openDemocracyUK: Opinion

‘Protect the NHS’ must not be another excuse to blame patients

Scaring people away from using Britain’s National Health Service is a dangerous and toxic message - and now it’s putting children at risk too.

caroline m.jpg
Caroline Molloy
6 April 2020
Michael Gove speaks during a remote press conference at 10 Downing Street to update the nation on the COVID-19 pandemic.
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PA Images

Yesterday openDemocracy ran a terrifying story. Senior paediatric doctors in the UK are warning that the government’s coronavirus messaging is putting sick children at risk. Some kids may already have died because parents have been too afraid to take them to hospital.

Parents are scared of catching the virus, of course. But some also “do not want to bother very busy healthcare workers”.

This is a disaster. For a start, the government needs to urgently clarify that the ‘stay at home’ advice does not apply to infants and children with a continuing fever. A prolonged high temperature can seriously endanger them.

But it speaks to the wider, longer-term disaster of the government’s messaging about the National Health Service, too.

Of course, we all want to “protect the NHS”. But this core message draws on the government’s decade-long, toxic strategy of blaming us – the patients – for everything that’s wrong. It focuses on our ‘excessive’ NHS use. Our ‘unreasonable’ expectations of being looked after. Our failure to ‘take responsibility’ for our own health.

Ever since the disastrous 2012 Health and Social Care Act, ministers have been looking for others to blame for the service’s woes. From 2012 to 2019, they often blamed NHS workers – labelling them lazy, greedy and cruel during Jeremy Hunt’s tenure as health secretary, for example.

But we’ve also been told ad nauseam that people can best “protect the NHS” by not using it. That in fact it’s our duty as good citizens to stay as far away from the GP and hospital as possible.

Waiting list targets haven’t been met for five years? It’s the fault of the ageing population, said every health minister interviewed on the NHS crisis in recent years. Increasing numbers of older people are a problem “more serious than climate change”, Hunt told us a few years back.

Dramatic cuts to NHS beds and doctors, and an utterly dysfunctional private social care market? Britain’s compliant media has largely ducked the deeper issues and too often dehumanised older people as ‘bed blockers’.

NHS workers tell me that older patients – those who generally need the NHS the most – have, during this pandemic, become increasingly apologetic for using it. “I’m so sorry to bother you, I know how under pressure the NHS is.” Even: “I’m so sorry to be old, and to need help.”

What kind of society makes people feel this way?

The same kind of society where ‘quality’ newspapers can run columns suggesting that the virus “might even prove mildly beneficial in the long term by disproportionately culling elderly dependents”?

Drunks, smokers and in particular fat people have been held up as scapegoats for the NHS’s problems, too. The Sun has run endless stories accusing “fatties” of costing the NHS billions and threatening to “bankrupt the NHS”. And the press love stories about ‘frequent flyers’ – the very small number of often distressed people who call ambulances on a regular basis, and the extremely lonely and disadvantaged people who visit their GP because it’s the only service they can still access.

Other stories have barely merited a mention in a decade of insistent patient-blaming. The cuts to public health programmes that help people lose weight, moderate their drinking and stop smoking. The cuts to maintenance of parks, green spaces and support for children and people with mental health problems. The ways that low pay and irregular working hours makes it harder to keep yourself and your family healthy.

It doesn’t suit the prevailing narrative, but NHS workers tell me frequently how older and poorer patients – and men – put off seeking medical help, and/or finding it increasingly hard to access, until their condition has already worsened. By which time they’ve become more costly or even impossible to treat.

Nonetheless, politicians and their allies – pro-market think tanks and ennobled technocrats running various NHS quangos – do not tire of repeating often-statistically dubious messages about how a vast proportion of NHS visits and interventions are unnecessary.

Cash-strapped, disrupted local NHS organisations have spent most of the past decade reinforcing the message. They have plastered buses and the internet with messages telling people to do anything but call on the NHS frontline for help. Don’t visit your GP! Don’t go to A&E! Visit Boots instead! Call this privatised, short-staffed 111 helpline! Use this iffy online service! Rely on volunteers and loved ones! Go to a confusing plethora of part-privatised Minor Injury/Urgent Care clinics!

Jeremy Hunt himself even floated banning people from walking up to A&E. He was accused by doctors of endangering patients when he told them they could use “Doctor Google” to check a child’s rash. And again, when he and former Prime Minister David Cameron claimed (entirely falsely) that we had only a ‘Monday to Friday’ NHS, doctors compiled a dossier of patients whose health they said had been endangered because the patient wrongly took Hunt at his word and delayed seeking treatment.

The NHS is famously our ‘national religion’ because of what it does. It protects what people hold dearest: their own health, and that of the people they love and of their fellow citizens.

Too many shaping NHS policy in recent years have lost sight of this. It’s seen as a cool brand to sell abroad, or even a cash cow.

So yes, protect the NHS. Many of us have been trying to do just that for years. But also protect each other. We need to – and we must call on our government to do the same.

Peter Geoghegan: dark money and dirty politics

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In conversation:

Peter Geoghegan Dark Money Investigations editor at openDemocracy and the author of ‘Democracy for Sale: Dark Money and Dirty Politics’.

Mary Fitzgerald Editor-in-chief, openDemocracy.

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