The Spectator’s Notes | 28 June 2018

Gordon Brown, echoing Aneurin Bevan, says that the greatest gift that the NHS brings to people is ‘serenity’. He is surely right that this is what it brought 70 years ago — for the simple, important reason that people would no longer need to say of treatment, ‘I just can’t afford it’. But comparable ‘serenity’ is provided, in different ways, in, for example, Germany, the Netherlands and Australia. Defenders of today’s NHS have to explain not why it is more serene than pre-1948, but whether it matches the current arrangements of comparable countries. ‘Serenity’ is not the word one would apply to many British hospitals today. In these Notes last week, I mentioned the fear felt by the old. I did not mention one key reason for it. In a nationalised bureaucratic system, each patient is a cost. So the NHS is exactly the opposite of, say, a restaurant or a plumbing business, which lives by getting more customers. A cost is a burden, and so the system instinctively identifies those costs which are most burdensome and easiest to jettison. These are the old. Thus a feeling seeps through the machine that the old are to be fobbed off, sent home, neglected, drugged up or, in the worst cases (if stories like that of Gosport are indicative), put to death. However great the kindness of individual staff, the internal logic of the system itself is ruthlessly cold-hearted.

Media bias consists not so much in the exact words of a report, but in how it is framed. Ask of any story, ‘Who is being put in the dock here?’ and you will soon see where the bias lies. A current example is the horrible war in Yemen.