New Labour, new Stalinism

New Labour came to power promising to sweep away the “culture of fear in the NHS” engendered by the Tory government. Instead, “all staff should be allowed to speak their minds.” The BMJ played a prominent part—in 1987 and 1994—in documenting fear in the NHS. Our thesis, which we support with four articles in this week's issue, is that today little is different. There is still fear in the NHS. But there is also an intensification of “spin,” a word not much used when we wrote our previous pieces and strongly associated with New Labour (whose very name is an example).

Tony Toft, an Edinburgh physician, describes “a climate of fear in the NHS, preventing the admission of inadequacies in the service lest it is interpreted as personal failure with serious career consequences.” He was motivated to write his compelling piece after surveying the wreckage of the busiest night on call in the Royal Infirmary of Edinburgh in 1999.

Judy Jones has repeated the exercises we ran before of collecting examples of suppression and misinformation (p 1457). By definition, this is hard to do—but she has found many examples. Several come from Northern Ireland, where consultants have been censured for reporting on NHS inadequacies or criticising policies. One consultant felt “extremely threatened” by an attack by John McFall, the minister for health in Northern Ireland. Calvin Spence, the BMA's deputy secretary in Northern Ireland, says: “Undoubtedly these two cases are the worst I've come across in my 10 years with the BMA.”

Another story describes Joe McCrea, who was then special adviser to the health secretary, attacking Victoria MacDonald, health correspondent for Channel 4 News, and shouting at her: “You fucking bitch, you stitched me up.” Her crime was being “off message.” The phrase “bully boys” is often heard to describe “the special advisers.”

Even the spin doctors have failed to produce a cogent response to the articles we published last year on the private finance initiative (p 1460). The press office told us, “We are always rebutting” but could not come up with anything useful. In truth, the government is divided over the initiative, which leads to reductions in beds when an increase is needed.

The final contribution is a review of an important book that argues convincingly that New Labour has gone further than most previous political parties in sucking the meaning out of language (p 1480). The truth may be, however, that it is business as usual. George Orwell wrote more than 50 years ago in Politics and the English Language, “Political language is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.”