Friday, March 04, 2005

NHS at War Again

It is a strange feature of British politics how the most aggressive exchanges at Prime Minister's Question Time always seem to be over the NHS - we had Kinnock crossing swords with Major in the War of Jennifer's Ear; Iain Duncan Smith made an extraordinarily ill-fated attempt at it when he raised the case of Rose Addis (at a time when he had an open-and-shut case of exam board incompetence to focus on); now Michael Howard has launched into an attack on Labour's claims on the NHS by focusing on the case of Margaret Dixon, whose shoulder operation has been cancelled seven times.

The Labour Party have been extraordinarily disingenuous over this. They castigate Mr Howard for politicising such an issue - "ruthlessly exploiting a woman's pain" - and yet they are quite happy to use their well-worn political mantras accusing the Tories of running down the NHS. Indeed, when John Reid, the Health Secretary, went to the hospital at the centre of the issue this week, he didn't say that he would be trying to get to the bottom of the problem, he said instead he would "ask people whether the NHS was better than under the Tories." If that isn't politicising the issue, I need to find a new dictionary.

It is easy to understand why Labour are incredibly touchy about the issue. They have poured huge amounts of money into the NHS, and yet the benefits are not easily seen by the public - much like the Commons select committee report on education, which suggested the amount of money that had been pumped in was in no way proportional to the marginal benefits received in return. And the law of diminishing returns must apply at some stage - the marginal benefit to the community as a whole is too small to justify its outlay.

The other difficulty is that most voters have a strange picture of the NHS and other public services. They will pick up on individual experiences that they see as characteristic of the service as a whole, even if they are extreme examples. We expect to be seen at the time of our appointment; if we aren't, we remember and get annoyed about it. Thus the personal cases that hit the headlines, largely because they sell newspapers (damn that human interest!), manifestly affect our opinion of the NHS - especially if it ties in to personal experience. No matter what raft of statistics the government can produce, word-of-mouth can be extradordinarily damaging. Especially when there are literally matters of life and death at stake here. Hence the willingness to launch into unseemly political scraps over small matters.