‘We send the EU £350 million a week, let’s fund our NHS instead’.

Remember that one?


A clear case of misinformation

At the time of writing, we’re several years on from this infamous message, which was even more infamously printed on the side of a giant double-decker bus. This slogan was, of course, a part of the Brexit campaign helmed by now-PM Boris Johnson. In the year 2020, we’ve finally reached a point where, not only has Brexit occurred, but Mr Johnson himself has been placed at the head of 10 Downing Street. And yet, this staggering claim has never been followed up on.

It was thoroughly debunked that we ever actually spent this much on our EU membership, but no-one seems to have held the sitting government accountable for the misinformation spread by its leader.

The great election of December 2019 saw partisan fighting over NHS-related votes as if they were the last few chocolate bourbons left in a biscuit tin. Labour pledged to increase expenditure by an average 4.3 per cent a year. The Conservatives promised us 50,000 more nurses. And UKIP assured us that, if they were placed in charge, they would close the country’s borders to the supposed exploitation of the NHS by foreigners (overlooking the fact that as of January 2020 169,000 NHS staff are non-British — making that 13.8 per cent of all staff).

Our dilapidated ‘pride and joy’

It’s clear that the future of the NHS is a huge decider of elections in the UK. And why wouldn’t it be? Black or white, gay or straight, Northern or Southern, the one thing that almost all British people agree on is that the NHS is our pride and joy. And, as a nation with a deeply troubled human rights record, our health service stands tall as a beacon of hope, offering care that is free at the point of delivery since 1948.

But the constant use of the NHS as a bartering chip in elections has become a troubling issue. Anyone who has ever worked even tangentially to the health service can tell you that its workers are ridiculously exhausted, and that this is in great part due to the lack of clear national focus stemming from constant debate.

This blurriness comes straight from Westminster, where the future of doctors and nurses is decided by policymakers who may have little-to-no experience in a healthcare setting. It’s likely that many people making these choices don’t even use public healthcare, opting instead for more efficient private alternatives. This reduces their incentive to properly run the NHS even more.

The reader would be forgiven for thinking that there’s no real solution to this problem. That this is the way that politics has worked since the dawn of time. That dealing with this issue is a non-starter. But what if there was a way around this? A way to move power closer to medical professionals on the frontline, and to begin to make up for one of the NHS’s biggest weaknesses?

Merits of decentralisation

Ladies and Gentlemen: The Bank of England has entered the ring.

On May 6, 1997, history was made when the Bank of England became free from political influence to set interest rates as it saw fit.

(This sounds boring, but I promise it’s worth it!)

Interest rates are set in the UK by the Bank of England and are effectively the cost of borrowing (or the reward for saving). Higher interest rates mean that loans are more expensive. But they also mean that people who save their money in banks earn more from it.

Before 1997, interest rates (like the NHS) were a hot topic in elections. A key fact to remember here is that older people are more likely to save than younger people.

They’re also more likely to vote.

Cut to parties vying for the support of the older population by promising higher and higher interest rates. This was all well and good on paper, but the Bank of England has an important job to do; it needs to keep the UK inflation rate at a healthy 2 per cent per annum. This is an extremely careful balancing act that requires constant adjustment, but the big thing you need to know is that interest rates are heavily involved.

If the sitting government forces the Bank of England to raise these rates to appease voters, the balancing act could be thrown entirely off-loop. And this could cause economic ruin.

So, the decision was made to take politicians out of the equation entirely and to leave it up to the professionals. This was a monumental occasion, and has yielded positive effects for over 20 years afterwards. The Bank of England had finally become free to make the decisions it felt were best for the economy, and it did it through decentralisation.

What would a decentralised NHS look like?

Well, I’m not really sure. I’ll be the first to throw up my hands and say that I’m nowhere near qualified enough to be making these kinds of decisions. But that’s where decentralisation starts. By admitting that we have limitations and by finding people who know what they’re talking about. Such people could be senior doctors and nurses with years of experience in making do with a broken system. Then we give them power over their own hospitals. We also set goals for the NHS that they deem to be realistic, and we listen to the needs of its workers. Crucially, we no longer allow for political manifestos to contain flashy yet empty healthcare promises.

(I’d like to add that we don’t forget about the unsung heroes of our health service; porters, receptionists, cleaners, and various others. They do a great job, and their needs are also very important to consider).

I really like the NHS. I was born in one of its hospitals, like so many millions of others. And I recognise that without it, Britain would be a much darker place. So, let’s put aside our political views, no matter how hard they may cling to us in these daunting times, and help heal the organisation that has healed so many of us.