The decapitation of the NHS and the ‘supposed’ consensus…

Nor, amidst the hue and cry for consensus, was it possible for dissensus to exist and creatively stimulate discussion, fostering a creative development of ideas that could yield new and ever-expanding perspectives. In any community, dissensus — and dissident individuals — prevent the community from stagnating. Pejorative words like dictate and rule properly refer to the silencing of dissenters, not to the exercise of democracy; ironically, it is the consensual ‘general will’ that could well, in Rousseau’s memorable phrase from the Social Contract, ‘force men to be free.’ – Murray Bookchin (1995).

Whilst Labour seize on today’s updating commentary and feedback of the coalition’s plans for a complete reorganisation (decapitation) of the NHS, it comes as no surprise that the Tories’ idea of ‘protecting’ the NHS equates to destabilising it through market mechanisms. Today, Unite, Unison, British Medical Association, Royal College of Nursing, Royal College of Midwives and the Chartered Society of Physiotherapy added to the mounting criticism of Lansley’s plans. The NHS Confederation has also deemed the move as ‘extraordinary risky’, especially in the context of extreme cuts. Even a cross-party parliamentary committee has criticised the plans.

Dr Peter Carter, general sectary of Royal College of Nursing explained that:

All of the organisations, the physiotherapists, the midwives…Unite, Unison, ourselves [the Royal College of Nursing] have all submitted extensive responses to the consultation. The core principles about reducing bureaucracy, making the NHS more efficient, getting clinicians nearer to the heart of decision-making, we absolutely sign up to. The problem we have here is that we have a parallel process of introducing a more market-based approach to this, which we think could potentially be to the disbenefit of patients, whilst at the same time the NHS has to strip out between £15 – 20 billion in the next four to five years. We think these two things coming together could potentially destabilise the NHS.

So retorting to the quote by Bookchin (at the top of the blog), it is clear to see who are the proclaimers of a supposed ‘consensus’ and who are the ‘dissenters’. Despite ‘consultation’, the government has completely disregarded the views of those that do not fit their ideological schema; those who work and represent the people the government’s reforms are to effect the most. Instead, the government pretends to have obtained a consensus that somehow represents the ‘will of the people’ that is nothing more but selective ‘evidence’ and a clear case of what Bookchin refers to, parading Rousseau, as the ‘force men to be free’.

For me, this is another example of how our political system has many aspects that could be deemed as faux democracy. Groups that are affected by the proposed reforms are ‘consulted’, but rarely listened to – nor are their specific objections often given much debate and public airing. Instead, a political system should provide real space for debate, space that engages more people into political reforms – and such political debates should also be conducted in less pompous style and more accessible language.

The government is set to embark on a disastrous restructuring process that will seriously undermine the NHS, and despite all the criticism it is getting from all sides of the debate it chooses to ignore this and instead claim a ‘legitimate’ consensus. A consensus that shuts out dissent as an unwelcome protocol ‘necessity’. Politics should be about listening to what people really want; instead, the government’s policies are based on ideological rhetoric rather real sustained evidential requirements.


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