Tony Blair’s answers on the National Health Service in yesterday’s Prime Minister’s Questions were a surreal but poignant indicator of his mind on these issues. The questions from Michael Howard, leader of the opposition, were part of a wider critique by the Conservatives of the way the NHS is funded and operated by the Blair government. In a nutshell, the Conservatives still believe in universal healthcare for all, funded by taxing the working citizen. However they also believe that this tax revenue should be used to give patients a new 3-way choice with regard to which hospital will provide their healthcare:

1) a public NHS hospital of their choice which is funded 100% by the tax revenue;
2) a private hospital whose charges are no higher than the standard NHS tariff – the tax revenue will then be used to pay 100% of this tariff on the patient’s behalf;
3) a more expensive private hospital whose charges are higher than the standard NHS tariff – the tax revenue will then subsidise the costs of this healthcare to 50% of the normal tariff.

This 3-way choice would constitute a definite improvement to the NHS, as long as the NHS must exist. The Conservatives in my opinion could go much further, by implementing policies to privatise all NHS hospitals and turn the tax revenue into a voucher-based system, essentially using public funds to meet the costs of private healthcare (thereby stimulating enterprise, encouraging competition, etc). Of course their stated policies are a huge step forward in that direction. But Tony Blair doesn’t see it that way. Between spewing his improvement statistics and waffling about Howard’s own record in government, he made the following remarks during Prime Minister’s Questions yesterday:

“[Michael Howard’s] only response is not a right to choose, but a right to charge” – and – “I will not introduce … a subsidy to those who take out private healthcare, which is going to mean that if people want to avail themselves of that they are going to have to pay, under his proposals, over £2000 for a cataract removal, £5000 for a hip replacement….” etc.

How arrogant!! To presume, on behalf of the individual, that they would not ever wish to avail themselves of another choice, whatever the costs may be? He hasn’t minced his words, either: “I WILL NOT” sounds fairly uncategorial to me. His answer is this: like it or lump it. If you want private healthcare, you can go ahead and have it, but you’ll still have to pay for the crappy public one too.

And Howard’s retort to the effect that people are ALREADY paying under Blair’s government did nothing to stifle the rhetoric that ensued from the Prime Minister. He is right of course, in two ways. Firstly that 300,000 people CHOOSE to pay twice: once public, once private, so that they can avoid the NHS – that’s how bad it is. Second that people are already paying, 100%, for the NHS, because they are dutifully paying their taxes! They are paying for their healthcare under force, and it will be collected, at gunpoint if necessary.

It is astounding that Tony Blair speaks as though healthcare is somehow free under his system. It should be obvious to anyone that it is not the place of government (or anyone else) to force healthcare on somebody – yet that very thing constitutes the current National Health Service in the United Kingdom. Meantime, aside from the principal, we see the practical results – 25,000 people a year dying of cancer unnecessarily due to waiting times and bureaucracy – while those with private health insurance in the same position are sent to hospital virtually immediately upon diagnosis and have a significantly better chance of successful treatment.

Only a good politician could convince 60 million people that their healthcare is free.

And that’s what we’ve got in Tony Blair – a good politician.

John Wright