Context is everything. The Dirty War on the National Health Service, the latest dispatch in journalist-turned-filmmaker John Pilger's ongoing War series (previous entries: 2007's The War on Democracy, 2010's The War You Don't See and 2016's The Coming War on China) received a limited theatrical run towards the end of November 2019, when it might have played as feature-length confirmation of those viral videos posted on social media by NHS staff urging onlookers to vote for anyone other than the party that had spent ten years running their organisation into the ground. Purdah rules meant, however, that it couldn't be broadcast on television until after the election that returned the Conservatives to power with an even bigger majority. Brexit, so deleterious to the nation's wellbeing that it began with the assassination of a sitting MP, resulted in the Government stockpiling bodybags and wound up having a clinical psychosis named after it, was evidently more important in the electorate's eyes than health itself: get it done, they cried anew, whatever the cost, even if it does for you in turn. You therefore watch the contents of Pilger's film with sadder, perhaps angrier eyes now: see the vulture-like private healthcare firms circling a newly vulnerable public sector, the animatronic actors in the dreadful health insurance ads we're all about to see a whole lot more of, the deaths caused by the combo of incompetence and mismanagement at those self-same companies, the empty promises of protection from politicians, the heinous policy of "patient dumping", the final rallying call to concerned citizens, urging us to stand up to the Government, listen to our doctors, and defend an institution for which the prognosis surely has to be bleak now, if not outright terminal. The people may have spoken, but they won't know what they've got 'til it's gone.
For the Australian Pilger, the NHS is (and perhaps always has been, as everything in Britain continues to be) a class issue. Aneurin Bevan's original post-War conception of the NHS was a levelling of the playing field: its aim was to make good healthcare available to slum dweller and city gent alike, and to make sure everyone paid their fair share (by tax) to keep such care available. Decades of capitalism, which naturally disagreed with that thesis, have worn away whatever ringfencing was set around it, leaving us with what amounts to a two-tier system - part-public, part-private - dividing up whatever tawdry spoils can be wrung from healthcare, while ensuring the haves have far better access to quality healthcare provision than the growing number of have-nots. Pilger is even-handed in apportioning blame; the dwindling of the NHS is, in his eyes, every bit as much the fault of the Left as it is that of the Right. We get a concise takedown of New Labour's PFI scheme (illustrated in barbed fashion via a photo of Tony Blair standing side-by-side with Margaret Thatcher) before moving onto the Conservative-Lib Dem alliance that expanded these Ponzi schemes to make their own pals rich, outnumbered the scrubs on our hospital corridors with suits, and looked ever more avidly West. Pilger eventually does, too: what he sees there is grim even by the standards of scare stories from privatised healthcare, namely the uninsured American working classes queuing for hours at an agricultural showground to be inspected like horses. What the film diagnoses is a near-comprehensive failure on the part of all our statesman to take due care of our caregivers. As it touches on the necrotic spread of management consultant culture, the relentless subcontracting, the absurd efforts to replace doctors with apps (overseen by the robotic Matt Hancock) and the general hollowing out of Bevan's original idea, you may find yourself amazed the NHS is still standing even in its current parlous state.
As polemic, the film is effective but rough-edged: Pilger would presumably regard the slickness of Sigma ad campaigns as a marker of inauthenticity, but a touch more finesse in his own rhetorical construction wouldn't have gone amiss. He's especially impatient in his cutting, barely allowing his witnesses to get to the end of their sentences in his rush to set this info before the general public; as a filmmaker, there's still something of the newspaperman about him, rushing to meet a tight deadline. (Similarly, he's a little lax in his labelling: we're offered plenty of doctors among the talking heads - and their manner reassures us they know whereof they speak - but I kept wanting to know more about their experience, where they sit in the system, and the onscreen credits are basic at best.) Pilger isn't above one dirty trick of his own. He doesn't need the split-second he keeps in of the CMO of health app Babylon looking shifty before his cameras rolled; the film's argument against the impersonal form of care his interviewee is peddling is strong enough, though I'll concede that strong, reasoned, principled argument didn't seem to sway many minds at the ballot box last week. The film's real strength lies in condensing a lot of pertinent information into a single 100-minute sit: you'll emerge feeling better informed and, unless you're one of those besuited vultures, appalled at the fact there is no good idea - even a potentially life-saving idea - that our moneymen can't keep their grubby little hands off. Three days before Pilger's film finally aired on ITV - just 48 hours after the election of Boris Johnson - news broke that the Tory promises to protect the NHS made during the campaign were already being dialled back and reneged upon. At the current rate of progress, this war may be over in a matter of months. Happy Xmas. Stay healthy.
The Dirty War on the National Health Service is now streaming via the ITV Hub.
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