Tuesday 6 April 2010

Vote Tory or the cancer patient gets it

One of the really fun things about having a kid is that you get to see just how hard-wired some of our more irrational behaviours are. Take my first stab at a genetic legacy (please): having learned that he could use his hands to maneouvre slices of banana into his face all by himself, he (as we all did) started trying this trick with everything: breadsticks, bacon, chips (fine), olives (hilarious), pickled beetroot (messy but fun, in a "vampire baby" kind of way), spoons, wooden balls, rabbit poo and assorted choking hazards (panic inducing, primarily for obvious reasons and secondarily in a "can I clean this up before his mother sees him" kind of way). Similarly, he's learnt that crying is a good way to a) alert us to genuine pain or discomfort or b) get attention when he's mildly bored. The point being that once we find a trick that works, we'll keep reusing it until either we run it into the ground or someone's pulling a lego brick out of our throat.

As with my incontinent, wobbly, emotionally manipulative offspring, so with the Tories. This latest wheeze of not raising National Insurance after all seems to have struck a chord (surprisingly for a cynical pre-electoral bribe), and so it's being used to attack Labour not only on the economy, which at least makes a crazy kind of sense, but also on health, which is both bizarre and unseemly. It's bizarre because it seems we're now to rely on efficiency savings paying for both reduced tax reciepts and extra spending on healthcare at the same time.* It's unseemly because it makes a simplistic, populist billboard slogan out of the genuinely complex issue of how we choose to fund treatments on the NHS. To hear the Tories tell it, you'd think that the only reason cancer patients die in this country is that a coterie of evil bureaucrats and soulless beancounters won't let them near the medicine cabinet full of wonder-drugs that will cure their disease, grow their hair back and improve digestive transit to boot. In reality of course, there is no such cabinet - there's a number of drugs which have shown some success in some patients with some specific conditions. Their manufacturers are only too keen to trumpet their efficacy, but more disinterested observers are less convinced that we'd actually see any benefit for our money. In a time when efficiency is all the rage you might think the Tories would want to establish what kind of value for money they were getting, but apparently that's not the point.

Well no. The point is rather distasteful - to use the suffering of cancer patients as just one more improvised weapon in the ongoing bar-brawl that is a general election. It's hefty, it's near at hand, so break that Ming vase over your opponent's head and finer feelings be damned.

*As far as I can work out, the argument goes something like this: We fund the NI non-rise by finding cuts and "efficiency savings", but because NHS-as-employer isn't paying tax to the government, it can now spend that money on cancer drugs in its role as NHS-as-provider-of-state-funded-healthcare. Meanwhile the government has less money because it isn't getting that tax but the overall NHS budget hasn't changed. So effectively the NHS has become more expensive, especially as any savings made within the Department of Health are already ear-marked for funding front-line services, so the savings that are paying for keeping NI static and thus for more cancer drugs are being made by quite different departments. I can see that Paul's come out of the deal quite well, but Peter seems a little out of pocket. Now, if the Tories simply came out and said that they were going to increase spending to fund these drugs, that would be one thing, but given both the current situation and their rhetoric over the past 18 months, they can't. So we get this three-card trick whereby efficiency savings pay for both reduced tax reciepts and extra expenditure at the same time.


Mike said...

Indeed this an example of cynical electioneering by one of the big parties.

It also seems to me to be crazy that when we are facing the largest spending cuts in modern history (whoever wins power), the Tories intend to exempt the NHS from this process, even though it would appear the NHS has plenty of low hanging fruit due to inefficient spending: http://www.hsj.co.uk/news/acute-care/mckinsey-cost-saving-proposals-focus-on-waste-in-acute-sector/5005785.article

But the Tories are not the only ones using cancer patients as a political football: http://www.timesonline.co.uk/tol/life_and_style/health/article7094604.ece
If true, Labour crossed an extra moral boundary by campaigning directly to vulnerable people in this way.

The problem is always the same: we bemoan how badly politicians govern and argue but enough people vote for the same old clowns.

Reinstate the monarchy!!!

Andrew R said...

The story about Labour isn't true - they didn't specifically target people. If you send out a large mailing of leaflets, you'll inevitably hit people who have had cancer. It's a surprisingly common disease (c. 2 million people in the UK are living with a diagnosis, c. 1 in 3 will be directly or indirectly affected - i.e. know someone who has a diagnosis) and survival rates are going up, so there are more and more people living with cancer.

There is a question over whether Labour should have realised this and how sensitive they should have been about the possibility of upsetting people, but I don't think you can refrain from confronting painful issues head on. There is a big difference in the cancer policies of the two parties, and it's not inappropriate for Labour to highlight that.

Mike said...

Yup - I heard that Labour had denied along those grounds.

But I don't understand why you say it is appropriate for Labour to highlight the difference in cancer policies but when the Tories do it you say:
"The point is rather distasteful - to use the suffering of cancer patients as just one more improvised weapon in the ongoing bar-brawl that is a general election. It's hefty, it's near at hand, so break that Ming vase over your opponent's head and finer feelings be damned."

Sounds like double standards to me!

Andrew R said...

The distinction is that Labour's cancer policies are, for want of a better term, genuine ones. That is, they've been developed over a number of years, certainly long before the election, in an attempt to deal with one of the big issues affecting cancer survival (early diagnosis).

By contrast, the Tories' policy of investing more in cancer drugs is spur of the moment stuff. The NIC "job tax" story had got them in the papers, and they wanted to keep the positive headlines going. So they introduce a new facet to the story - now they'll use the savings to help cancer patients. It's purely opportunistic - their policy on cancer had never involved spending more money on (ineffective) cancer drugs. Until suddenly it did. It's notable that the King's Fund (well-respected health think tank) immediately criticised the plan for not understanding how NHS budgets worked - any money spent on cancer drugs next year has to be paid for by cutting something else, not some mythical saving from a non-existent tax. So this is not a well-developed policy, it's a headline.

I know you can argue that any policy is by definition an electioneering device but there's still a difference between something that's actually been developed by policy analysts over months and years, and something that was thought up to boost a positive story.