Britain now has the worst Covid death rate in the world, due in large part to Boris Johnson’s fatal refusal to make decisions in time, from the late lockdown in March last year to the delayed announcement of Covid PCR tests on arrivals into the UK – the norm in most of Europe since early summer.
The provision of PPE has given rise to widespread accusations of Tory chumocracy pocket lining, with exposés in The New York Times and Le Monde portraying Johnson’s Britain as venal and corrupt. Testing and tracing has also come under fire. By any yardstick, it has been a failure.
The one shining success story, however, has been an old-fashioned, mid-20th century, state financed, centralised, top down controlled, public sector, fully unionised organisation – the NHS.
The NHS ticks nearly all the boxes the Johnson generation dislikes. But it has risen to the challenge of a total reorganisation of hospitals, the building of wartime equivalents of Bailey Bridges, the Nightingale emergency hospitals that arose overnight, as well as a massive, and well-managed, re-allocation of personnel – from trainees to veterans – done with speed and efficiency not seen since the mobilisation, planning and execution of the Normandy landings in 1944.
Today the NHS is the envy of Europe as it vaccinates 10 times as many people as France, once the byword nation for state centralisation.
All over Europe, political jaws are dropping that Brexit Britain, which seems to unable to slow down death rates and is making a complete hash of the early days of its new trading relationship with its partners, is moving faster and more effectively than any other European state in grabbing coronavirus by the horns and wrestling it to the ground with its vaccination programme.
Sir Simon Stevens, the NHS leader, did organise Boris Johnson’s election to be president of the Oxford Union nearly 40 years ago, but there is no trace in his leadership of the NHS of the ministerial blunders, late decisions or cronyism that has infected political, ministerial management of the pandemic.
This is British public service at its finest. After 1945, all of Europe set up health care systems which would not be based on private wealth. Most were based on obligatory insurance schemes with medical bills reimbursed rather than being free at the point of use. Quite often they were generous, with stays in spas reimbursed or expectant mothers having their own specialist doctor rather than taking pot luck with a duty midwife at hospital when giving birth.
Germany has 16 health ministries to cover its devolved governments and overlapping health insurance schemes. French patients felt cheated if they did not leave a surgery without a prescription for three antibiotics at unnecessary cost to the insurance schemes and all the object of ferocious lobbying by pharma firms.
Because there was so much private sector money at stake in Europe, there was paradoxically much more application of precautionary principles in case a drug used turned out wrong and patients suffered.
In 2000, Tony Blair boldly announced Britain would so increase the NHS budget it would ensure health spending matched the then much higher averages in the EU. The Treasury tried to stop Blair but he powered through his neo-liberal ideology and over a decade there was a massive improvement in facilities and recruitment of staff – though, sadly, not a big increase in training of British doctors and nurses, as the Treasury insisted on recruiting already trained medical staff from the enlarged EU.
In 2011, a group of thrusting new Tory MPs – including Dominc Raab, Liz Truss, Priti Patel and Kwasi Kwarteng – produced a manifesto, Britannia Unchained. They argued the current NHS should be broken up and private operators should be allowed into the service and indeed should compete on price.
Again, luckily, Johnson’s old Oxford chum, Sir Simon Stevens, was put in charge of the NHS in 2014. He skilfully outmanoeuvred the NHS grave diggers now in the cabinet. He saved the NHS for the nation and now it is the envy of Europe. The millions waiting to roll up their sleeves for a jab should light a candle to the Liberal Sir William Beveridge and the left-wing Labour MP Aneurin Bevan, who thought up and brought in the NHS.
And Britain might think anew about whether the maxim of recent decades that private profit is good and public service is out of date maybe needs rethinking.
Denis MacShane is the UK’s former minister of Europe