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Labour’s communications challenge for the NHS

Posted on 18 February 2009 | 10:02am

I sat recently
at the back of a focus group and watched people discuss their favourite and
least favourite brands. It was a business rather than a political exercise, but
there were as ever some interesting political points to emerge.

At the end of a
long discussion, in which the economy dominated, and people admitted to their
spending patterns changing as the recession deepened (most felt insecure about
the economy generally but not their own jobs), the moderator asked them to rate
a number of well-known brands and people.

They were given
the logos of the brands or, in the case of individuals, pictures. They were
split into two and asked to put them on to whiteboards, best at the top, worst
at the bottom. The discussion before the groups reached agreement lasted
about half an hour. But certain decisions were taken early, and stuck to.

Google was the
top private sector brand. ‘Politicians,’ including Gordon Brown and David
Cameron, were close to the bottom. Barack Obama on the other hand was close to
the top. The likes of Tesco, Asda and Findus, Ben and Jerry’s ice cream I seem
to remember were between top and middle. The media had a bad day, with the BBC in the middle, the Times not far behind, the Mail and the Sun lower down.

But one brand was put at the top of both groups.

Any ideas? It
was the NHS. That fascinated me, because it showed once more that public
opinion often develops outwith the prevailing media mood. Except in regional
media, and even there it is rare, it is the exception not the rule to see the
NHS presented in a negative light. Yet when I spoke at a health conference
recently, I heard a polling presentation for one region – the North East – that
had 90 per cent satisfaction ratings. That is almost North Korean in its

There is both a
problem and a challenge for Labour here, as I was saying when I spoke to Labour
Party staff last night and today at a training meeting. The problem is that
people do not link that success with politics. That the NHS is so popular is
partly about history but also about the decisions a Labour government, and
Gordon Brown as its Chancellor and Prime Minister, have taken on spending and

I visited my Mum
yesterday, who was positively raving about the treatment she had when
undergoing a minor operation recently. You hear all the time of people saying
their own experiences of the NHS were good, their general impression (i.e.
media image) bad. But Tory-style waiting lists are a thing of the past. Even
with the credit crunch resources for good health care are available. New
hospitals and surgeries are still being built. 

The Tories
barely ever talk about the NHS, other than to run it down. They have neither
the policies nor the commitment to build on the improvements made. I remember how TB always
used to hammer Tory MPs at Question Time with the facts and figures of schools
and hospitals in their area. We need to do that in every part of the country,
and build the link between progress and politics. 

When the focus
group had ended I spoke to a couple of the people who had taken part. I asked
if they saw any link between politics and the NHS. They didn’t, at least not
immediately. That they didn’t see it straight away is a communications not a
policy challenge. But what the evening told me is that it is by no means too
late to put it right.

  • Rob Atkins

    It’s not just the NHS Labour have a communications challenge with, Mr Campbell

  • Barbara Cannon

    I entirely agree with you. I used to Chair a Hospital Trust and before that a Health Authority.

    What I learned from that the public believe politicians interfere too much. Interestingly when we were working hard in government in our first term to decrease those waiting lists, remove bed blocking etc the public were with us as this was the ticket Labour were elected on. However it was a hard fight and some difficult decisions were made. Labour introduced regualtion in the form of CHI – Which was resented for the extra work it created. Ordinary people believe that Doctors and Nurses run the NHS and do not need any politician to tell them what to do. We made it worse when our Secretaries of State started telling people that they were putting the NHS in the hands of Doctors and nurses. The public and some staff also believe that their are too many managers. This is often not the case as the NHS insists that management is contained within a percentage of the payroll budget. The other factor is that many of the ‘managers’ were either trained exclusively in the NHS or are themselves former clinical staff.

    The only way to sort this out is to get folk to see the NHS as an organisation of the many talents. Team NHS from Government investment and policy making to the folk that keep the wards clean.

    The other problem we have is that sadly we appoint to the NHS trusts via the NHS appointments commission. It is a gravy train these days for folk in a pre or post retirement from business (usually) who are making a little bit of cash and keeping occupied. More and more of the elected representatives who had the passion and committment (from across the political spectrum) have been rooted out because of this feeling that politicians should not be in the NHS. That helps to perpetuate this belief that politics should not be anywhere near the NHS. These trusts are also quango’s – is it not time we stopped all of that anyway. The greatest advances in public health were made when Directors of Public Health were employed by Local Authorities. The greatest contribution to health generally was when Labour created the NHS – we need to revisit all of thIS – you can fix all of this but you cannot do it by branding alone!! Over to you.

  • Simon Leonard

    Every Labour MP and PPC should have a list of all the new buildings and services in their constituency so they can counter the ridiculous ‘didn’t fix the roof when the sun was shining’ charge with actual examples people use and can relate to.
    Then ask the Tories which one they would have cut to ‘save money for a rainy day’.

  • wonderfulforhisage

    Was Education covered? If so where did that show?

  • stewartfinn

    Interesting, although I am not sure that the NHS would have featured had they not been provided with the logos and brands.

    I don’t think that people would see the NHS as a brand anymore than they see it as being political.

    I could be wrong but it would have been nice to see the results had one group been given the logos and brands and the other simply the task with no prompts.

  • stewartfinn

    Sorry for the double post but….

    The NHS is a big Labour plus point, something that should be claimed as a political victory. Not only have Labour made it better over recent years but its also their creation.

    Despite ‘left of centre’ and ‘socialism’ being difficult to sell and almost negative words (especially here in Northern Ireland) the NHS is a huge success story and essentially a socialist principle – one which survived the purge and indeed is a fundamental part of UK life.

    This is not the case by any means worldwide. I was actually flabbergasted in the US while working on the Obama campaign to hear universal healthcare described as a ‘socialist plot’ by someone who was not foaming at the mouth.

  • Alastair Campbell

    No problem with double posting, and I agree with you and with a lot of the other points made. Re education, no, it wasn’t covered, so maybe that answers the question about whether the NHS would have come up unprompted. I think it would, but schools didn’t, so maybe not. Then again there is nothing that draws schools or universities under the same umbrella in the same way. I certainly think there needs to be far more energy put into remaking that link between Labour creation, Labour progress, and a public sense of an improved service.

  • Alina Palimaru

    What was the composition of the focus group? Could it be that appreciation of the NHS is generational? Beginning with the post-WWII period, the NHS has been path-dependent, growing superbly on a few brilliant decisions made in some of Britain’s darkest hours. Clearly, older folks, especialy those who understand the NHS’ fundamental imperative and those who saw it embrace unions, the common man, etc. will presumably remain stalwart supporters.

    The perception of twenty-somethings, on the other hand, is probably overwhelmed and saturated with all the media doom and gloom.

    If this is the case, then the link between progress and politics might be strengthened: first, by reminding the former of the patient-centered attributes of the NHS, which are consistent with Labour values; second, by educating the latter about the larger context of this reputable institution, and how it reflects the long-term investment made by Labour, particularly after 1997.

    Frankly, there are so many positive aspects of the NHS, that perhaps it would more efficient to focus on what it doesn’t do, like allow 12-year old kids to die from brain infections which originated in tooth decay, and have people waiting in the ER for seven hours with a burst appendix.

    Americans are drooling over the NHS, and it will be centuries before they get anything that resembles this system remotely! There has to be a way for Brits to see Labour’s role in this.

  • Charlie

    There is absolutely no doubt that the NHS has improved. No one can seriously dispute that. BUT I think that the question many people would ask is has it improved in proportion to the amount of additional money spent? Should more care have been taken to fix the bucket before the cash was poured in? The bang is bigger but could less “billions” have been spent?

    (Of course this question meant more when a billion was worth something!)

  • Alina Palimaru

    Charlie, valid questions indeed. I would only dispute your use of the term “spending.” In my judgment, we spend money on something that satisfies immediate needs, without any long-term benefits or consequences. If I buy a T-shirt, I’ll say I “spent” my money on it.

    But what the Labour government did with health care was an “investment.” Their social imperative is clear: the nation’s well-being is a priority and it should be secured at ALMOST any cost (GB and the rest are obviously aware that perpetual budgetary deficit will not help, and he has been doing an awful lot to tackle that). But the bottom line under Labour is that national health ultimately benefits everyone, it’s a public good/service with tremendous positive externalities.


  • Charlie

    Thanks Alina,
    I pose precisely the same question with the word “invested” substituted for “spent”.
    regards, Charlie

  • Jane A

    Hmmm. The terms “Labour”, “communications” and “the NHS” are each so close to my heart that its hard to know where to start here, or where to stop. So I’ll try and be cogent.

    1. The connection between politics and the NHS. Increasingly, if people have an issue about the care the NHS have given, or not given (ie they can’t get prescribed the life-lengthening drug they need because NICE haven’t had their mitts on it yet) they tend to do two things : write to their MP, and endeavour to get the media to pick up their story. The connection is forged. But people write less to the media *or* their MP when they are cured/fixed/helped/etc. We – as NHS customers – expect that. So the media and politicians alike receive a skewed view, and good news NHS stories get covered less in the media than they should.

    2. The same “Korean” (love it) approval ratings for the NHS in the North West tell us that those approval ratings are lowest for the South East. Not low – not by a country mile – but lowest, and that region is Parliament’s doorstep.

    3. It isn’t too late to start to press home the improvements, achievements, and investments made since 1997 in the NHS. But it needs to be done at a local as well as national level. What will sway people’s views and voting is about what’s been done in each and every area of both health(cardio/cancer survival rates; waiting lists/new builds/GPs open longer hours) and geography to show the local steps forward under the umbrella of a national service.

    Sorry – already way longer than I intended…

  • Alina Palimaru

    Jane, I agree with you on your three points.

    Charlie, I am assuming you ask about returns to scale. Tony Blair invested more money, true, but he also introduced a range of market-based measures to ensure economic efficiency (i.e. fair allocation of resources). In principle, this should have taken care of what you call the “broken bucket.” What’s more remarkable, though, is the way TB brought market principles to the NHS, that is: competition for excellence (to keep your patients) but NOT for profit (see rapacious US doctors).

    I am not familiar with the government’s books on NHS funds, and even if I were, it would be very difficult to assess the returns in an aggregate, because of the nature of the services, each with its own challenges: primary care, emergency care, elective care… each might be tricky. Bur I will tell you this: no system is perfect. If the NHS had wasted the billions that you refer to, I think it would have become apparent by now (at least the market component would reacted somehow). What’s essential is that, when compared to the U.S., Britain spends less in health care per capita, YET it has lower mortality rates and better health indexes!

    Even if we assume some loss, it’s a SMALL PRICE to pay for all the benefits. Think about it: No insurance premium, no co-payment, no fee at all! Ergo, no medical-related personal bankruptcy. Sign me up!


  • Caspar

    Don’t forget to ask your mother to post a review of her experience in an NHS hospital onto NHS Choices! The patient experience reviews on there are an invaluable resource, both positive and negative.