Friday, 11 May 2007

Toynbee: the bullsh*t years


Even the BMJ are now allowing Polly Toynbee to repeat her tired arguments, I am somewhat lost for words. There is nothing new in this piece, it is the same old guff rehashed and cobbled together into a patchwork of propaganda. One of Polly Toynbee's tricks is the use of the pretence of conceding ground to encourage the reader to assume that a few of her 'facts' are true. She does this with statements such as:

'results have never been so good'

and

'If, on that May morning back in 1997 a soothsayer had told him what the results would be 10 years later, he might reasonably have expected to rank somewhere alongside Aneurin Bevan as a hero of NHS history.'

She tries to make the reader swallow these statements of Toynbee 'fact', however these so called 'facts' rest on very shaky ground indeed. Where is this evidence that everything is so much better and that results are so dramatically improved?

The crux of her article now rests on this initial dodgy premise; she goes on to claim that patients, the public and all the NHS staff are just too demanding and over expectant, in her eyes everything is better but people always want more than can be delivered. This argument rests on foundations of hot air, just where is Polly Toynbee's evidence that the NHS is so much better? Her evidence is nothing more than a Labour party political broadcast. She quotes the waiting time figures for A/E and for operations, she then talks of the greater number of doctors and nurses; at least Toynbee has enough sense to admit that rising life expectancy may not be just down to Tony's genius.

In fact no one doubts that the government's figures are better, but the manipulation of statistics has become this government's specialty. The Stalinist drive to meet centrally set targets has led to the measures themselves becoming entirely meaningless. Waiting lists may be less, but hidden waiting lists and the dishonest manipulation of the figures is largely to thank for this 'progress'. If something does not have an attached target then it is put on the back burner and the patients left to rot. The A/E wait is a prime example of this dishonest spin, this four hour target means that unwell patients do not take priority over patients with trivial problems who are about to 'breach'; many NHS staff have seen first hand how dangerous these targets can be, as clinical need is overridden by the desire to produce yet more political propaganda. The A/E target means that patients are moved from place to place to satisfy the targets, while no one really has time to properly sort the patient out during this game of musical wards.

It is strange that Toynbee does not mention the appalling record this government has as regards a very high maternal mortality rate that is going up and up, countries such as Albania and Armenia have lower rates than the UK. The UK's poor statistics regarding cancer survival are again something not mentioned by Toynbee. It is also strange that Toynbee doesn't even mention that vital medical treatment that is clinically indicated is being with held thanks to systems that Tony Blair has put into place; in some regions inguinal hernias are not operated on, varicose veins are ignored and certain radiological procedures have been outlawed. There are many more examples of areas that have been left to grow fallow thanks to selective use of targets. This is the real Brave New NHS of Blair.

Polly Toynbee then goes on to struggle in explaining the internal market of the NHS. Her slant does not really flow with any cohesion:

'Many of these closures had been due for years and this was just the inefficiency the market was designed to throttle'

'news of the accidental overpayment of consultants and general practitioners reached public ears.'

She continues to slip in her 'facts' which are not facts at all, merely her propaganda dressed as concrete evidence. The fact that Blair's 'babes', a loose use of the word I know, were caught plotting the deliberate closure of hospitals in opposition constituencies has passed Polly by. There is actually much more evidence that these closures are politically motivated that clinically motivated. The pay increases have received much coverage in the press and in blogosphere, it is funny that Toynbee tries to disingenuously describe paying doctors fairly for the work they do as 'accidental overpayment'.

There are some rather glaring omissions in Polly Toynbee's piece. How can she sum up Blair's record on the NHS without even mentioning the short sighted financial time bombs of PFI, the incredible waste of billions on creating and maintaining the ludicrous internal market in the form of CFISSA/PBR/PBC/ISTCs/C&B/WICs et al, the wrecking of medical training and selection via MMC/MTAS/PMETB, the dangerous empowerment of quasi-practitioners in many guises, and a Department of Health that has a remarkable knack of turning everything it touches into muck in its uniquely secretive and undemocratic manner. In fact Toynbee also forgets to even mention that productivity has been on the slide under Blair's never ending program of reform. I don't think that Toynbee's piece can claim to be credible when so many key issues are completely ignored.

"Voters asked about the NHS said it was a disaster, although when asked about their personal experience they reported that their local services were indeed better."

The NHS has indeed got better over the last ten years, health care will always continue to improve; however the key question is not did the NHS get better, but did the government's management of the NHS mean that all the money invested was put to good use in an effective and efficient manner? The answer to this is a emphatic 'No', and this Polly, is why the workers and the public are fuming. It is not because the public are a bunch of morons who naively believe all the scare stories in the press, as by this logic there would be someone out there who believed what you wrote, and I doubt that such a person exists.

Tony Blair's NHS legacy will be remembered for all the wrong reasons. He has broken his pre-election promises by reinventing the internal market and privatising services left, right and centre. His leadership has seen record levels of spending but the money has been wasted catastrophically. The money has been frittered away on gimmicky centralised initiatives and ideological reform, it is tragic that so little of this extra money has reached the front line. Depressingly his style of government has seen more unaccountable autocratic central control that ever before, a most nontransparent and secretive style that has infuriated the pubic.

"Tony Blair leaves with the NHS as his Iraq on the home front. But history may be kinder
if in a couple of years the new system has been allowed to bed down. The internal market
may work and good results may speed up. If so, Blair’s NHS legacy may be rewritten
more favourably, but his successor will have serious problems."


Polly Toynbee finishes as she started, writing nonsense. Her piece is full of disingenuous attempts to appear objective but the sycophantic light does shine through in the end, as it always does in her Labour party broadcasts. Blair and Toynbee are remarkably similiar in a number of ways; both are always trying to justify the unjustifiable with their unique brands of logic, both are great fans of using propaganda and spin to further their own interests, and both of them are living in a state of complete and utter denial.

Does she really think that history will judge Blair's record on Iraq kindly after a 'bedding down' period as she calls it? Ironically the comparison is valid in that both Iraq and the NHS have been unmitigated disasters thanks to Tony Blair and his dishonest malignant rule. The problems in the NHS now are symptomatic of the decay of open and transparent democracy under Blair; the policies that have brought us MMC and MTAS from behind closed doors are what he really leaves behind. I would not be proud of these achievements.

1 comment:

HospitalPhoenix said...

I knew you'd appreciate that article! In fact, after I'd told you about it I had a sneaky suspicion you'd be writing a blog post about it, then paste said blog post in DNUK.

Perhaps I should become a fortune teller when MMC leaves me unemployed!