A friend of mine has been asking a lot of questions about the elections on Facebook. In a chat, she asked this:

“Would you personally prefer the NHS to be looked after by Labour, Conservative or Lib Dem?”

So seeing as she is taking the election seriously I’m taking her questions seriously.

It’s a really good question. Please be aware that the answer is long. It’s complicated. But I think it goes to the core of why this election is important. 

It’s comforting, given much of the noise surrounding politics. particularly the ad hominem insults.

Anyway, let the mansplaining begin.

Definition of an ad hominem attack:

“whereby genuine discussion of the topic at hand is avoided by instead attacking the character, motive, or other attribute of the person making the argument”

souce: Matthew Syed, via Wikipedia. He is a table tennis champion and a journalist. This doesn’t make him right and it doesn’t make him wrong. 

I think a certain amount of ad hominem hostility is natural. A murderer, for example, or someone who was sacked by a newspaper for dishonesty, or who has a track record of lying, might reasonably be expected to lie again. 

The problem is that people who lie are also masters at ad hominem attacks. They know their audience.

Whatever your views, insulting the idiocy of the person with the perceived incorrect view is unlikely to change minds, based on what we know about behaviour change theory. People change their minds gradually and in stages, with contradictions and insults relating to current thinking usually not effective. 

Lots of people look to attack the argument of the person by finding flaws in that person’s background…

Looking at someone they disagree with to find chinks in their armour – like they have a posh voice, or eat their bacon sandwich the wrong way, do a certain job, or their hair is a bit scruffy, or they have a weird shape neck, that’s an illogical ad hominem attack.

Who the hell are you, anyway?

Me? As it happens I’m state-educated but went to university when it was still relatively cheap. I’ve voted for three of the major parties: I’ve even had a Thatcherite phase, when I was too young to vote.

I’m still only 90% sure who I’m going to vote for, for what it’s worth. It’s probably not the party I canvassed for at the local elections.

I’m pro NHS, and I wrote about the joy of tax before I heard there was a whole book about it:

Beware ad hominem justifications too:

‘I’ve been a teacher for thirty years and…’

‘As a parent…’

Experience in a particular field is useful; but unless there is agreement amongst people in this group it does not suffice as a dealbreaker when you are trying to prove someone else is wrong. Which brings us to something that has worried me a lot lately:

lots of political debate ignores the fact that things can be simultaneously true

There are great debates to be had, but social media tends towards short, simple statements which tend to work as confirmation bias rather than illuminate an issue.

Take Grenfell. I think it is deplorable that long term underinvestment in cladding could lead to the deaths of people. 

It is simultaneously true that there could have been mistakes made in the way that the fire was dealt with. 

It is simultaneously true that firefighters are incredibly brave and saved many lives. 

And so on. 

But people are inclined to cherrypick a single element because it fits in with their political or ideological viewpoint.

Here’s a list of some simultaneously true things about the NHS, etc:

(and please note I’m using the phrase Big Pharma in a neutral way, neither to attack nor support the big pharmaceutical companies)

1. Medical inflation exceeds regular inflation
2. This is for a lot of complex, interconnected reasons, some of which are unconnected to party politics… for example…
3. America is increasingly litigious. Thus Big Pharma has to make more from drugs as people sue them more, so the cost of drugs outpaces inflation
4. Big Pharma has to make more from drugs as shareholders demand it
5. Big Pharma has big overheads, and attracting decent scientists, building labs, carry out trials, etc, is very expensive
6. We are living longer and that’s a sign of successful medicine, public health and lifestyle choices
7. An ageing population means that the NHS will cost more
8. Prevention is better value than treatment
9. Many voters see spending money on prevention as frivolous, particularly when their tax dollar goes to media companies
10. Apps can be a part of prevention
11. Many of the firms that make apps are more interested in maximising profits than patient wellbeing
12. If people avoid tax, the burden for it falls on people who do pay tax
13. Even those companies that pay no tax here, but make profit, benefit from a healthy workforce
14. If the economy tanks the NHS is proportionally more expensive
15. Whereas many British people are used to seeing the NHS as a resource for the people, many people  are looking at it as a potential revenue stream
16. Many people on the political right see health care provision as being best delivered by the private sector
17. Personally, I strongly disagree with 15) based on my own observations of setting up a justgiving site when I was raising money for a charity
18. Neither major party is good on the economy. The highest interest rates (1981), the highest ever unemployment rate (1984), for example, all happened under Tory governments
19. But the biggest factor in the UK’s economic health tends to be global – with a few notable exceptions, like the disastrous Lamont ERM moment, or the Brown bullion sell-off.

Point 1) gets important when you start to look at figures and spending pledges. Think of the NHS as being like a middle-aged person trying to keep fit…you have to put in extra work to stay the same, to improve you need to do extra extra work.

It’s very complicated. I just skimread a report, called:

Comparative Life Cycle Assessment of an Artificial Christmas Tree and a Natural Christmas Tree

It’s a deep-dive, into what kind of Christmas tree you should have. This is how complicated the world is.

And why the alarming rise of populism scares people like me.

In a world which is more connected and complex than ever, leaders who simplify, blame, and chant are a dangerous breed.

We have these on all sides of the political spectrum.

In other words….beware false binaries 

I saw a re-post about the NHS, posted by my Mam’s best friend.

You wonna save the nhs? Then educate yourselfs, stop going to gp for stupid reasons, stay out of a+e unless it’s an actual emergency, start taking reposibility for your health and your families, don’t drink or take drugs to such and extent that your organs fail and stop eating so much that you become a health hazard.

[spellings are theirs]

The thing is, it kicked off an argument where it was originally posted. Because the post seemed to some people to criticise the NHS. Maybe the poster hated the NHS.

But all of the things mentioned above can be true along with the simultaneously-true statements:

‘the NHS is under threat’

‘many Tory MPS genuinely believe in the NHS’

‘a party which has a track record in selling off publicly-owned utilities, is unlikely, in the long run to care so much about preserving the NHS’

‘there are people who seek to dismantle the NHS, including commercial interests who would benefit from this’

…and so on.

You are voting for ideas, as well as MPs

People on the political right have an ideological commitment to free trade solutions and to reducing the size of the public sector, and increasing the size of private sector. It’s their stated aim.

The Conservatives (and to a degree New Labour) privatised utilities such as water and gas, sold off council housing, fire stations, as well as parts of the prison service, and various government bodies I hadn’t even heard of till I started working with them.

This is a global trend. But not evenly distributed throughout the world.

So the aim of many on the political right is to reduce the size of the NHS. 

In the long run, this will either:

a)   introduce the efficiencies of the private sector into the inefficient dinosaur that is the state-funded NHS 

b)    allow unscrupulous private firms to exploit health care and make money for shareholders at the expense of ordinary folk, like in America

This time, the two statements can’t be simultaneously true.

5 to conclude

My opinion is that public service ethos is important to areas like nursing and health.

The NHS needs to change, and evolve.

I think it is easy to criticise the NHS, as it’s one of the biggest organisations in the world. There will always be horror stories.

It needs more funding than ever.

For most people in the UK, it’s logical UK to support the NHS.

It’s not rational economic choice to not support the NHS if you are so rich you’ll always be able to afford private care… this is a fairly small category, but an influential one.

Many people in America think they will always be rich enough to afford medical insurance, a life event happens, and they find themselves begging for cash on JustGiving.com.

Personally, I think the NHS is a miracle and worth fighting for. 

The evidence I’ve seen suggests the Tories can’t be trusted on the NHS. There is a healthcare crisis, which can’t be solved by Brexit, privatisation, tax cuts, false claims over nursing numbers; nor the influence of countries with a much more mature private health care infrastructure and the likely price hike of medicine following uncertainty over trade deals.

I don’t know who I’ll vote form but it will be a vote to keep the Tories out.