The BBC recently justified its entire license fee with the airing the late Bill Hicks' stand-up show Revelations, filmed live at the Dominion Theatre in 1992. For me , the highlight of the show was Hicks' invective against those who work in advertising or marketing. "Kill yourself," he deadpans. "Kill yourself, seriously, you are the ruiner of all things good. No, this is not a joke. You're going, 'There's going to be a joke coming', there's no fucking joke coming. You're Satan's spawn filling the world with bile and garbage. You are fucked and you are fucking us. Kill yourself."
The rant continues: "I know what all the marketing people are thinking right now, too. 'Oh, you know what Bill's doing? He's going for that anti-marketing dollar. That's a good market, he's very smart.' Oh man I am not doing that. You fucking evil scumbags! 'Ooh, you know what Bill's doing now? He's going for the righteous indignation dollar. That's a big dollar..." This continues - Bill's fevered protestations against the imagined marketing character getting more and more desperate. You can hear the frustration pouring out of him.
Although funny, this sketch also serves to nicely highlight an established truth of capitalism; it's ability to neutralise dissent. Such is its flexibility, it absorbs rebellion and counterculture so that even such opposition becomes part of the existing system. It's a perverse paradox; we cannot rage against the machine (© Sony Records) without further feeding into the diverse riches promised by the capitalist ideal. Dissent and anarchy themselves become commodities to be bought and sold. Hicks' rant against the marketing drones who wish to "put a dollar on everything" captures the catch-22 nature of this situation all too well; he is highlighting the inability to truly escape the capitalist bubble, and the offer something truly external and striking without it being amalgamated into the current status quo.
We live in post-ideological times; the current socio-political order is so ingrained and ubiquitous that we are no longer aware of it, no longer conscious of its pervasive influence and control. Alain Badiou says that the global dimension of capitalism de-totalises meaning; it's universality defines it as a global truth, but its 'hidden in plain sight' realisation makes it impossible to truly conceptualise and understand it. When the machinations of the dominant system become invisible, when they effectively and seamlessly utilise rebellion in their favour, what hope is there for autonomy and free choice?
Cameron's rationalisation for the impending changes being introduced in the upcoming Health and Social Care bill can perhaps be seen as a concrete and consciously formulated instantiation of this idea of rebellion-as-control. The bill - which contains the largest number of proposed reforms to the NHS in its history - contains a smattering of proposals which suggest that the long term goal of the Tory's health policy is a gradual move towards the privatisation of the NHS.
On July 11, Cameron unveiled an Open Public Services white paper in which provisions were made which would allow public run services to be open to competition from the private and voluntary sector - the first concrete hint of what was to come in the upcoming Health bill. The bill - which will be put before a vote in the Commons this week - proposes that a duty will be placed on local GP commissioners to ensure competition within the provision of NHS services. Monitor, the industry regulator, has also been given increased impetus to guard against 'anti-competitive' behaviour.
What does this mean? Does this genuinely mean that the Tories are planning on selling off the NHS to private companies, or is this just paranoid lefty conspiracy theory? Well - it cannot be denied that the above proposals open up the possibility of any of the NHS services being bid for by private companies, and presumably being sold to them if the proposed running costs are cheaper than the publically run equivalents. Such moves, along with the lifting of caps on the number of private beds permitted in hospitals, and the potential to outsource service commissioning to private companies such as KPMG, certainly seem to suggest that privatisation of the NHS is likely, even if not the direct aim of the bill.
Such moves, if made transparent, would be extremely unpopular. The British public love the NHS, and are proud of what it stands for. It represents a commitment to free healthcare for all, regardless of income, background or postcode. It has also been phenomenally successful: a 2010 report by the Commonwealth Fund placed the UK's health service top (in a survey of 11 industrialised counties) for effectiveness, equity, efficiency, patient confidence and safety. It was also rated as significantly cheaper than the equivalent systems of France, Germany and the US. The NHS is a towering monument to the capability of public services to be as good as those offered privately; and as such it represents a deep affront to the Conservative ethos.
However, openly dismantling it would, as said, be met with public indignation and resentment - not least because the Tories promised to ring-fence spending on the NHS during their 2010 election campaign ("We'll cut the deficit, not the NHS"). Furthermore, it's surely just be embarrassing for the Tories to admit to doing this. I mean, it's just so clichéd! I can imagine Andrew Lansley and his fellow Cabinet ministers moaning to each other, "But this is just what everyone expects us to do! It's so lame!" No one wants to turn into their parents, but such ideological manoeuvring certainly has hints of Mother Thatcher's dismantling of state utilities and council housing. No wonder Cameron is keen to bury the true motivation behind the reforms.
And bury it he certainly does. First of all, the aforementioned speech announcing the Open Public Services white paper came in the middle of the media and political controversy that was the phone-hacking scandal. July 11 was, for those of you who can remember the chronology of the saga, about the time when serious questions were being asked of Cameron's decision to hire former News of the World editor Andy Coulson, and about Westminster's relationship with Rupert Murdoch and News International in general.
By revealing these reforms at this time, Cameron effectively buried a massively controversial announcement in the middle of a scandal he was himself embroiled in. It was like farting in the middle of a shit-storm - a shit-storm he'd had a big part in creating himself. It really is advanced cynicism, even for an ex-PR man well versed in the dark arts of media manipulation.
However, the timing of the speech was not the only masterstroke by Cameron. Rather than debate the merits of privatisation, our PM decided to obfuscate the issue entirely by tapping into the reservoirs of cynicism and distrust a lot of people currently feel towards politicians. Decrying the "old-fashioned" "state-monopoly" of the past, he announced his plans as putting "power in people's hands." In his own words:
"So let me tell you what our change looks like. It's about ending the old big government, top-down way of running public services ... releasing the grip of state control and putting power in people's hands. The old dogma that said Whitehall knows best - it's gone. There will be more freedom, more choice and more local control. Ours is a vision of open public services."
It has been widely acknowledged that Cameron's Big Society rhetoric has been a resounding failure, its attempts to put a positive spin on the cuts being generally ridiculed or ignored by the wider public. Telling people that the cuts are an altruistic initiative designed to increase community spirit and cohesion is about as transparent an attempt at retrospective-justification as claiming that you raped a group of awkward teenagers just to give them something to talk about afterwards. It doesn't wash, yet still Cameron perseveres.
The above quote is perhaps a fine example of his attempts to revitalise this issue, and actually has the potential to gain his proposals some confused support. With trust and respect for politicians at an all time low following a steady stream of scandals unearthed in the past few years, the 'anti-government dollar' truly is a big dollar at the moment.
However, unlike Bill Hicks, Cameron's utilisation of anti-establishment feeling is far from genuine. He has consumed the ill-feeling against politicians (ill-feeling which, incidentally, he had a role in creating) into propagating reforms that will undoubtedly further alienate voters from those in power. People don't want to see the NHS privatised. It is not in the majority's interests - the main beneficiaries of such plans being the private companies who can profit from the services they take over, and possibly (in the short term) the politicians who can point to reduced public spending figures as a sign of their superior management of the economy. The general public will be the ones who suffer - their ideals of fair and democratic governance being utilised against them in the marketing of a poisonous and deceptive radicalisation of our health care system.
The manoeuvring taking place here is, as Hicks observed, common in advertising and marketing. It is no surprise that Cameron , who prior to becoming an MP had a public relations role for Carlton Television, is so adept at it. This does not, however, make it any less worrying. When opposition and distrust becomes absorbed into the discourse of those it intended to challenge, we must be extremely wary; such tactics de-totalise the meaning such dissent can convey. Now, with the stakes for the future of the NHS so high, the time is ripe to challenge such manipulations. The Tory's proposed reform of the NHS can undo the work of generations of Britains in creating a health service to be proud of. We must not allow this to happen.
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