Thursday, 7 June 2007

Is the NHS eroding our civil liberties?

Tuesday's Times reported on its front page a headline on the proposed 'Crackdown on middle class wine drinkers' that Boris Johnson has since kicked up a storm on his blog, as doctors have been renewing pressure on this already legislation-happy government into imposing higher taxes on alcohol sales and providing more 'safety' warnings on labels. It represents a fundamental shift in Whitehall policy towards drinking, which in the past has focused on underage and anti-social drinkers. It also represents an unwelcome return of that old familiar stench 'the man in Whitehall knows best'. With this change, policy no longer rests on merely enforcing the law and protecting the public from violent individuals - it is taking the very odious decision of protecting the public from themselves. Not content with deciding for responsible adults (and employers) when and where they may smoke, doctors and ministers are now seeking to control how much individuals should drink in their own homes for their own good. A Whitehall source told The Times that they wish now ' target the older drinkers, those that are maybe drinking one or two bottles of wine at home each evening' before woefully adding that they simply 'do not realise the damage they are doing to their health'!

Now, although this writer is all in favour of shifting income tax onto indirect taxation, we all know this is not going to happen. This pernicious tax would simply add to the public's burden and is nothing short of a naked attack on individualism and personal responsibility - two things that are already sorely lacking in this country. For while the pen-pushers at Whitehall wither over their charts and statistics, the reality is that it is the responsible lower-middle income drinker that will suffer from this ludicrous piece of nanny legislation. It does not even hold the shred of authority that the smoking ban claimed - namely, protecting non-smokers from the passive smoke they do not choose to inhale - and yet the head of science and ethics at the British Medical Association still felt confident in her assertion that 'It is not the nanny state. It is about informed choices'.

But the truth is it is about neither. The root motive of this, and by extension all nanny health legislation, is money. More specifically, the ailing NHS's money. We have to ask ourselves seriously; why else should the man in Whitehall really be so concerned with our health? The Times reported in same said article that 'ministers wish to highlight the increasing burden that drink-related disease is placing on the NHS...estimated to be costing between £1.3 billion and £1.7 billion [a year]'. So there it is. In black and white. It's because it costs them money. Though technically it's our money. So instead of having the individual responsibility of drinking reasonably in order to avoid large personal medical costs, we must be chastised and taxed collectively by the state to make sure we're taking good care of ourselves and aren’t doing the terribly selfish thing of costing our neighbour money.

In this sense the health service stands out as the last socialist holy cow to survive the Thatcherite era. It is the last post-war institution to be maintained despite making zero economic sense, racking up enormous public debts, and by proxy eroding individual responsibility through more and more government legislation. British Gas, British Airways, British Rail, British Waterways etc were all privatised for these very reasons, and although Mrs Thatcher would very much have liked the NHS to follow, realpolitik of the time made this an impossibility far surpassing the 'troubles' of the Poll Tax. However, with Tony Blair's Labour government having 'alleviated' more and more of the health service through the Private Finance Initiative in the last 10 years, perhaps it is time for complete privatisation to be (very gently) put back on the table.

It needs to be addressed that - wonderful an idea as it was, and great things it has nonetheless achieved - the stark reality is that the NHS is unsustainable, that it has become a monster with an insatiable appetite for vast amounts of money that seem to go nowhere. It has proved itself unable to cope with the challenges of an ageing population in the aftermath of the post-war baby boom. While more and more medical care is needed and new treatment becomes more and more expensive, our population and ergo tax revenues decrease. This has placed the health service in a situation of perpetual decline, while the taxpayer is paradoxically forced to cough up more and more of their earnings for a worsening service. In business this would be called a diseconomy of scale. Added to this - as Whitehall are attempting to point out - the responsible drinker ends up paying for the reckless indulgences and misdemeanours of others.

On the other hand, privatising the health service would enable the government to massively slash income tax - giving the public the free choice of where to place their hard earned cash and removing the fiscal motive for Whitehall poking their nose into peoples' decisions. A private firm would in no way be worried about the strain placed on their resources by people who wish to drink more than they should, and the subsequent treatment would in fact be welcomed as good for business. The government would no longer have to worry about taxing the public into good health, nor would it feel the need to emblazon bottles of wine with large ugly health warnings because it would no longer be any of their concern. Such a huge reduction in the scope of government and of nanny statism - which is only ever a few moral panics away from police statism - can only be seen as a victory for liberty.

Of course, it would be a difficult campaign to fight - the health service is somewhat of a Pandora's Box in that when you're seemingly getting something for free, you're not going to want to give it up, even if it is in a terrible mess. Nigel Lawson is said to have called it 'the national religion' [1]. But in the campaign that will no doubt soon need to be fought, it needs to be addressed to the people that the problems the NHS is now causing outweigh its benefits in the modern day, particularly in regard to personal choice and responsibility. No longer should the prosperous, the responsible, the frugal, hard-working and law-abiding citizen be held back by paying for the reckless, the idiotic, the short-sighted, and criminal members of our society. This writer remembers very vividly being taught Aesop's story of the Ant and the Grasshopper at school, yet wonders what on earth is the point in teaching children such an important lesson if the Welfare State is going to be there to work for you just in case you decided to ignore it?

In June 1945 - campaigning against the socialist future of welfare and equality Attlee's Labour Party were proposing - Winston Churchill warned the nation that however benignly such a doctrine was conceived, maintaining it would nonetheless

...gather all power to the supreme party and party leaders, rising like stately pinnacles above their vast bureaucracies of civil servants, no longer servants and no longer civil...nip[ping] opinion in the bud. My friends, I must tell you that a socialist policy is abhorrent to the British ideals of freedom.

Churchill was laughed down at the time - with the utmost respect of course - as an old-fashioned reactionary conjuring up fantasies of totalitarianism to preserve the imperial Britain everyone else was fairly certain was coming to an end. Yet, in a time when the authorities are able to shoot dead an innocent man in a tube station [2], or break into an innocent Muslim’s home during the early hours and shoot him [3] - all for our own good, these words may demand review. The NHS is the last bastion of this socialist future Churchill warned against - it continues to place government in a position of over-reaching responsibility - and thus power - to interfere with peoples' lives for what it believes to be for their own good. As Milton Friedman observed, the worrying thing about this is that 'the power to do good is also the power to do harm...[and] even though the men who wield this power initially be of good will...those who control the power today may not tomorrow'.

This writer is not for a moment suggesting that privatising the NHS would somehow magically restore Britons' lost civil liberties or instantly reduce the scope of the state in our lives. Not at all. But it is the cold hard truth that it was this post-war craving for a strong, far-reaching and powerful government to enforce equality that got us into this mess in the first place. In the words of David Bowie's chilling homage to Nineteen Eighty-Four (released as Diamond Dogs in 1974) - a demoralised people wanting 'someone to claim us/someone to follow/someone to shame us - some brave Apollo' ended up with Big Brother. I doubt there are many in this country who wish to live up to that Orwellian nightmare, but they would do well to remember that - as every revolution has taught us - the road to hell is indeed paved with good intentions.