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The NHS and the Tory Party – is it really true love?

Filed Under (Conservative party, Culture of the NHS, Health and Social Care Bill, Reform of the NHS) by Paul on 11-04-2011

This ‘listening exercise’ – even if it is not a serious attempt by the Government to change course – does give the rest of us two months to mobilise both policy and argument for sensible reform after this 11 month disaster.

So for the rest of April and May most of my posts will be trying to argue through the policy and practice of NHS reform in 2011.

But today one last crack at the Government’s shambles on NHS reform, and it’s inspired by the first page of their pamphlet “Working together for a stronger NHS”. Here they bring up love as a part of NHS reform, so I think that means I can discuss what we might mean by “love” in the current context.

I’m in my 60s so this post has to rely a lot on memory as well as a more than a nodding acquaintance with psychoanalytical thought.

It’s about falling in love.

Falling in love has become an integral part of NHS reform since the number 10 communications department published its pamphlet last week. It begins,

“We love the NHS. The NHS is our most precious national asset. Every second hundreds of people walk through its doors. Every week it saves thousands of lives. Every year millions of us rely on it.

We love the NHS because its there when the people we love fall ill. Because its there all the time. Because whoever you are, wherever you are from, however much money you have got in the bank, theres somewhere to go to get looked after. And because that says amazing things about our country. That why we love the NHS”

When the relaunch of a Government policy contains the word “love” four times on the first page, something a bit odd is going on.  It’s a policy for God’s sake. Most people I talk to are simply very cynical about the Government use of emotions and dismiss it, but over the weekend I have come up with another analysis which it may be worth exploring.

And to make sense of this we are going to have to get into an analogy where you as a reader have to remember the experience of building a personal relationship about love. Some of you (I hope) are doing that in your lives now. But for the rest of us we have to remember mainly the errors, but also how we managed on occasions to turn those errors into success.

For the purpose of this relationship you are the NHS.

You have had a 13 year relationship with someone who we will call, Labour Government. It had its downs ups and downs. Highs and lows.  You’ve grown quite a bit through the relationship – now bigger and stronger than you were before, but you also feel pushed around. Whilst your lover has been attentive, sometimes it feels much, much too attentive and you’ve felt like you are being both taken for granted and told what to do.  You want your own space. In any case over the last three years it’s felt like they don’t really know what to do with this relationship. Is it going anywhere?

Across the room is someone who in the past you didn’t like at all. And in truth he – Tory Boy – has spent much of the last few years taking the mickey out of you. Accusing you of wearing old fashioned clothes, being overweight (sometimes even calling you “bloated”), trying to say that you spend too much, and all the time wanting to replace you with someone younger, fitter and with a seductive US twang to their accent.

Then, over the last couple of years as the relationship with Labour stalled, Tory Boy became quite affectionate,

“Look, I’ve changed, I know I have been wrong in the past put I believe we can be really happy together. I will maintain your allowance at whatever amount your current lover gave you.

I respect you.

I love you for what you are and will not change everything about you, neither with a new set of reorganisation clothes, or a new diet. Forgive me for the past and believe me, people can change”

And actually of course that is true. People can and do change. Life moves on, different circumstances prevail in all our lives. And so you think  – let’s give them a limited chance. You’re anxious about this but think – OK let’s have a little look at what life with Tory Boy would be like.

You are of course flattered by the attention and the gifts. Wouldn’t it be lovely to get to know him? And he really is more interesting than old Labour.

It starts quite well. He rips up the list of rules that Labour had made that seemed to be telling you to do things that you would have done in any case. And it’s true – when the family budget gets tight, they keep your allowance and cut everyone else in the family. Even their favourite sister with whom they have lived with throughout their life, Ministry of Defence, loses money.  But they spend the same as before on you.

Then, after a few months in July, it seems to change dramatically. It had started in May and June – as always with comments about your weight – but in July his criticism of you becomes savage. He still says he loves you for what you are, but puzzlingly he wants to change everything. He writes to you saying that everything about you has to change. His love for you is the same as ever but,

  • You have to start training for a marathon and lose a lot of weight
  • You have to wear completely different clothes that all have American labels
  • You have to stop seeing all your old friends and just go out with his
  • You have to go on holiday with his friends from university who appear to have been in some awful club called the Bullingdon club and just seem posh
  • You have to change your taste in music and start listening to something that he won’t explain to you what it is – so you have to keep trying to guess.
  • You have to move your address to a flat in the centre of town
  • You have to ditch everything you know about medicine and become an accountant

This is all a shock. How can he love you for what you are but want to change everything about you? You try to see him, to talk about it but over the autumn he won’t come out of his room. He’s working on a plan to make you change. He just speaks through the door. “It’s all obvious. Work it out for yourself.” He won’t tell you why this is happening.

In the autumn that’s what you want to know – every day. Why? Why? Why? Do I really have to change everything? What about just keeping something, anything? But he is stern. He never tells you why but you have to change – completely.

In December he says he will come and have a chat with you on December 13th and explain. You remember how nice he was in the summer. You feel sure he is going to be like that again so you look forward to meeting him on December 13.

He turns up with someone called Bill. Bill is the person he has been working with over the autumn. He now says Bill will be your personal trainer, estate agent, accountant, clothes adviser and generally will run your life.

You ask if you can amend anything that Bill tells you to do, and he says NO NO NO! Bill is in charge there will be no amendments to what Bill says and does.

You have a really rotten Christmas. A lot of your friends have stopped spending time with you because they don’t like Tory Boy, and they like his new mate Bill even less.

But he seems such a nice person and loves you so much. He just doesn’t talk to you about his plans for you.

Then, in the New Year, a number of your friends get very angry on your behalf. They tell him very strongly that this is not good enough.

You have always known a lot of doctors. Most of the time they treat you as if they own you and you have learned over your lifetime that it’s important to keep some distance from them. But they really take against Tory Boy and they start to attack him in public on your behalf. They don’t trust him – especially the fact he seems to know some Americans.

Then your old lover, Labour Party, a bit chastened by his rejection in the spring of 2010, starts to attack Tory Boy for his hidden plans. Labour Party now sends you letters saying don’t trust Tory Boy, he’s just doing this so that he can move you to the US.

But you think that can’t be true, can it? Tory Boy has said that he loves you for yourself. He loves you just the way you are. But if he does really love you why does he want to change everything about you? If he really loves me for myself why change me so much?

From January onward Tory Boy’s friend Bill really starts to get his teeth into you. You can no longer go to the PCT every week and you have to have a new friend called Cluster. Bill says that you will now be bought by GPs and perhaps that won’t be too bad. Your whole relationship will be governed by somebody from school called Monitor.

Still Tory Boy won’t talk to about why he wants to change you. He still says he loves you the way you are but then he still wants to change everything. So given that he won’t tell you why all this is going on, you start to believe the doctors and your ex.

You become angry.

This feels like a lot of relationships you see around you. This looks like a classic problem and you realise that you don’t need to be Freud to understand what is happening.

Tory Boy doesn’t love you. He loves the idea of you. He really, really means it when he says he loves you – he is not lying. He does love you but he doesn’t know you.

In loving the idea of you – he is projecting something else onto who you are. Lovers often don’t bother with the concrete. They are in love with the abstract.

You think back over the years and realise that actually he has never really got to know you. It’s all idealised. He knows your birthday and that your favourite colour is pink, but he has never found out what really makes you tick. He has never found out that you are afraid of heights. He doesn’t know that you are both fascinated by new things, but that you are a real creature of habit. You realise that Tory Boy doesn’t know anything real about you – he just knows bits and pieces.

It’s really lovely to have somebody new loving you, but now you have realised that he doesn’t love you for yourself but for some vague old notion of what your Mum once was. Like the time you stayed in the cottage hospital and Matron came and looked after you, and there were people bicycling across the village green outside the hospital to get some warm beer in the pub.

But that’s not you. That’s an old, idealised version of you.

He loves that version and as if this isn’t hard enough, he also wants to change you into a slimmer model whizzing round the fast lane in a sports car.

You recognise that there is no reality in either the idea of you that he is in love with; or the one he wants you to become. It’s all a projection from within him, and to change from one fantasy to the other will be impossible.

That’s why he can’t explain it to anyone. Why he can never come out of his room to explain how you are going to change from idea a to idea b.

So in the last days of March you pluck up your courage go and knock on his door and say,

“Bill’s got to be stopped. He can’t go on telling me what to do. You have to listen to me about the way in which I want to live my life. Stop. Get rid of Bill and listen”

He gets angry but for once you hold firm. “I won’t go on seeing you if you go on treating me this way.”

There is much grumping. For a few days he says nothing has changed.

Then he says everything has changed.

Then he says – “OK for the next two months I will send Bill away and I will sit down and listen to you, your family and friends and see what they say.”

You are relieved. He is such a nice guy perhaps he really will. He has said he loves you. So you stay in that night and think a bit about what you want to say.

The next day you open the newspaper and see he has written you a public letter which says,

“I love you NHS. You are our most precious national asset. Every second hundreds of people walk through your doors. Every week you save thousands of lives. Every year millions of us rely on you.

I love you because you are there when the people we love fall ill. Because you are there all the time. Because you look after everyone. That says amazing things about our country. That why I love you”

He then goes on in his letter to make it clear that he wants to change you. You are left with the same confusion. He has told the world he loves you (four times) and yet he wants to change everything about you.

You disagree with both the doctors and your “ex”. You know that Tory Boy really does mean it when he says that he loves you.

But you also know that he doesn’t love you. He loves the idea of you, not the messy reality.

He has never really got to know you. Never explained to you why you have to change everything.

So what are the lessons we should draw from this story?

Firstly for the Conservative Party – it is much better to get to know someone before falling in love with them. I know Andrew Lansley has spent 6 years talking to the NHS, but the rest of his colleagues really don’t know anything about it and I have to say I don’t see what he has picked up about real life in those six years. You need to know who you both are, and what it is that you might mean to each other.

This gives you a chance of falling in love with a real person and not an abstract idea.

Given the Conservative Party’s general approach to life it’s difficult to see how they would love something,

  • Where all the money comes from national taxation
  • Where it is free to people at the point of need
  • Where there is equal access to all.

These are not natural things that people can believe the Tories love. So they are going to have to go beyond mere professions of love to demonstrative actions.

Secondly people find it a bit weird to profess love one minute and try and change everything about you the next. Of course when we fall in love there are sometimes a few things that we would like to change about our new love. But if it’s nearly everything and so rapidly, it’s hard to trust the love.

And if you do want to change things that your lover is or does, then you have to do it with them and not against them.

We will discover the some of the answers to this conundrum in two months’ time at the end of the listening exercise.

So from tomorrow – if they are listening – let’s all start talking to them.


6 Responses to “The NHS and the Tory Party – is it really true love?”

  1. An excellent piece of analysis and writing. Thank you Paul.

  2. love this piece!! brilliant and somehow hopeful. TPerhaps the NHS is like an awkward old uncle in current Tory thinking, someone they are supposed to love but don’t really, someone who they had to let go from the family firm to fend for himself.

  3. Paul, brilliant as ever!

    If this were ‘true love’, as you say, the ConDems would be helping the NHS to adapt to its evolving circumstances. Just as in life, a ‘lover’ should encourage and support the one they love, through every adversity. The ConDems do the opposite by bashing everyone’s morale and motivation.

    Moreover, it is insulting to want to ‘love’ an entity as they profess. Most of the people I know with polycystic kidney disease certainly do not love the NHS. They are extremely grateful for its free life-saving services but have to tolerate its poor ‘interpersonal communications’, its lack of care integration, its time-wasting inefficiencies, its GP gatekeepers, its poor record-keeping, its ‘doctor-knows-best’ attitude. Many people I talk come to our charity because the NHS has let them down.

    This current round of NHS reorganisation by Tory boy career politicians who have never done anything useful in their lives is wasteful and arrogant.

  4. Hi Paul
    Sonnet 116 springs to mind…

  5. Superb Paul, made me laught out loud, and thus enriching the lives of fellow passengers on yesterday’s 08.37 Abergavenny to Paddington. Thank you.

  6. Fantastic piece Paul. Both thoughtful and funny and clearly explains the emotional aspects of both parties’ relationship with the NHS.

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