The NHS in ‘The Apprentice’ Society

Sugar and friends

Sugar and friends

Caring is out. Ruthlessness is in. That’s neoliberal morality.

Recently I had cause to partake of the National Health Service – or, more specifically, I had to accompany someone to an appointment at the Bristol Royal Infirmary, which at least involved riding an NHS-provided bus, sitting in a nice warm NHS waiting room and watching repeats of Grand Designs on an NHS TV.

I’ve been fortunate enough not to need the health service much. Yet. I still think it’s the greatest political achievement in the history of British statecraft. Given that national politics has been monopolised by nest-feathering plutocrats since time immemorial, it admittedly hasn’t got much competition for the title.

As the kind of lentil-munching ultra-leftist the Daily Mail presumes uses the Union Jack to mop the floor, I’m constitutionally obliged to hate dumb, tub-thumping patriotism in all its forms. But if there is something about ‘being British’ that’s genuinely worth being proud of – rather than a piss-poor football team, a plasticated Barbie and Ken monarchy, and a millions-enslaving, famine-inducing, continents-sundering imperial past – it’s the fact that our society commits to providing high-quality healthcare free at the point of use to anyone who needs it.

The NHS was born out of that dismayingly brief period, more of an blip when you look back on it, when top-drawer politics wasn’t entirely dominated by said nest-feathering plutocrats. “No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means”, proclaimed Nye Bevan, post-war Health Minister, lovely Welsh socialist and exemplary human being.

In the decades since, national politics has slowly but steadily reverted to business as usual. Now we’ve reached a critical mass of high-functioning sociopaths in positions of power, the NHS, like everything else left over from that bountiful five minutes of post-war welfarism, is under relentless attack.

You might not know it, because the mainstream press has barely mentioned it aside from the odd mildly concerned Guardian editorial and a few gutsy exposés by the crass-but-reliable Daily Mirror – the BBC, inexplicably silent on the issue, has been abysmal.

But huge Coalition spending cuts have caused the loss of 35,000 NHS jobs, 5,000 of them nurses. ‘Austerity’ has shut 250 ambulance stations, half the national total, 10% of Accident and Emergency departments, and a third of NHS drop-in centres. And as a result of 2012’s Health and Social Care Bill, British governments of whatever party are no longer legally obliged to provide a comprehensive, nationwide health service.

£11bn of NHS contracts, meanwhile, have been given to the private sector. Last year, the NHS blood service was sold off to asset-stripping private equity firm Bain Capital, originally founded by Republican oligarch and 2012 Presidential candidate Mitt Romney. Considering a study by the Social Investigations website found that 200 Lords and MPs have or have recently had financial interests in private healthcare companies, including practically the whole cabinet, we probably shouldn’t be surprised – senior Cameron ally Oliver Letwin is known to have boasted that ‘within five years’ of a Tory government the NHS would no longer exist, and in 2009 current health secretary Jeremy Hunt and Tory Chief Whip Michael Gove both called for full-blown NHS privatisation.

Miraculously, the NHS keeps going. My experience of it in Bristol was generally superb. Without spending a penny beyond a train ticket to Temple Meads, the individual I was chaperoning got to see a world-class expert in their particular ailment (an Italian, Ukippers take heed, with a professorship at Bristol University). The treatment prescribed will cost thousands of pounds. The individual will get it absolutely free.

But if you kept your eyes open, there were still subtle signs of something amiss in the NHS. Arriving at Temple Meads, I caught a – free – shuttle bus to the hospital. The bus, unusually, was painted bright gold, something that would presumably make the Taxpayer’s Alliance implode with rage. Walking round the hospital, I kept seeing gold signs on the walls too. After a while, curiosity overcame sloth and I lumbered over to have a closer look at one. It turns out the signs and the buses were advertisements for the so-called Golden Gift Appeal – a fundraising drive asking for public donations to buy vital pieces of medical equipment. It’s ludicrous that paying for air ambulances and lifeboats is left to charity – now the NHS is being forced to rely on it too.

Obviously, it’s an inexpressibly good cause. If you’re in the area, and have money to spare, of course you should make a donation. But health care should never be anything other than generously, totally state-funded. Catastrophically, the current government believes the opposite.

The Apprentice society

That evening, safely holed up back at Fort Bemalot, I saw the BBC’s The Apprentice was on.

I occasionally dust off the Bemolutionary goggle box and watch Alan Sugar and co when I need some reassurance that the world has indeed gone mentally unstable. While the weekly tasks it herds its gaggle of raving narcissists through have practically nothing to do with real business, the show is still essentially just an hour of corporate porn – fetishising the trappings of excessive wealth, the executive lifestyle, and the cut-throat (a)morality of rampant big money.

From the opening shots that swoop over the City’s big silly skyscrapers to the laughably awestruck presentation of ‘Lord’ Sugar himself – doing its best to make a short, grizzled pensioner from Hackney come over like a cross between Blofeld and Batman – the show has one constant, underlying message: big business is great, and so is being very, very rich.

The show’s producers might also want us to poke fun at the candidates’ boastful excesses. Any decent person feels something approaching revulsion when, say, 25-year Robert Goodwin declares that his “absolute worst nightmare” is retiring at 50 with only a “40 grand salary and a four year-old Toyota” to show for it. But that’s only because he dares say it out loud. A sizeable chunk of the ‘professional’ business people the show fawns over, including Sugar himself, probably think the same. They just keep their mouths shut.

What we’re supposed to find objectionable, then, is the extreme, exaggerated version of business values represented by the latest clutch of arrogant wannabes – not the values themselves. But many high-flying business people really are greedy, hyper-individualistic, cut-throat-competitive and all the rest (and, as is now well established, far more likely to be sociopathic than the rest of the population) – they’re just a bit less overt about it, and a lot less interesting. The Apprentice isn’t a fictionalised presentation of corporate culture – it’s certainly been sexed-up for TV, but it’s largely accurate.

Dismayingly, it’s this same ruthless, deeply unpleasant culture that successive governments have foisted on the rest of us over the forty-odd years of the neoliberal era. It’s not just The Apprentice that’s telling us that big business is great, and so is being very, very rich. It’s mainstream politics, popular culture, much of the media and the education system, too. What are the values that have lost out as a result? Compassion, selflessness, generosity, modesty, empathy, and other such bleeding-heart backwardness.

The kind of values, in fact, that you see quite a lot of in the NHS – and I’d seen in action back at the BRI. In the waiting room, with Kevin McCloud on mute, I’d sat and watched nurses and doctors and administrators efficiently bustling around, constantly on the move.

In one corner, there was an 83 year-old woman waiting to see a specialist. I know she was 83 because she told absolutely everyone she interacted with. Her appointment was about fifty minutes late, and she was making a fuss about it.

With ingratitude being one of my most ferociously despised pet hates, I’d have probably just wheeled her outside and told her to come back when she’d learned to appreciate the wonders of free health care. Instead, I marvelled at the saintly patience, and, more than that, the kindness, that the frenziedly busy ward staff showed someone who was being a colossal pain in the arse.

The ward receptionist was incredibly in demand, in charge of answering the ever-bleating phone, bellowing appointment updates to a nearly-full waiting room that could probably seat about a hundred, greeting, processing and directing a steady stream of new arrivals, and, whenever he was left alone long enough to allow, bashing away at his computer keyboard. But when it became clear the lady in question had been waiting quite a long time, he continued to do all that (minus the typing, for obvious reasons) squat in front of her while she circuitously rambled her life story at him.

He got her whole medical history, the string of clinical decisions that had brought her to the BRI – a trip that she vehemently, exhaustingly, repeatedly maintained was a ‘waste of time’ – what she had for breakfast, regular updates on her blood sugar levels, as well as frequent reminders that she was 83, and that she’d been waiting for ‘nearly an hour’. All the while, he was patient, sympathetic and exceptionally kind. He insisted on going to buy her a sandwich – which would’ve required about a five minute jog to the relevant bit of the hospital. After a lengthy discussion of her ‘dodgy stomach’, it was concluded that a biscuit might be best – and, overhearing, a smiley young nurse who’d hitherto not stopped yo-yoing in and out of treatment rooms took the time out of her manically busy schedule to dash off to the staffroom and return with a packet of digestives. Every ten minutes after that, she’d come back to check the old woman was alright.

That was just one scenario, in one waiting room, in one hospital. Perhaps it was an exceptional example of overworked, underappreciated staff still finding the time to be patient and kind. Perhaps on every other ward they throw staplers at impatient old women. But somehow we think it was fairly representative of everyday compassion in the health service – it certainly tallies with our own experiences with the NHS.

Yes, things go wrong sometimes, there are delays, and like in every profession you’ll find people who are neglectful and rude. But as is all too frequently forgotten, or belittled, or taken for granted, these are people who surrender the best years of their lives to care for other people. They could probably get paid better in the private sector – they could certainly find work that was less exhausting, mentally and physically. But they don’t. And that makes them more deserving of our gratitude and respect (and money) than practically any other group in society.

In fact, they’re getting a 1% pay ‘rise’- really a pay cut, given the rate of inflation – after years of stagnant wages, while MPs get 11%, and top bankers get 35%. We’re already hearing stories about nurses falling below the poverty line. And when NHS boss Simon Stevens nonchalantly announces a further £22bn of cuts, these are the people who’ll be on the sharp end.

Excess/Success

That’s Apprentice society. Leave the caring professions floundering on the breadline. Instead, laud the masters of the universe, the captains of industry, let them make billions at the expense of everyone else and be grateful to them for it. Who cares about caring? People only do that kind of job if they’ve failed – if they’re not ‘entrepreneurial’ enough to make it in business.

We’re supposed to respect Alan Sugar even more than your average oligarch, because he ‘came from nothing’ – which isn’t a very nice thing to say about Hackney. But, unsurprisingly, society doesn’t shine a spotlight on all the other determined, hard-working salt-of-the-earth types who tried to get rich and didn’t – because that would involve acknowledging that the most important factor of all in Sugar’s rise to extravagance was luck.

That’s not to say everyone could do what he’s done with his life, even with fate grinning at them. A lot of people wouldn’t have the ruthlessness and the drive, wouldn’t be able to stomach the relentless self-advancement. To put it another way, they’d be too nice.

Success is excess. Live more modestly, sustainably, be kind and compassionate – you’ve failed. Unsubtle conclusion: Western civilisation is morally sick. I’ve thought that for a long time. But the NHS versus The Apprentice presented me with an especially sharp and unpleasant contrast between what neoliberal society tells us is good and worthwhile, and what actually is good and worthwhile.

Really, someone who cleans hospital toilets will do more social good in a year at work than most of Mr Sugar’s apprentices will do in a lifetime. If they end up anything like their idol, they’ll have failed more profoundly than they can ever imagine – in a world brimming with preventable suffering, they’ll spend their fragile, fleeting one-shot at existence prioritising themselves.