Only people well above retirement age will remember a gentle 1950s TV panel game called What’s My Line? Panellists would try to guess a person’s line of work from a mime and answers to ten “yes” or ”no” questions. Right now, Theresa May doesn’t seem to know what her job is. She spent too long as Home Secretary and still hasn’t woken up to her apparent promotion.

The Home Office

It’s been a truism of British politics that the job of being Home Secretary breaks politicians. In the last 25 years we have had 11 jobholders in that post. That’s an average duration of 2 years and 3 months. Theresa May stuck it out for 6 years (with Michael Howard and Jack Straw next, at 4 years apiece). That speaks to me volumes about May’s politics and outlook on society.

For a long time, I’ve believed that the Home Office is the most illiberal, dysfunctional of all the government departments. Even more this is true of its bastard offspring, the UK Border Agency, where asylum-seekers and would-be citizens have to navigate a nightmarish, Kafkaesque system to gain residency and citizenship rights. Anyone who has had any dealings with the system knows that the tabloid portrayal of Britain as an “easy touch” for immigrants is a gross, downright lie.

May is, I believe, a rather small-minded person with a strong authoritarian streak. I detect no real sense of empathy or genuine humanity – just like I view the Home Office. No wonder she lasted so long there. During this time, Prime Minister Cameron often repeated that Government policy was to reduce net migration into the UK to “tens of thousands”. This policy was absurd, as achievement was outside his control.

Possibly bruised by her experience of repeatedly failing to meet Cameron’s daft immigration “target”, May appears to be over-obsessed about immigration. May has swallowed whole the argument, put forward by UKIP, her Europhobic flank and the rabid tabloids, that the referendum result implies reducing immigration is a top priority in the EU negotiations. There is no sound reason to draw this conclusion.

Motives for Voting “Leave”

Let’s unpick this assumption a bit. The referendum produced a binary result to the question whether the UK should leave or remain in the EU. It stands to reason that voters on both sides would have had a variety of reasons in mind when voting. I’m unaware of any convincing research as to what those reasons actually were. Let’s try to list those of the “leave” voters, in roughly ascending order of merit:

1. Bigotry: racism and xenophobia: sadly, there is still a minority of people who fit this category. They are implacably opposed to the EU and all its works and their opinions are fixed firmly. A few of these are those responsible for the rise in hate crimes since the referendum. Clearly, all people with such a reason would wish to see a drop (to zero, presumably) in immigration.
2. Credulity: the referendum saw politicians in the leave camp at their most mendacious: I have never known so many blatant lies. This followed 40-plus years of lies, distortions and propaganda from sections of the media (you know who). I have to keep reminding myself that many – most? – people do not take the degree of interest in politics that I do. Such people may be more willing to accept these lies as the truth. A difficult-to-quantify proportion of these will agree that immigration should be reduced.
3. Post-imperial hubris and delusion: Likely to be skewed towards older voters, there are many Brits who continue to live in the shadow of our airbrushed imperial past. They hold instinctive views that we can relive our former imperial glory and be better off going it alone. Probably a majority holding these views would wish to reduce immigration, since, obviously, the British are better at doing things than Johnny Foreigner – despite vast evidence to the contrary.
4. Resistance to change: I would guess there’s a far greater number of “leave” voters in this category. Too-speedy change to the composition of a community can be disconcerting and a proportion of people will be opposed. It’s likely a significant proportion of this group would want reduced immigration. Some may not: they may see the economic and key skills benefits of migrants, as long as there are not too many in their back yards.
5. Desperation to be heard and for a change from the status quo: Much has been heard about this group and their vulnerability to populist siren voices. There’s a partial overlap with “credulity” in that they’re likely to have allowed their anger about “elites” to be diverted away from those people and policies responsible (bankers / free market fundamentalism) to the “faceless bureaucrats” in Brussels instead. There’s no obvious way of guessing the importance they attach to immigration as part of the problem.
6. Socialist dreamers: There is an honourable reason to want Britain to leave the EU, exemplified by the late Tony Benn. This is that the EU has been “captured” in ideology by the free market fundamentalists. Britain would be better going it alone with a (presumably Labour) Government introducing legislation which restores the balance of rights to employees and poorer members of society. Control of immigration hardly enters this line of reasoning. Attractive as this idea may be, I suspect this isn’t going to happen any time soon. The greater danger was spelled out by Phillip Hammond threatening to turn the UK into a tax haven with even fewer rights for workers and the poor and a further erosion of our tax base.

Of course, an individual voter may have weighed up several of these factors and some have clear overlaps. But there’s nothing to suggest that immigration is the top concern of Leave voters. When you add in the 48% who voted Remain, the argument for prioritising immigration over the economy – or anything else – falls away entirely.

Read the Job Description!

For me, this all leads to a straightforward conclusion. May was in her comfort zone as Home Secretary. By definition, her brief as Prime Minister is much wider. Viewing the EU negotiations from the perspective of her previous job has led to a grievous consequence. She has, without perhaps realising it, surrendered to the view of the most nauseating and bigoted of the extreme Europhobes in her own party and to the even more nauseating populist slimebags in UKIP.

In short, Theresa May clearly falls a long way short of the Job Description for the job as Prime Minister of the UK. As predicted, she has now lost the Supreme Court appeal – at great expense and waste of time. Let’s hope that members of parliament will help her to understand she is not some medieval monarch, but the Prime Minister of a 21^st century democracy.

The Red Cross, not known for exaggeration, calls it a “humanitarian crisis”. The “it” is, of course, the state of the NHS and its A&E services in particular, as winter takes its toll. Three times as many NHS trusts are in deficit as a year earlier, key targets such as waiting times are being missed on a spectacular scale.

The NHS remains one of Britain’s most cherished institutions. And yet, it seems that significant numbers of the electorate are very slow learners: The Tories can’t be trusted with the NHS!!

On the Cheap

Britain has been getting its healthcare on the cheap for a long time, compared with similar countries. The graph below compares spend on healthcare (as a percentage of national income: GDP) of around 30 countries:

It can be seen that most of our comparable countries in the developed world spend more than the UK – the USA spectacularly so. The obvious consequence of this is that the NHS is less well-resourced than its main European neighbours (but not the USA! – see below).

The degree of goodwill shown by NHS staff in maintaining the system becomes apparent when you see the relatively thin provision of key staff: doctors shown above and nurses below. (NB: no / incomplete nurses data for the Netherlands and Italy.)

But perhaps the most shocking of all is Britain’s incredibly low provision of hospital beds: see below. When you add in the “bed blocking” caused by draconian cuts in social services budgets over the past few years, it’s easy to see why “running out of hospital beds” is a daily news item. It’s not just the cold weather and feckless patients, it’s the result of government policy.

The US Confidence Trick

It’s perhaps worth pointing out something else that jumps out of these graphs. That’s the spectacularly poor performance of the USA healthcare system. Despite the eye-wateringly high spend, Americans get very little for their money – as the graphs above show in terms of doctors, nurses and hospital beds. US life expectancy is lower than the UK and EU average, its infant and post-natal mortality rates are practically third world standard. A stark warning is the fact that a significant faction of the Conservative party wants to undermine and destroy the NHS to bring in something more like the US system. Clearly, the Americans are being conned big-time. Their dollars must go to the fat profits and the spending on major lobbying and propaganda campaigns of the private US healthcare companies. You have been warned.

Recent Healthcare History

All the above information shows how Britain compares to similar countries, using the most recent data available to the OECD. A historical perspective of trends in healthcare spending in the UK is also instructive, as the graph below demonstrates. Background colours on the graph represent Labour (pink), Tory (blue) and Tory / Lib Dem coalition (green) governments.

From the 1950s through to the mid-1970s, both Labour and Conservative governments followed similar policies in terms of funding the NHS. Spending rose slowly in line with longer life expectancy and a wider range of treatments available. The period of decline in the late 1970s can be attributed to shock to the economy of the oil crisis and the five-fold increase in the price of oil. The jump up in the graph in 1980, shortly after Thatcher won the election, is not due to an increase in spending on the NHS. Rather, it is due to the sharp drop in GDP; Thatcher’s monetarism experiment resulted in a sharp recession, wiping out much of British manufacturing industry and the steady jobs with them – never to return.

Spending was stagnant through the 18 years of Tory government, mostly falling slowly under Thatcher with a slight compensatory rise under John Major. When Tony Blair won the 1997 election, spending was under 6% of GDP, whilst average spending in the rest of the EU had steadily risen to over 8%. Blair pledged to bring NHS spending up to the level of the EU average: a 25%-plus increase overall. The graph clearly shows a rise to nearly 8% by the 2010 election, but the EU average by then was approaching 11%.

Under the 2010-15 coalition, spending was stagnant, despite the continuing increase in demand due to increasing longevity and new, expensive treatments. The graph shows the forecast decline for the Tory years to 2020. This forecast is made by the respected, expert medical charity The King’s Fund, based upon stated government policy announcements. No wonder that Simon Stevens, Chief Executive of NHS England, told the House of Commons Public Accounts Committee on Monday that Theresa May’s assertion that the NHS was getting all the funding it wanted “stretches it” – “it” being the truth. That’s polite speak for pointing out she’s a liar.

Tory Private Healthcare Links

The figures above speak for themselves: Tory governments since the 1980s tend to underfund the NHS. The institution is still much loved by the UK public whereas, to some implacable free market Tories, it acts as an inconvenient contradiction to the “truth” that private provision is always better than public. Add to that the many Tory MPs with vested interests in private healthcare providers: see this 2014 Daily Mirror article, for example. (It’s interesting – and disturbing – to note that many people in the Mirror’s article have now moved to government posts closer to healthcare and cabinet posts since the article was written.)

Which brings us full circle to my original point: how much more evidence do people need that the Tories cannot be trusted with the NHS?

Serious attempts are being made to formulate some kind of non-partisan, consensus policy-making to secure long-term funding for healthcare in this country. Indications so far are that May and company are resisting this: she appears always to want to have her own way and dismisses, rather than listens to, dissenting voices. Failing that, we will need some organised, grassroots political movement to get the Tories out of office before they destroy the NHS completely. The fightback must begin – soon.

Welcome to my one-hundredth blog post.

It became something of a standing joke in our household. Whenever something went wrong, I would say “I blame Margaret Thatcher”. The joke has long since worn thin: I get a withering look if I still use it. And yet, in some important ways, I do still blame Thatcher. Let me explain.

All human beings (or at least the psychologically healthy ones) have a mix of selfishness and compassion for others. (One of my earliest posts, Being Human II: The Four Cs, goes into more detail.) But there’s clear evidence that the balance varies from person to person. But the problem is that the economic theory which has dictated government policy globally since the early 1980s does not recognise this.

Triumph of Greed

The rise of the new economic orthodoxy began in earnest under Thatcher in the UK and Reagan in the USA. Even though the main development in the thinking was in America, (and specifically the University of Chicago) I would argue that Thatcher was the true champion of the new thinking. Reagan, the “Great Communicator”, never appeared to have the intellectual capacity to understand the significance of these ideas and went along with Thatcher. He would presumably have been comfortable with the Orwellian “private sector good, public sector bad” bit of the new creed.

My post Two Castles (part 2), published 12 months ago, explains the two falsehoods upon which our entire economic order since the 1980s has been based. Briefly:

• Falsehood 1: material self-interest is the only motive driving human behaviour when making economically-significant decisions.
• Falsehood 2: people behave rationally when making such decisions.

Cambridge economist Ha-Joon Chang provides excellent rebuttals in his excellent 2010 book 23 Things They Don’t Tell You About Capitalism. In his “Thing 5”, he lists several alternative motives to that in Falsehood 1: honesty, self-respect, altruism, love, sympathy, faith, sense of duty, solidarity, loyalty, public-spiritedness, patriotism. (Doesn’t that sound more like real human beings?) His “Thing 16” goes into great detail about all the reasons people cannot have access to all the information in most of the decisions they make, in order for them to be rational.

Thatcher didn’t question the tenets of free market fundamentalism. Its prescriptions: free markets, small government, low taxes, fitted with her prior world view. But those tenets got boiled down into “Greed is Good” and a whole load of evils have flowed ever since.

The Rise of Finance

Deregulation of the City of London in 1986 led to the enormous growth in scale, reach and innovation of financial services. The new financial “products” (a daft term, if ever there was one) were practically all socially useless or downright harmful. Instead of providing steady, patient funding to allow promising new companies and industries to grow, City money was pumped into financial speculation (“gambling with other people’s money”) and property bubbles. This has had the effect of putting London houses out of reach of people with “ordinary” jobs and facilitated a massive money-laundering racket of the world’s worst fraudsters and racketeers. The UK’s appalling productivity record is one consequence of this.

The City was the first sector of the UK economy to really pick up on “Greed is Good” and led the way in pursuing policies which led to the short-term profit of the companies and individuals involved, regardless of the wider economic consequences. Insurance companies were first to pick up on the idea of a “loyalty penalty”, using their existing customer base as a cash cow for exploitation, punishing those too “lazy” to switch suppliers on every annual renewal. The privatised utilities, operating in a false market that was not really competitive, made money by exploiting the same tactic and making tariffs too complicated for customers to make comparisons with competitors. Policy capture is now so complete that government policy is now to “force” customers to shop around rather than tackle the predatory behaviour of the suppliers – even to the point of encouraging more junk calls from competitors.

Destruction of Manufacturing

The UK now has the lowest proportion of its economy in manufacturing of the major developed countries: 11% against 15% for the EU as whole and 12% for the USA. From Thatcher onward, government economic policy was biased towards the interests of the City. Broadly speaking, what’s good for finance is bad for everyone else: financial services, unlike the “real” economy, lead to a zero sum game. So the rise in finance damaged manufacturing. But Thatcher also hated any competing source of political power: specifically, in this case, the trade unions. In her desire to smash the unions, swathes of manufacturing capacity were also lost. Once the jobs are gone, so too do the expertise and the machine tools. Then there follows the decay and demolition of the factories themselves. So easy to destroy, so hard to rebuild.

Job Insecurity and the Gig Economy

With the significant reduction in Trade Union membership and a succession of anti-union legislation, some inevitable changes happened. Standards of protection of workers’ rights have fallen. This in turn has led to the rise in poorly paid, insecure jobs and zero-hours contracts: the “gig” economy. The “Greed is Good” mantra has been taken on board in a big way by CEOs and top managers. Pay rises for those at the top have well outstripped inflation; lower paid workers have seen stagnant real pay. Income and wealth inequality are back to levels last seen in 1914.

Nationalist Populism and the Rise of the Extreme Right

Politicians in the UK and elsewhere – particularly in France, the Netherlands and the USA – have taken up the “Greed is Good” theme. Blame for the bad economic deal for the many has been successfully deflected away from those responsible to others: the poor, disabled and immigrants. The EU referendum and US presidential election results are the culmination – so far – of this trend. I fear worse to come in France next spring.

These “victories” seem to have stirred up some of the nastiest individuals – racists, bigots, homophobes, Islamophobes – and to have spurred on their cheerleaders in the press, TV and online. The screaming, emotional, irrational hysteria of the Mail, Express, Sun, Breitbart, Fox News and their ilk drown out calmer, more rational voices.

And I think there is a direct line of causation between all this, via Bush Jr’s military adventurism (with Blair as poodle), Osborne and Duncan Smith’s misrepresentations about benefit fraud, Johnson’s lies about the EU, Farage’s …well, everything… and the tone and direction set by Thatcher in the early 1980s. As Chang says in his book: “Assume the worst about people and you get the worst”.

And Yet…

The good news is that the people as a whole still have much more generous a spirit than is reflected by their governments’ policies. A recent survey by CAF shows the USA as having the second most generous people in the world (after Myanmar) with the UK coming eighth: the highest in Europe. The decent people just have to get a voice and get organised. It’s high time we started to push humanity back from the brink. Damn the legacy of Thatcher and keep the faith in human nature!