With the NHS, reality has finally caught up with Theresa May

This article was taken from: https://www.theguardian.com/commentisfree/2018/jan/07/nhs-falling-apart-theresa-may-evasions-crisis

By Zoe Williams

The prime minister’s evasions and blandness used to work. But the winter crisis has left her floundering, and with no plan to end the misery

It was like watching an anxiety dream: you’ve been made prime minister, but you don’t know why. Andrew Marr is interviewing you on the BBC, but you haven’t been briefed on anything. Your syntax is wild and a snarl keeps creeping into your smile, like an unexpected wolf in the forest you’ve forgotten to plant.

You promised to plant a million trees, and you haven’t even started. The planting is meant to be the quick bit: waiting for them to grow is what takes all the time. Where did you even put the seeds? The questions won’t stop: your answers become more and more inane. “What I see when I look across the railways is people wanting to provide the best service”; “The environment is about a huge variety of things.” What does any of this mean? Even you have no idea.

You can say what you like about Theresa May, but the fact that she keeps on keeping on is astonishing.

In 2016, Peter Bull, a psychologist at York University, published analysis of political interviews in which Theresa May emerged as the prime minister least likely to give a plain and practical answer to a question. In two interviews he studied, she gave a direct response only 14% of the time (the average for a politician was 46%).

Her peculiar formulation – to rephrase a specific question into a non-specific matter of bland principle, then agree with the platitude – appeared to work frustratingly well, for a vexingly long time. Suddenly, though, it has stopped working. This is partly because she seems to have lost all confidence in her replies; but mainly, of course, because reality has caught up with her. Nowhere is this more apparent than with the NHS.

The cancellation of scheduled operations this winter was “part of the plan”, according to May on today’s Marr show, which she thinks makes it OK; if it had been done on the hoof, that would have been chaotic. You could argue that the definition of a functioning health service is one that’s able to cope with emergencies and non-emergencies simultaneously, but you’d be wasting your breath, since even on their own terms they’re failing.

“It’s about making sure that those who urgently need care are able to get care when they need it,” May stated tortuously – yet the urgent cases for whom the less urgent are making way aren’t being treated properly either.

Marr raised the case of Leah Butler-Smith – whose mother, having had a stroke, was kept waiting in an ambulance outside a hospital for four hours before she was admitted. News of an 81-year-old woman who died waiting for an ambulance presumably hadn’t reached Marr ahead of the interview, since that picture of a nation failed by sustained spending cuts across its essential services is even more graphic.

“If you look across the NHS, experience is different,” the prime minister flailed, as if the fact there wasn’t a stroke victim waiting for four hours in an ambulance outside every hospital was proof of her competence. “Experience is different,” she repeated, taking a moment’s refuge in a new evasive tic, of turning everything into a passive voice where nothing is the consequence of anybody’s actions. We’re just a nation of people having a set of experiences which are all different, and everybody’s working very hard because we all want things to be good.

May’s most luckless task should have been executing Brexit; but it was inevitable that, having ploughed all her attention and resources into that splenetic and unmapped project, it would be her failure to carry out the day-to-day business of governing that would bite her first.

The health service is plainly in chaos. Hospitals across the country, from Somerset to Nottingham, Kent to Cornwall, are at operational pressures escalation level (Opel) 4, previously known as “black alert”, a state in which trusts are “unable to deliver comprehensive care” and there is “increased potential for safety to be compromised”. The managerial language does nothing to obscure what this actually looks like: hundreds of people stranded on trolleys and in ambulances, people dying in waiting rooms. “Where multiple systems in different parts to the country are declared Opel 4, national action should be considered,” the guidelines state.

Confronted with this crisis, the prime minister makes the nonsensical assertion: “Consistently, where we’ve felt that it did need more funding, we have put more funding into it.” Everyone knows this to be untrue – or perhaps the government simply didn’t “feel” that the black alerts were all that significant. “You keep talking about money,” May told her inquisitor. She wanted to talk about innovation; but she didn’t, not really. Her idea of innovation is everybody cooperating with one another, which is about as novel as illness itself.

Such Conservatives as do recognise the extremity of this crisis like to call for an “honest conversation” about what we can actually afford. It is an underhand rhetorical manoeuvre, since the only honesty missing from this debate is from the government itself.

There is no dissemblance from the nation at large. We want health spending per capita to meet, at the very minimum, the OECD average. We want universal provision, and we don’t want anyone to make a profit from it, not because we dislike Richard Branson personally but because we think to profit from another’s misfortune is immoral. We want doctors and nurses to be treated fairly and with respect. We don’t want nurses to have to use food banks.

These principles, give or take the food banks, which are a Conservative “innovation”, were enshrined in the foundation of the NHS, which has been consistently hailed as the state creation of which British people are most proud. It isn’t complicated or contested territory. A government that wants to deviate from it must justify itself; blaming an “ageing population” won’t cut it. A bad government blames its citizens, but citizens can blame back.

It is to Theresa May’s credit that she has the self-awareness to unravel of her own accord, losing faith in her rhetoric even faster than her opponents can attack it. It was, without compare, the most rambling, directionless, insecure and inarticulate new year’s interview a British leader has ever given. It was like a political seance: vague answers and forlorn delivery, a signal to the living that it’s time to  move on.