Photo: “Change is inevitable - except from a vending machine.” from Kate Ter Haar flickr photostream

I knew it was coming. I didn’t know what shape it would take but I knew that, eventually, my habit of drinking voracious daily amounts of Diet Pepsi would eventually catch me up. I’d been told once by a drunken man in a pub that it gave brain tumours to rats. I wasn’t a rat though so I ignored this. I’d been told on another occasion that it could disintegrate a coin in a few days. Once again, I wasn’t a coin so this didn’t overly trouble me.  The defining moment came a few weeks ago when I read the results of recent research showing that drinking a can of diet soft drink a day is associated with almost three times higher risk of stroke and dementia.

That was it. I decided to quit.

We’d drive past petrol stations (where I had previously tended to get my fix) and my daughter would tell me to stay strong when she noticed my hands shaking as my central nervous system saw how close it was to those beautiful little plastic bottles of fizzy heaven.

A friend with a similarly monumental diet fizzy intake told me I didn’t need to worry. She said that if I’d read that article fully (I didn’t. I read the headline and  panicked wildly) there was a clear disclaimer at the end where Dr Mary Hannon-Fletcher, said: “These data are sound as far as they go. However, it is important to note ‘the associations between recent and higher cumulative intake of artificially sweetened soft drinks and dementia were no longer significant after additional adjustment for vascular risk factors and diabetes mellitus”. All of a sudden I was asking whether I really needed to take such drastic steps to curb my Diet Pepsi intake after all.

The reason I make public my internal battle with soft drink addiction is because it highlights what can happen to a message when the waters get muddied.

Take the following examples-
A report on a sudden spike in the number of mental health patients dying unexpectedly in NHS care provided compelling evidence on “threadbare” services that were “struggling to cope. At the end of the article an NHS spokesperson says “Reporting of incidents is intentionally up right across the NHS, including mental health, as part of our national effort to encourage transparency and a culture of learning. That’s the lesson from the airlines – openness is a precondition for safety and improvement. That’s as true for mental health services as it is for maternity care or surgical operations.”

Another report suggested that action being taken to restore financial stability was affecting patients’ access to services. NHS performance was suggested to be declining against the four-hour waiting time target for accident and emergency (A&E), ambulance response time targets, and the target to be treated within 18 weeks of referral. Once again late in the article the mythical Department of Health spokeswoman says “We are united behind the ambition to make the NHS the safest, highest-quality healthcare system in the world, which also means ensuring financial sustainability for the future, and the hospital sector’s financial position has now improved by £1.3bn compared to this time last year, with 44 fewer trusts in deficit.

On the warning of a “crisis”, the King’s Fund was quoted as saying that there will be rationing of patients’ NHS care unless the Government commits significantly more funding to the service. Here the King’s Fund says that after the deepest funding squeeze in health service history the NHS is “approaching a crisis” that will see patients suffer. At the end of the article Jeremy Hunt himself defended the Government’s record by saying that ‘a promise of more funding depended on Britain achieving a positive Brexit deal’.

The PR apparatus of this government have understood better than any other that they don’t need to win the public debate on the NHS. They simply need to neutralise it. They have constructed an impressive machinery to neutralise the potential toxicity of any NHS issue. These include but are not limited to

  1. Talking about putting record funding into XYZ
  2. Being utterly committed to improve quality of service XYZ
  3. Saying the highest ever demand means that XYZ
  4. Understanding that the strain of older people means that XYZ
  5. The public need to “play their part” by using local pharmacies and NHS 111 for medical advice for XYZ
  6. Making comparison to a time in history (ideally ‘this time last year’) and show that in actual fact the NHS is now doing better on XYZ
  7. Congratulating the committed NHS staff for XYZ
  8. Due to better reporting mechanisms, we now see more complaints of XYZ
  9. At election time simply give these tropes a little boost by repeating them following a tour of a hospital that sees a member of government chatting to a smiling patient in their hospital bed recovering from XYZ.

Much, although not all, of the blame for this lies at the door of the fourth estate. The focus of critique of the British media is usually on account of its overt ‘right-wing bias’. However a potentially greater and considerably more banal issue is the inherent ‘neutralising bias’ where a seemingly unrelenting capacity to neutralise the most politically febrile topics is mobilised through sacrificing sense-checking and fact-checking at the altar of being seen to be ‘balanced’.

Are many of the rebuttals by the mythical ‘Department of Health Spokespeople’ factually untrue? Print it anyway, it’s important to hear both sides. Are rebuttals factually and technically irrelevant to the matter under discussion? Print it anyway, it’s important to hear both sides of the story. Are rebuttals scapegoating whatever patient group are seen to cost money? You get the gist.

At the 2015 general election the NHS was the most important factor influencing people’s voting. The problem was that it was extremely difficult for voters to know what the major political parties had recently done to the NHS and what they intended to do. All they had seen in the non-partisan press was 5 years of muddied waters.

As this goes to press the country will be heading to the polls to cast their vote on an election that will almost certainly prove crucial to the future of the NHS. After talking to hundreds of people in the last month about the NHS I have borne witness to the fruits of the neutralisation machine first hand. It has worked. A great many voters are worried about the NHS and have no idea which party to vote for in order to address what has now been discussed as a humanitarian crisis for the NHS.

Yannis Gourtsoyannis bemoans the ‘post-truth’ age but this is only part of the story. The government don’t defend their NHS record through post-truth statements. They don’t have to. They just take advantage of the British Press’s acceptance of almost any kind of statement in the name of balance to consistently muddy the waters.

And me? No more shaking hands as I fight to drive past petrol stations. I’m back on the Diet Pepsi.