On Tory "competence"

A poll in the Independent shows that voters think Theresa May and the Tories would do a better job than Jeremy Corbyn of managing the NHS. Which poses the question: how can Labour be so weak on what should be its core strength?

Let’s start with the statistics. Since 2010, real spending per person on the NHS has grown by just 1.3% per year. That compares to growth of 6.3% per year under the 1997-2010 New Labour government. This relative squeeze means that, as Simon Stevens says, there are "clearly substantial funding pressures" on the NHS. It’s surely plausible that, in the absence of policies to greatly improve efficiency, this reduced spending growth might have contributed to the “humanitarian crisis” in the NHS.

Why, then, isn’t the government being blamed more?

One reason is that these statistics aren’t sufficiently well known. They’re quite hard to find: I got them from publicspending.co.uk. One reason why they’re not is lies with the atrocious standard of political reporting. This usually consists of “he says, she says” claim and counter-claim in which clear facts and ground truth are effaced.

The result of this is that austerity has been presented as an abstract concept which is a matter of debate within the Westminster bubble rather than what it is – an act of vandalism which does real harm to real people. Closures of Sure Start centres, prison riots, bad social care, benefit sanctions, flooding and now a malfunctioning NHS are all seen as separate issues rather than what they are – the real human damage of macroeconomic policy.

Stalin once said that "if only one man dies of hunger, that is a tragedy. If millions die, that’s only statistics." The Tories are pulling off a similar trick.

But there’s something else – the halo effect. Traditionally, Hollywood heroes have been not just better-looking than villains but more charming, smarter and better shots too. This reflects our tendency to assume that if someone has one good quality they must have others. The fact that the Tories are popular for other reasons thus spills over into a belief in their competence even in an area where it is not deserved.

This is magnified by three other tendencies. One is simple deference. As Adam Smith said, we have "a disposition to admire, and almost to worship, the rich and the powerful". A lot of the routine rituals of government exploit this disposition by enhancing what Rodney Barker has called legitimating identities: apparently minor matters such as pictures of Ms May getting out of chauffeured cars, greeting foreign leaders, speaking at a podium with the media a respectful distance away and having speeches trailed as big set-pieces all serve to enhance the appearance of authority.

A second is a trick of Ms May. In being quiet and boring she has allowed the media to assume that she must at least be competent; in this way, she managed to avoid getting blamed personally for the government’s failure to hit its immigration targets despite being Home Secretary.

Thirdly, though, Labour is itself partly to blame. Legitimation rituals and the halo effect work in both directions. If you don’t obey the Westminster rules of politics – for example if you speak at rallies rather than do the standard media rounds – you’ll not be spoken of as a “credible” leader. And if you are incompetent in some respects, you’ll be thought incompetent in others. Voters might well ask: “If Corbyn can’t manage the Labour party, how can he manage the NHS?” Whether the blame for this lies with the media, recalcitrant MPs or Corbyn himself is of course a matter of debate. In this debate, however, facts can be ignored.

Comments

[Carol]

C-suite execs are also regarded as competent: they tell everyone the stories everyone expects to hear, so they must be true

[Martin_lowe]

The remark about the 'Halo effect' is interesting.

In my opinion, I'd trust a hypothetical Corbyn Labour government far more than the Conservatives for the simple reason that the NHS's main issue at the moment is a lack of funding.

One of the criticisms of Blair's administration was that when it came to power in 1997 it threw billions at the NHS with little critical oversight, and that money was wasted. However, there *were* dramatic improvements in healthcare provision across the board, so it clearly didn't all go to waste.

The point is that I don't think any successor government to a Conservative administration could fail to make significant improvements to the NHS by spending more - even one as structurally incompetent as one run by Corbyn. If people thought about this for a couple of minutes, they'd probably realise this for themselves - but as you say, the Halo Effect is hard to ignore.

[Blissex]

«Closures of Sure Start centres, prison riots, bad social care, benefit sanctions, flooding and now a malfunctioning NHS are all seen as separate issues rather than what they are – the real human damage of macroeconomic policy.»

And this is the usual "delusional leftie bubble" attitude that gets me depressed.

For a lot of voters all those are not seen as a issues, but asbig tax savings at the expense of worthless losers, that is doubly meritorious.
Many, many voters *celebrate* all that as big improvements in the distribution of income in their favour. For many if not most they are not fooled by the "halo effect", they know very well what is going on, and they love it.

And then there is the number one indicator of "competence": is the Conservative government "competent" at pushing up house prices and rents in the south, and thus redistributing fantastic sums from "unproductive" low income workers to "wealth creating" property owners? For many, many voters that is the main story as to "competence".

[Blissex]

«Blair's administration was that when it came to power in 1997 it threw billions at the NHS with little critical oversight, and that money was wasted.»

Quite a bit of that went into higher incomes for consultants and GPs, and some of that income boost was funded by outsourcing lower income jobs to private contractors and agencies using much cheaper immigrants or just abolishing pensions.

Another chunk of that went into PFI contracts designed to be very profitable to the contractors via various ruses, a chunk that is increasing as the PFI contract costs were heavily back-loaded. All "astute" governments and corporate executive teams work hard to front-load benefits and back-load costs, so expected.

Whether bigger incomes for consultants, GPs and corporates are "waste" is a matter of perspective :-).

«However, there *were* dramatic improvements in healthcare provision across the board, so it clearly didn't all go to waste»

Yes, a large chunk, probably even the majority of extra NHS funding, did go into better levels of service.

The problem is that 1997-2007 were the "golden years" of the NHS:

* It was the period in which most of the boomers had not retired yet but were still paying taxes and NI. People born in 1945-1955 were only 52-42 in 1997. Today they are 72-62, and that's quite a big deal.

* It was the period in which scottish oil production peaked, boosting tax receipts and exports, allowing a much looser fiscal and monetary policy than today, when the UK is a net oil importer.

[Blissex]

«If you don’t obey the Westminster rules of politics – for example if you speak at rallies rather than do the standard media rounds – you’ll not be spoken of as a “credible” leader.»

A certain J Corbyn was very aware that even if he did «obey the Westminster rules of politics» he would have regardless «not be spoken of as a “credible” leader» by the media.

So he adopted quite consciously the strategy of giving up on the «standard media rounds» choosing instead to «speak at rallies».

The causality is vice-versa from what our blogger says.

[Blissex]

«Why, then, isn’t the government being blamed more?
One reason is that these statistics aren’t sufficiently well known»

That may be one reason, but that's way optimistic. The policy wonks at various think tanks and ministries and parties have all the numbers at hand beautifully disaggregated. D McBride in his memoirs reports that when he was a civil servant at HMRC he could score in detail the impact of rising VAT on dog food across various income classes, for example.

My impression is that the "real" issues and numbers are not openly discussed because both parties and their sponsored "experts" are both compromised by many shared policy choices; a even the Labour wing of the Labour party cannot renege that part of party history when the Progress party-within-a-party entrysts took it over (even if R Hattersley tried to).

Also some of the "real" issues and numbers are so bad that they probably assume they would scare the voters, and there are no votes in that. They are however sometimes discussed "publicly" as long as it is done with heavy jargon and in obscure journals or workshop proceedings or think-tank reports.

Sometimes they are even discussed more overtly, consider this article from 2012:

pragcap.com/you-cant-handle-the-truth-2
«The Bank of England estimates that as much as 14% of all UK home loans are either delinquent or in some sort of forbearance process. Nobody really talks about this because nobody wants property prices to fall out of bed. Can we handle the truth?»

The answer is probably "no".

[Igor Belanov]

"A poll in the Independent shows that voters think Theresa May and the Tories would do a better job than Jeremy Corbyn of managing the NHS."

This reminds me of Victor Meldrew's verdict on 1992:

"Just couldn't believe that last election result. It's like hiring a man-eating shark as your children's swimming instructor.'Yes, I know it bit my baby's head off last time but I still think it deserves another chance'"

When people are this stupid and masochistic then there is little you can do, unfortunately.

[rogerh]

I doubt many people conduct any sort of analysis of political parties, they go with gut reaction just as they do in the supermarket. On this level the Tory product (bean tins) look nice and clean, has a bright label and look cheap. The Labour product looks dusty, has dents in the tins and the label is stained and frayed.

Hardly surprising that Labour is doing poorly - they don't understand marketing. But times change. Brexit may well brings about the social conditions that benefit Labour. Ten years of Brexit will probably be an economic disaster and a few more boomers will have shuffled off. The Tories are walking into their own destruction. Corbyn's product may then come to the fore. But right now it looks fit only for the skip.

[Blissex]

«It's like hiring a man-eating shark as your children's swimming instructor»
«Labour is doing poorly - they don't understand marketing»

In part, but as I tried to argue above, there is also the theory that many voters even outside the 1% choose Conservative fairly rationally because it makes them winners of big money, and those southern «aspirational voters who shop at John Lewis and Waitrose» don't care about the consequences on the losers in the north or in the lower classes, or actually like having cheaper servants and workers and lower taxes.

And if that theory applies, complaining that voters are stupid or Labour markets poorly is not that productive.

[rogerh]

A reasonable adage is that oppositions rarely win elections but incumbents lose them. Thinking back over that past 30 to 40 years I think the adage is right, the Tories used to lose through economic incompetence or sleaze or arrogance. Much the same ills befell Labour.

So, the Waitrose/John Lewis set will generally follow the Mail/Telegraph line of consumerism and self interest. But enough other people will look a little further and if the incumbents seem unattractive and the opposition is not too appalling the incumbents risk losing the vote.

My guess is that the Tories will win 2020 and 2025 (they would probably prefer not to) but after that anything could happen.

[Igor Belanov]

"And if that theory applies, complaining that voters are stupid or Labour markets poorly is not that productive."

It's one thing for middle-class people to believe that the Tories might look after their financial interests or maintain their status, but the question was who is more competent to run the NHS not who they would vote for. As current events demonstrate, it's pretty stupid to think that the Tories would be more competent to run the NHS.

[Bonnemort]

Corbyn has Michael Foot-ish policies, but he's got a problem that Footy didn't have - as well as having the Tories against him, he has powerful sections of his own party and the normally-supportive liberal media against him. Being mates with Sinn Fein/IRA is one thing, but Hamas? No way.

So it isn't surprising that his image isn't all he'd like it to be.

[Blissex]

«but the question was who is more competent to run the NHS not who they would vote for. As current events demonstrate, it's pretty stupid to think that the Tories would be more competent to run the NHS.»

That's not a wholly wrong point, and I did say that stupidity and poor marketing are partly applicable explanations, but it is still quite optimistic.

All politics is local, someone said, and «competent to run the NHS» for most middle class voters means "squeeze the costs elsewhere so I enjoy lower taxes but don't impact *my* area".

And the Conservatives are quite competent at doing that: a lot of the overload on the NHS is in areas where local council and thus old-age care budgets have been cut hard, and the local council cuts have been expertly and competently targeted at low income areas that don't vote Conservative.

The model the Conservatives have been transparently pushing for decades is: first class services if you can afford going private, second rate services for middle income whig/tory areas, and third class services for lower income "scrounger" old-labour areas.

They seem to be quite competent at going towards that, and who doesn't like it? :-(.

[Blissex]

«if the incumbents seem unattractive and the opposition is not too appalling the incumbents risk losing the vote. My guess is that the Tories will win 2020 and 2025»

My usual story is that middle class voters fire immediately and without appeal governments that let house prices fall, or conceivably do other *colossal* fuckups, and keep giving majorities to governments that push southern house prices up, even if appalling. Examples: 2001 (PFI) and 2005 (Iraq).

The potential for a southern house price fall or a colossal Brexit fuckup between now and 2025 is pretty huge, and still quite large before 2020.

The southern housing market is running on fumes, to the point that recently the Chief Economist of the Bank of England recently told pensioners to dump share and bond pension accounts and buy southern property instead.

The last thing "The Establishment" (New Labour or Conservative) want is for someone honest and sensible like Corbyn to "manage" the aftermath of the big reset, and the frantic attempts to eliminate him before 2020 might indicate that "The Establishment" reckons that there is a good chance of it happening before then.

[Blissex]

«to "manage" the aftermath of the big reset,»

As to that some people reckon that large factions of "the establishment" are gunning for war to bury the "big reset" amidst bigger carnage. Not entirely outlandish. I was startled when an anti-Corbyn commenter on "The Guardian" perceptively (but hopefully mistakenly) wrote that Corbyn is clearly not suited to be a war PM and the UK will need one soon.

[Blissex]

The point I am trying repeatedly to make (for years!) is that many on the wishful thinking wing of the left accuse the tories (whether New Labour or Conservatives) of being incompetent at running left-wing policies, while many voters reckon that the tories are quite competent at running right-wing policies and they are right...

[cjcjc]

Surely someone as concerned with evidence as Chris might question why no other country has chosen to adopt the "envy of the world" NHS model of health provision...or are we stuck with this 1940's cult forever?

[richard stevens]

"real spending per person on the NHS has grown by just 1.3% per year"

"The result of this is that austerity has been presented as an abstract concept which is a matter of debate within the Westminster bubble rather than what it is – an act of vandalism"

This is where I'm finding it hard to take this seriously. If a real term increase of 1.3% a year is austerity, what exactly is it you guys want? Eternally increasing by 5% a year?

[richard stevens]

Though I'll give you credit for admitting real term spending is increasing. You wouldn't guess that from the way this is being reported in general.

[garfield]

"Since 2010, real spending per person on the NHS has grown by just 1.3% per year. [...] these statistics aren’t sufficiently well known."

Indeed. I had no idea that the Government had not just delivered a real-terms spending increase in aggregate, but a real-terms increase *per head*. 1.3% compound over five years gives a 6.7% per-head spending increase. Impressive, given that the UK population has increased by around 2.5 million people over this period.

Many thanks for bringing this fact to light, even at the expense of somewhat undermining the rest of your article.

[Fathomer]

'As current events demonstrate, it's pretty stupid to think that the Tories would be more competent to run the NHS.'

Which just goes to show who has control of the narrative. NHS staff know who is to blame, they say so forthrightly, and in public, yet no-one is listening to them. MD's excellent column in Private Eye is a good source for just how much of a mess the Tories are making, and limited though it's readership is, it reflects what those in the know feel. But in the mainstream media, Hunt is bigged up, May defends him to the hilt and blames everyone but the govt (a wearisome, time honoured, Tory tactic), and people believe her. It is a sad reflection of how our opinion makers, despite all the easy access to information these days, can still triumph over the cold hard facts of the situation.

And that people, sheep like, believe them.

[Fathomer]

'This is where I'm finding it hard to take this seriously. If a real term increase of 1.3% a year is austerity, what exactly is it you guys want? Eternally increasing by 5% a year?'

In line with increasing costs is all NMS staff and the public want. If that is 5.3%, then so be it. Other govt depts budgets increase year on year, so what is your issue with the NHS which actually needs the money to help people?

As for comparing the NHS to other countries, the most expensive health care system in the World, is the USA's. This is because (and it;s been fact checked) under total private care, Senior staff and MDS are paid a hell of lot more than in the Uk, meaning research is also more costly, and the overall running costs are much higher. It doesn't work, as it also means care is not provided equally across the board, and that at point of access, people who 'might' have needed minor care, to avoid the costs, end up putting it off until they need major help - thus putting themselves further in debt.

If you really thing a debt based health service rather than one publicly funded and, and one, when not being starved of cash, that compares favourably with the best in the World (the stats are out there..), is a good idea, then be my guest.