Speedy Boarding for the NHS is government by gesture

Over seven and a half million people are currently on NHS waiting lists. That’s a new record. Today, the government announced its plan to reduce that number. From now on, under the “matching” system, people will be encouraged to travel in search of medical centres that can offer treatment quicker than their local provider.

In one sense, this announcement is encouraging. It is the first time in a while that No 10 has turned away from the blast furnace of the culture war and towards an issue that actually matters – health.

And in electoral terms this change of subject makes sense. According to YouGov, 46 per cent of people think the health service is Britain’s most important issue. Immigration, the government’s tub-thumping obsession, is down at 36 per cent. It turns out that health matters more to people than stopping the boats.

But in another sense, this announcement is really not encouraging at all. It is an obvious point, but it needs saying – travelling costs money, meaning that this idea will put a disproportionate burden on the less well off. And a lot of people are feeling the pinch at the moment. YouGov’s research shows that, according to voters, by far the most important issue facing Britain today is the economy.

No10 is – finally – looking in the right place, but its new idea suggests that, though the government can see the huge problems facing the NHS, it isn’t really prepared to do anything about them. Not really. Because to do anything substantial would require a much deeper, longer-term solution than simply advising seven and a half million people waiting for appointments to hit the road in search of help.

Yes, a few people might jump a queue here and there. But at the heart of the NHS issue is the sense that the situation in the health service is getting worse. Sunak has said he thinks it’s all because doctors and nurses are going on strike. What this overlooks is the long-term demographic shift that’s happening in Britain. People are living longer, which means more people are suffering from late-life illnesses and the NHS is straining to cope with the huge increase in demand. How do you provide all that healthcare and how do you pay for it?

An issue like this is a “hard” problem. And because it’s hard, it needs a long-term plan to deal with it, which, from a political perspective, makes it incredibly unattractive. So the government doesn’t have a long-term plan. Instead, if offers a gesture.

This inability, or unwillingness, to confront difficult problems emerges directly from the Conservative party’s obsession with the culture war. Nowhere is this more evident than on the question of immigration. Wars, climate change and crushing global inflation have created a refugee crisis so vast that only an international effort could possibly solve it. The answer is to direct aid and diplomatic attention towards the nations and regions where people feel they can no longer live, with the aim of improving people’s lives and giving them reason to stay.

That is a “hard” problem – probably the hardest of them all – and it needs a long-term international plan to fix it. But this government has no interest in confronting that problem, or in participating in a diplomatic push for a solution. And anyway, Britain’s meagre diplomatic capital is being spent on trying to build back the trade deals we lost because of Brexit. There’s not much left for anything else.

And so despite all the tough talk about stopping the boats, all the headlines in the Daily Telegraph and the reassurances from Sunak that something is being done, Britain isn’t really doing anything to address the refugee crisis. The extent of the government’s engagement is summed up by two things: first, the decision to cut the foreign aid budget; and second the remarks by Lee Anderson, deputy chair of the Tory party, who said this week that immigrants arriving in Britain should all “fuck off back to France”.

Conservatives used to complain about the “dumbing down” of Britain – but that same party has now been made stupid by its own culture war. The result is a kind of willful blindness – and paralysis. Britain’s economy is still smaller than its pre-Covid level, but there is no hope of a recovery because the government can’t bring itself to accept the root cause of our economic failure – Brexit. And because we are in an economic slump that the government is ideologically incapable of diagnosing, let alone solving, and because No10 is unwilling to raise taxes, the health service doesn’t have enough money. The result is a rolling crisis in the NHS.

We have a lot of noise about stopping boats, flights to Rwanda and now a plan to introduce a form of “Speedy Boarding” for the NHS. But these are not policies. Culture war governments are very bad at making policies. Instead, we have gestures. This government, consumed by its own ideological stupidity, is capable of nothing else.