.

That is why, I suspect, some Conservative MPs vociferously oppose the Rashford campaign. It’s not heartlessness, or even this specific extension they oppose, but the precedent and direction of travel. They can foresee the vision of government this type of reflexive policymaking and its paternalistic particulars end with.

The problem for them is that they are on a hiding to nothing in claiming this specific measure risks creating longer-term “dependency” or “nationalising children” if the public think today’s needs are real. Conservatives who believe in a small, limited state have to have answers —about what responsibility the Government should have in dealing with hardship, what tools it should use, and what its role should be for those falling through gaps.

After ten years in government and riding cycles of support for the welfare state, there’s a lack of clarity in the Party’s position, with a mix of preferences among its MPs for income support, service provision, civil society solutions, and combinations of the three. There is a clear, principled alternative vision of how to deal with poverty if the Tories want it. But it requires getting off the fence.

That alternative would say that “food poverty” is not distinct from poverty. Free school meal campaigners are broadly right that hunger is not usually caused by parental fecklessness.

Therefore, logically, food poverty largely results from insufficient disposable income for some families. If widespread hunger is evidenced, the debate should therefore be about whether benefit levels or eligibility are sufficient to meet basic needs—the goal of a safety net welfare state.

This type of limited support that trusts people to use top-ups for the betterment of their families is vastly preferable to a paternalistic state stripping us of responsibility, through demeaning out-of-term food vouchers akin to U.S. style food stamps.

In deep unexpected crises, the case for additional emergency income relief is greater. But if there really is a more structural problem of hunger, then it demands examining why wages plus benefits are insufficient to deliver acceptable living standards. Rather than just look at benefits then, we should examine living costs, too—the poor spend disproportionately high amounts on housing, energy, food, clothing and footwear, and transport.

My former colleague Kristian Niemietz wrote a free-market anti-poverty agenda back in 2011, which I’ve pushed MPs to adopt since. He showed that market-friendly policies on housing (planning reform), food and clothes (free trade), energy (ending high-cost green regulations), childcare (reversing the credentialism and stringent ratios), and cutting sin taxes to economically-justified levels could shrink poverty by slashing the cost of living for the poor, so reducing food hardship, homelessness and more.

Most of this agenda would require no extra spending or busybodying from government paternalists; some of the policies would bring the double-dividend of raising wages .

The Government has ambitious policies in a number of these areas. But why are they never linked to the poverty discussions? As they press for planning liberalisation, why is nobody highlighting how cheaper housing would lessen these tales of distress? Why is nobody identifying the discrepancy of some campaigning about food poverty while opposing trade deals that would make food, clothes, and manufactured goods cheaper, to the huge relative betterment of poor consumers?

Sure, there would be families who make bad decisions and find themselves in trouble, even in a world of cheap and abundant housing and an effective safety net.

But instances of poverty owing to lack of resources would be much lower and these thornier challenges (often stemming from addictions, loss, ill-health, criminality and more) are much better identified by local charities and civil society groups anyway, as Danny Kruger argued in the Commons last week in relation to hinger. Giving nearly three million kids “free” school meals year-round would be an absolute sledgehammer to crack any remaining nut.

In today’s emotive debates, it’s not enough to just oppose proposals when the need is perceived as urgent. Conservatives must be better at re-setting the debate on their terms—a task much easier if they held a clear vision of the role and limits of state action.

Fight crimes not Grimes

11 Oct

The Metropolitan Police are doubtless pursuing Darren Grimes as the publisher of the David Starkey interview as well as the interviewer.  That doesn’t make the decision any less sinister.

Such non-Conservatives as Tim Farron and Nick Cohen suggest that the Met’s decision to interview Grimes under caution is wrong.  Our readers are likely to agree.  So we won’t waste words attempting to talk them into a view they hold already.

Instead, we ask for the Met to be held to account for its push to curb free speech.  Did Cressida Dick approve the decision?

If she did, she needs to explain why it doesn’t represent a vendetta by the force against an innocent man who won in court against the established might of the Electoral Commission.  If she didn’t, and the officers have never heard of Grimes (or the Commission either), she should make it clear why they are pursuing him.

It will be claimed that this decision is an operational rather than a strategic matter, but there comes a point when the first blurs into the second.

Is it now Met policy to muzzle free speech, and intimidate journalists in this way.  There are three potential sources of accountability: the Mayor of London, the Home Secretary, and the Home Affairs Select Committee.  Sadiq Khan will do nothing.

Priti Patel has tweeted for freedom of speech, but has fallen into the trap of seeing this incident as an operational matter only.

She should haul in Dick for an interview without coffee, and get the bottom of who in the Met made this decision, and why.  We gather that Tim Loughton, a member of the Select Committee, intends to raise the case when it meets this week.  Good for him.

Meanwhile, Karl Turner, Labour’s Shadow Minister for Legal Aid, tweeted: “Freedom of speech Darren doesn’t afford people the freedom to make racist remarks or generally offend”.

But its inherent to free speech that it will sometimes offend, and it’s important to note that at least one member of Keir Starmer’s front bench either doesn’t get the point, don’t understand it, or don’t care.  The tweet has since been deleted.

The last word on the Met’s decision belongs to Kristian Niemietz of the Institute of Economic Affairs, who tweeted the following yesterday:

-“Hello? Police? I think there’s a burglar in my house…”

-“Sorry, we’re a little busy right now.” -“

…and the burglar just muttered something that sounded a bit like “All lives matter.””

-“We’re on our way.”