I still can’t get past what Sir Keir Starmer said about private healthcare. It should have been the biggest story of the week, far bigger than Rishi Sunak’s slip-up in missing a meeting of world leaders after he had attended the commemoration for British veterans in Normandy.
To remind you, the moderator of the first head-to-head debate, ITV’s Julie Etchingham, asked both party leaders for a one-word answer to the following question: “If you had loved ones on a long waiting list for surgery, would you, if you felt that was the only way forward, use private healthcare?”
“Yes,” said Sunak.
“No,” said Starmer.
Surprised, whether by Sir Keir’s uncharacteristic clarity or by the reply itself, the presenter gave him a second chance:
“Absolutely no? If your loved ones were on a waiting list for surgery?”
“No,” repeated Starmer a touch impatiently. “I don’t use private health. I use the NHS.”
I’m not sure which is more alarming, the prospect that he was telling a cynical lie, or the horrifying possibility that if, God forbid, a close relative of his needed surgery, he really would be so cold-hearted.
Dishonesty might at first seem the more plausible explanation. A lot of politicians have a propensity to say what they think their audience wants to hear, and Starmer has more flexible opinions than most.
As recently as March 2020, he was describing Jeremy Corbyn’s 2017 manifesto as “our foundational document”. Six months later, he had kicked the old boob out of the party.
Which was the real Keir? The Corbynite or the anti-Corbynite? The former editor of the Trotskyist magazine Socialist Alternatives, or the dullsville centrist dad?
The answer is that he was saying what he thought his target electorate wanted to hear at the time. When he was rising through Labour’s ranks, he was a man of the Left. When he was trying to win the party leadership, it suited him to suck up to Momentum activists. After he had won, he wanted to show that Labour had moved on from Corbynism, and so picked fights with them.
Who was he trying to impress on Monday night? Not the electorate as a whole who, according to YouGov, would give the same reply as Sunak by 74 to 17 per cent. Indeed, many of those in the 74 per cent must have shuddered at Starmer’s response. Could he really be so inhuman as to deny care to a loved one, even if it were one of his children, on some abstruse ideological principle?
Perhaps Starmer was aiming his answer at the NHS trade unions, whose members wield disproportionate power in Labour. But I think the likelier – and, frankly, creepier – explanation is that the Labour leader was telling the truth.
For one thing, his answer was unwontedly emphatic. He did not sound like a man weighing his words. For another, he repeated it the next day, and in doing so recalled his mother, who had tragically suffered from a chronic illness.
Starmer has spoken before of his mother’s aversion to the private sector. “You couldn’t say a word against the NHS to my mum, in any shape or form,” he told the BBC’s Nick Robinson in November 2021. “An abiding memory I have [is] of being in an intensive care unit, and it was very touch and go, and she just held my hand and said ‘You won’t let your dad go private, will you?’”
Now people can hold all sorts of odd positions out of conviction. Sometimes, we can respect their conviction while disagreeing with it.
All religions come across as bizarre to non-adherents. And Starmer’s position on healthcare is more religious than practical. There is no utilitarian justification for refusing to pay for surgery for a family member who needs it. It is not as if, by doing so, you are helping anyone else. On the contrary, you are taking up a place on the NHS and so lengthening the queue for others.
Should we none the less respect his strength of principle, much as we might respect the piety of someone who is prepared to suffer for a faith that we ourselves don’t profess?
Well, that depends on the faith. The Aztecs, for example, believed that the only way to ensure that the sun would keep rising was to cut people’s hearts out and offer them to the god Huitzilopochtli. Sincere as they undoubtedly were, it is hard to feel much sympathy. Being prepared to prolong someone’s pain out of a dogmatic commitment to equality of outcome strikes me as another faith with which we should feel no sympathy.
Starmer, remember, is not a private citizen imposing his cultish dogmas on his own family. He aspires to run our healthcare system. It will be all of us mounting those gory pyramids to satiate his egalitarian deity.
You might think it preposterous to write of grisly Mesoamerican rites in the same article as the NHS. But only a religious analogy captures the way our underperforming healthcare system is treated. When Starmer says he would let a family member suffer in the name of state healthcare, he is stating, in its purest form, the impulse that leaves Britain as a whole with lower survival rates than comparable countries.
We could keep more people alive if we moved towards the mixed healthcare systems that are taken for granted in almost every other European nation. But doing so would be seen as blasphemy against the NHS. Sorry, RNHS.
If you think I am laying this on a bit thick, cast your mind back to the lockdown, which was defended in expressly sacrificial terms: “Stay home, protect the NHS”. We were servants of RNHS rather than the other way around.
When we refuse to ask for meaningful reform in return for the record sums being spent on the system, we assume a similarly votive attitude. We are there to pay up, not to ask awkward questions. Huitzilopochtli is to be fed, not bargained with.
Starmer’s convictions, whether born from socialism or filial loyalty, make a nonsense of the hope that Labour might spend some of its political capital on reforming healthcare. To the extent that it had a plan, it had been promising to use the private sector to bring waiting lists down. But how could Starmer, feeling as he does, preside over such a scheme?
An analogous argument could be made about Labour’s hostility to private schools. European countries do not tax education, because they recognise it as a public good. Imposing VAT on private school fees will, ironically, be Labour’s sole use of our Brexit freedoms.
If we wanted to reduce inequality while increasing standards, we would not drive private schools into bankruptcy, but make all schools private – in other words, give parents an education voucher to take to a school of their choice. But, whether from envy or deference to public sector unions, Labour won’t go near the idea. It would rather cram more kids into state schools than allow them to go elsewhere, easing the pressure.
Here, in truth, is Labour’s Huitzilopochtli, the irrational principle to which the rest of us are expected to offer up sacrifices. If pushed, it prefers equality of misery to prosperity for some. It would rather that we all lived in 400 sq ft homes than some of us in 1,200 and others in 6,000 sq ft homes.
Before the campaign began, there were vague hopes that Starmer might be different. Now we know better.
