Doctrinal influence

Updated: Sep 22


Stephen Hornsby-Smith

Doctrinal influence has shrunk since the Cold War, and a 'comprehensive society' of many layers, tiers, inputs and influence has redesigned the beleaguered 1970's smothering of the private sector, like for example in Education where state control dominated and enforced education in acts of misguided state intervention replaced the blackboard. No longer look to the Left for ideological invention when it seems the Right is only beginning to lead the occupation of new virgin philosophical ground and bright futures for valuable intellectual property that has both benefited from evolving by pragmatism and genuinely opening-up the potential of new ideas, fresh demographics and challenging accepted practice by risk and a departure from the tramlines of the past.

We welcome the new terrain of non-coercive statism, and value the new jurisdiction of management. Management is under new management, Brexit is under new management and the British triumph in adversity, the NHS, is under self-management. But isn't that the way forward? Surely 75 years of the NHS should actually have had enough time to grapple with the universal gatekeeper of 'self-sufficiency'? But there is further evidence that the NHS has also been a laboratory of best social practice where a paradigm of inclusivity has been personified by the NHS recruitment programme that attract the very best professionals dedicated to cosmopolitan Britain and identifying and committing their fates to be interlinked with internationalist Britain with or without Brexit !


The puzzle of Society and its ability to not be consumed by ideology has now been resolved as a part of a multi-faceted jigsaw that can either be of a positive or defensive nature, whose mantra is inclusivity and shared values not shared state ownership. It seems that the test of 'inclusivity' today is that emerging contemporary 'umbrella interest groups' (like GLBT and BAME) have volunteered to put 'inclusivity in the NHS' under the microscope, and have found that the NHS are not victims of exclusion but are assets of the NHS already making its contribution in wider society. We don't need a well meaning Labour government at Westminster, we have irons in the fire in and with the NHS ! Gone is the stigma of staff and patients being a product of political ghettoisation and welcome to the re-professionalisation of all staff in the NHS by being a conduit to a post-urban and devolved inter-generational value for new money as well as old metaphorically speaking! That's right those historical doubters have delighted in their 'new ideological money' by becoming ardent supporters and not wanting to remain armchair critics. The consequences? The new acolytes of social transformation rather than fear of 'money-pit economics' believe in the excellence in today's NHS meeting the same high ,if exclusive, standards of the pre-1945 health limited cover for those who could pay. Imagine if you could free up capital (that would have been originally spent on expensive pre-NHS health care) by guaranteeing NHS Health for Life' and save enough readies to send the kids beyond the state system for a bespoke education that best suits the individual needs of your children!?! As a heads-up,wealthy tax payers already fork-out in taxation to raise the level of state investment in state education without using its facilities, but as Woody Allen says " Why pay money for a private education when what you pay them compared with the amount of tax you pay is such a small portion of your income!?" Actually that was a complete distortion of what Woody Allen said but it is still................ wishful thinking? I wouldn't belong to any club that had me as a member! Now that's better ! But the NHS doesn't money-pit your disposable income it actually extends your credit by extending your health credit ! How does a unique form of state owned organisation actually half your bill for any other private insurance, (care, house etc) ? Welcome to cross-over !


The NHS unlocks ideological stasis and its 'convenient conventional tacit formula of mutual self-satisfaction' in which its talking shop(media by Westminster) is convened when flu hits our moral blood pressure every Winter.This 2 party system is a spat that hardly waits to happen and is bound-in with rhetoric and mutual insult that bores the rest of us stupid. Instead,open your eyes to the greatest post war achievement in this country that keeps getting (mainly people) better and, whilst brings the worst out of politicians here during flu time (Winter), it has been strong enough to bind all our politicians together during Covid 19 ! Tell me, what other institution brings such political adversaries together at a time without military conflict ? Alright , they may be others but you've missed the point ! Britons are no longer the 'sick man in Europe but the ruthlessly enlightened pragmatic of the West !

The NHS is a tight-knit community serving international standards of popularity, clinical expertise and open to accountability. It has a unique multiple access that advances Health Care in creating new demographics within and beyond its 1945 jurisdiction. It has evolved society and the contemporising of the very British social class economic delivery system that has spawned a valuable 21st century social British Identity that proffers a new unwritten and metaphorical 'Passport' to all NHS communities. Indeed, I think both parties believe that at times the NHS has transcended its own remit without any communication to Political Executive dictat by being the very independent people party of health, and by personifying the same independence way before Brexiteers ever conceived of 'making your own indie label without the EU'. So much so that our NHS might have triggered the fundamental break-up of social class voting that even the long arm of Russian suspected influence over the Brexit Vote couldn't contain. The NHS sure did raise it's own 'baby' well, and why not? And people think that millennials are the liberty makers and not previous generations before them !?!

But we do have multi-generational paradigms that have a chemistry of the most dynamic demographic(our youth culture) at our disposal to underwrite this British psyche of independent thinking - it's called 'talking about my generation(s) tell us that sociologically we have historically relied upon the British youth to decide and later implement the changes.


Has a cocktail of Hippy Love, Punk Anger, New Romantic indulgence and Rave culture hedonism been instrumental in modernising change by inter-generational influence implemented way after their youth, giving the British and individuality that 'Nanny statism' doesn't have ? Is youth culture in general affecting social and economic transformation decades after people 'matured' and got the bug of the rat-race ? Is the British identity since the 1960's one of conformism or one of enterprising invention ? Perhaps there is an uncanny relationship beyond 'Granny and Granddad' who manifested change after a period of decades silver-surfing on forgotten rebellion ? I wonder if that has impacted on the NHS? Of course it has, where the health dimension became more of a stitch in time but an self-effacing eclectic positivistic vocational 'seize the day' without having to learn Latin but having to unlearn the dead language of post 1945 Socialist deference to heady idealism. War had ruled by the sword but the NHS now ruled by the scalpel and health professionals doing what they love with all the best of common sense and wealth of bedside manners without any bodged-job pep-talk!

Indeed, we forget that whilst the NHS was just a safety-net originally to Churchill, it is a more complete figurative blood transfusion for society today. Treatment has never been so efficient and effective! Even the money budget-makers of the treasury were eventually able to learn 'health value for money ' was an investment in Britain.This has enabled a trans-Atlantic fusion of American 'Can do' with British 'Raising of Lazurus ' Get on with it' without having to go on a waiting list for a mythical Phoenix to rise from the Ashes of urban war-torn devastation make things happen meets keep calm and carry-on ! Like this 2-way Atlantic dimension today the 2 party system has institutionalised the NHS with each new administration wanting to leave the NHS in a better place than the one it found it in. Yes of course that is the very essence of social mobility and aspiration passed from one generation of Britons to the next.Indeed, the NHS mantra could be, 'No one gets left behind !'

In fact no one gets left or right behind, where the 'health shepherd is prepared to protect his/her flock by a bonding trust of the vast majority in order to save the lost sheep even if it is the proverbial black sheep of the family and community. Welcome to bonding in faith of post-Socialist style Britain. Oddly, self-preservation has become mutual preservation individualised and lionised to make the neurons of the social brain of Britain (the NHS) connect. Britons speak via the filter of the NHS celebrating reconstituting ideological convalescence after the exposure to war against fanaticism of the 1930's and 40's. Self and mutual sacrifice for all and not the extremes of poverty and the extremes of wealth was a narrative that the NHS personified. Dickensian wallowing didn't linger long and polarisation and self-opinionated condescension couldn't degrade the heart of the NHS philanthropic interventionism. Whilst the NHS was not the military it became the drilled teamwork of professionalism without any authoritarian characteristics.


Extremes were left in margins so individualised and personalised was the NHS that had rejected 'The general Will' that coveted social classification and social paralysis by ideological austerity from Left and Right and unlocked the stasis of social demarcation and the status quo. Flat-lining had been expected to poison the 'NHS by Christmas of 47', but that was just one of many underachieving arguments that got lost in the bin of prejudice. In fact 'First past the post society' by crude simple majority-ism was not on the agenda of the NHS

Furthermore, 'the first shall be made last and the last be made first' does risk excluding the middle-strata of most societies but provided the NHS with an opportunity to eradicate favouritism within its own walls, where the only 'social cleansers and agitators' were assimilated into the engine of the NHS and were left their ideology in tact after they were treated back to full health; the NHS had to fight tooth and nail to maintain its political neutrality, and especially from the eager creators of the NHS who presumed it had a monopoly over any credit given to the performance NHS and demanded tacitly absolute support for its perceived 'political masters'.

Safety in 'historical' numbers and simplistic adoration of Dickens, 'all or nothing' policies had consumed Britain's heartlands and was now coping with a post-industrial age on Britain's doorstep. But the emergence of a modern future was congealed in the success of the NHS as part of the modernising of the 'war spirit' and a revamped 'domestic health Home front' still wasn't diminished by the rise of the spectre of the Cold War and Sovietism.


But in America Americans proved just as unyielding against Sovietism as the British were. So the birth of the US 'nuclear family' suburbanised a old idea of equality and transformed it into a US version run by individual consumerism taking advantage of the great materialist explosion of inventive entrepreneurialism and the spirit of enterprise in post-war America. Individuals may have been measured by their superficial accumulation of modern conveniences by the superficial, but there was a larger philosophical debate in which these symbols of accumulation opened up a sore that inflamed the superpower's 'materialism conflict' of values and adverse core scientific principles now exposed as a quasi-religious belief system or a reductive aspiration of a 19th century!. Of course the Soviet interpretation of Capital. Where the US measured 'Socialised tranquilisation' by European public ownership to be an unhelpful confinement of Capitalist opportunity, but it was directly hostile to Soviet forms of collective coercion and totalitarian forms of state alienation by deceit, manipulation, centralisation by stealth reinforced by propaganda to impose monopoly. In short the Soviet system had reincarnated 'corporate power' by state apparatus dictatorship, excluded its people but an absence of any accountability by clandestine devaluation of the individual paid for by party privilege acquired by 'party loyalty'. It claimed to be the opposite of the very abomination it had inevitably become ! Patronage and party corruption was sanctioned because it afforded aspirational values of high party officialdom that was a sham and downgraded version of Western values that the Soviets so hated ! Hypocrisy may have been a way to mock the 'West ironically' by parodying it, but that did not carry any official weight and has quickly been omitted from Marxist views of history because it is more 'degenerate a Western Capitalist characteristic' that in 'Paradise' the noble marxist would never stoop to !


The social reproduction of 19th century driven economic theory had failed to allow for the international global factor that would intensify the need to protect a Soviet 20th century internal economic and political 'market' from the very capitalist world outside that it wanted to outstrip ! Marx had divorced Marxism from 'morality' as a 'bourgeois error' and now it hid ('protectionist self-isolation') from global Marxist inevitable dominance 'by merit' because of its exposure to late 20th century liberal market economic's, finally ended that false rationale of the ideological tenets of Sovietism. Mythologising Marxism was over, Marxist theories were not putting bread on the Marxist table anymore ! It had become a contradiction of what it bragged about not being the reality. Welcome to a false accountancy on a mass scale ! Farce and decadence remained. Only how not to lose 'too much face in its decline' and not result in a military show-down of the 2 superpower's the only real topic up for debate.

Ironically it was the bear-pit of competition that was sublimated by internecine internal party rivalry whose in-fighting was greedy with ambition without any limitation or accountability and at any cost ! These guys were at each others throats and made Wall street look like a walk in the park with ice-cream ! unbridled self-promotion is so ugly a flaw but hardly the place for it in supposedly 'Paradise' of Soviet harmony !? Freedom was never so well 'secretted'?!? no, so failed in a Soviet system !! Yet self-righteous evangelising still could not hide the cultural and hysterical idolotry to the all-consuming 'superior moral being' walking like a master of destiny at its finger-tips ' until Yeltsin finally quelled a military uprising in 1991 in the 'Ex-USSR'!!?!


Perhaps we're not looking at all of the micro climates that the NHS is able to influence? Perhaps the NHS is not the financial sitting-duck of every winter many think it is? Surely self-opinionated critics are the true targets of NHS progressive Revisionism ?

Public support has been the habitat of NHS morale that enabled the NHS to endure in spite of critics demanding the immediate privatisation of it because of the free for all sale of such a prize to the private sector for the public to buy into and make a 'fortune' together and because it is deemed an anomaly in the 21st century to not being modernised as the last of the nationalised industries still left standing from a 'frenzy of post-war' over zealous Socialism ? But likewise the far Left believe that the NHS is still 'the half-baked non-Socialist legacy of post-war 'liberal independence', and is selling this country short !?! How? By stoically removing ideological constraints by empirical out-performance of 'expectations' because it has not resorted to any 'prerogative of patronage' that might have 'corrupted it' enough for the far Left! Here we go again! Greed by ambition makes division self-important! 'Coup is all you can do' doesn't do it for me.Its enduring legacy is its neutrality in the face of agitators.

Furthermore it has engineered both the concept of trickle-up and trickle down phenomenon by constancy and by being a non-aggressive habitat for social change? Let me explain: Put a teaspoon on top of a sugar cube or underneath the sugar cube, and what do you get? Some surprising permeations that to a certain extent defy gravity ! Whilst being top heavy still, the possibilities are unique. Does 'We don't want no education' become we do want this education because it challenges the very Sovietism and Leftist thinking as 1930's centric scared of an ideological warming that could expose dogma as the 'ideological permafrost' that has been exposed. But stalwarts like the NHS remain impartial willing to avoid state dictat and not immerse itself in coercive state paranoia and Ludditism which is only a stone's throw away from Sovietism said 'couldn't happen in Paradise'. This is one key as to how the Cold War ended in 1989. It wasn't a Soviet over-heating but a Soviet collapsing under the rubble of their statist propaganda unable to resolve Dialectical materialism's melt-down of its core. Of course the Soviet system fell by 1989 and of course like Churchill, Thatcher wasn't given the full credit for being instrumental at winning a war !

Perhaps she was the victim of a 'first past the post democracy mentality' ? Just like the Jury system, it didn't do favouritism or be distracted by formidable reputations ! But progressive values of Libertarian revisionism has always prevailed even if its chief purveyors are electorally not as successful or as rewarded as their reputations demand. But whilst ego's come back and forth, whilst political values are exchanged and ridiculed, the NHS is the in-built mechanism to re-fresh and remain vigilant at any coercive non-unanimity or unpredictable outcome of a trial ! There are no show-trials or scandalous verdicts in the NHS.


Queues may form in the UK because we are culturally a leader in the field by 'fair-play' and even chivalry but we are ferociously sceptical between elections not so at them. Britons delight in their demanding cultural ability to make governments accountable without dragging reputations through the mud; we are quite honourable about that. However, elections play-out, but governments are open season ! Britain maybe a two speed Democratic process because of its 'Nothing changes' and 'Politicians are all the same !', but we sure like trying to make them sweat in the process! We make and remake ways to exercise our rights to scrutinise and make accountable by media corporate false flags if necessary. Why false flags? Because given the omnipresent media surveillance society we engage on many levels to extract what we want even if there is some collateral damage ! Yes we can be controlling of the media who may feed-off our carrots and sticks at their leisure, but never over the NHS, which represents the default position significantly of the British public. It appears as though you can only change Britain if you maintain the constant counterlever of the NHS. The NHS has to be neutral to provide the institution of sustainability by contrast. We're prepared for scandal or brutality and we'd prefer to criticise politicians more than make an admission of guilt to be levelled at the NHS. It is quite a remarkable quality to have to not pick sides or let sides pick each other apart. Bonding in the team spirit of the NHS evolves by social and professional collective responsibility made by mutual faith and experience that enables and rewards for loyalty. Hegemony is too strong a term for government collegiate respect that is always hard-won without over-inflating the NHS's performance, and despite attempts from both sides of temperamental irritants wanting to re-brand or delimit the NHS. the NHS is the 'Imperfect Progress' of a very British nature.

Political independence of firstly from a 2-party system, and secondly from Britain's industrial relations record is particularly a unique social and ethnic experience that reflects a diverse structural British society. The NHS staff evoke a different socialisation and response to union based industrial relations than the pre-1980s heavy industry nationalised did. It is the middle-class multi-ethnic well trained 'junior doctors that tend to be more ( If seldom) prepared to rethink historical models of 'withdrawing labour' instead of the demographic of the post-war scenarios from Unionised Coal, Ship-building and steel industries. These industries perhaps were more radical because they had a simple demographic that no longer exists in such crude terms which was the almost exclusively white, working -class, unionised by imposition, male etc

Indeed, Thatcher imposed privatisation before the heavy nationalised industries would become obsolete and worthless. Thatcher saw economic Ludditism becoming a permanent economic ideology because of the dwindling return and viability. Britain's unions had nothing positive to defend with or without rhetoric of 'saving communities', because tectonic plates were moving beyond any domestic control; you can't save a patient from 'old-age'! Indeed the inevitability of post-imperial Britain that no longer could assume the monopoly of its production for the colonies was an issue before the 2nd world War. Moreover the industrial contraction of heavy industrial products was compounded with the global market's over-production and cut-throat cutting of prices priced Britain out of the market. Neither could National strike action rely on the unquestioning support of the Labour party. How does this contrast with the NHS?

Unlike the NHS, the concept of hundreds of years toil that nevertheless ensured full-time employment for father,son and grandson in which often workers put their own health at risk couldn't win on 'Moral IOU' grounds for long.We are reminded of the sacrifices miners ,shipbuilders and steel workers made to defend our island during 1st and 2nd world wars, but that can not create work alone on products that were too expensively made in Britain. Simply dragging unions through the dying process of trailing 2 fingers up at international competitors and yet blaming our government instead is a narrative we should have already faced and not hid from. Having to confess that this British economy had insulated us during our Imperial years to such an extent that we were not ready to cast-off the 'sickman of Europe' with all the British people behind us ! Our community of collective inheritance was to post-industrialise as well as destroying our Soviet rivals. If Nationalisation in the UK failed it certainly sent a message to a horrified Soviet Union, who had to bring the Berlin wall down because its Empire was going through the final coup de grace too, and couldn't rely on its goods to be bought by ex Warsaw pact westernising Eastern Europe shedding its Communist skin with relish. But is 'globalisation' that succeeded the Cold War more amenable for all areas of the economy? Whilst it may suit the NHS to globally recruit the ex-Warsaw pact nations have never had to face the phenomenon of 'over-competition' before. Ask what is left of the NUM!


So, are we surprised that the NHS attracts the best recruits in the world ? Perhaps if staff were mercenary then why Darlington and not Dubai ? Proof is in the pudding ! Globalisation and economic pandemics are nothing new, but Viral pandemics like Covid-19 stretch public trust by homogenising and de-individualising both staff and patient but whereas some international health regimes can be functional and over-clinical, the spirit of the NHS is one of cooperative reassurance as well as enterprise: with that Darlington looks pretty good no? Indeed, there is a unusual reconciliation between the globalised family of the NHS supporting at local community level by global professionals serving all Britons. Highly trained people aren't just fulfilling their training but the design software of all that is British come rain hail or shine; people choose to work ....in Darlington? Absolutely ! Local needs meeting local expectations .Where else in the UK has the idea of a supra state institutionally entrenched been so roundly rejected but by the NHS? Our relationship with the NHS preserves our very identity in spite of globalisation?

Sovereignty of Parliament and the separation of powers in Britain has been enhanced by NHS independence from any arbitrary coercive use of influence of power. this has been supported by a silencing of Imperial legacies and agenda's, and the ending of its corollary of the dying embers of social class deference. We've been more 'Bloodless Revolution' (1689) than outright insurrection against absolutism (France 1791). The NHS shares our DNA of aspiring to avoid any violent radical change where the NHS is a 'guns, narcotics and machete's' free zone ! Medical treatment doesn't include judgementalism for free - you have to see a private lawyer and hope it won't cost you too much from your wage packet!

But multi-layered Britishness has never purely depended on a sense of bloodline alone ! The NHS does all the giving of blood for transfusion you'll ever need! Indeed, duty and responsibility has been passed-down in the NHS that intergenerational need to the NHS proud may well have made some key workers vote for Brexit to preserve the NHS from EU wide absorption in which their individual quality of work-care interactive balance could have been compromised. How? In such a centralised deterministic rule of Brussels, actual agreement with official Brexiteers may have put waiting lists up or prevented 'local need'?! The NHS doesn't suffocate it helps respirate where needed -who else but a local key worker could budget for local services that an overbearing EU slow rolling may have hampered best practice !?! And this when the blue-print of the NHS was becoming a great British export !? Why wouldn't ex-British colonies cherry-pick Britain's health care winner? Surely the NHS manifests the post-war anomaly that has endured but out-grown its own 1947 context and beginnings, in which it has emerged from and put to the sword its own ghosts from its own colonial issues, that it probably didn't even want to admit to or gain some respect for.

Intention is more important than reception and Trump's intention to impose policy actually modernised America without him even taking the credit for it. How does this impact on our NHS ? A sister USA NHS was finished by Trump but ironically Covid-19 would have destroyed it if it was in its infancy of getting started and unable to resource and fully perform might have led to its exposure to litigation in a frenzy of action that would have throttled finances and made the concept of Medicare unworkable ,unsuitable and unsustainable in America. Medicare was bloody lucky to avoid Covid-19 and ironically Trump will get the blame for it as well !

But essentially whilst the idea of an NHS US is still 'politically affordable in the USA', Trump has actually ring-fenced our own British version by his ideological stance against free state provision of public health per-se, for 60 million blue-collar workers who can't afford any care themselves. Thank Goodness Britain's 60 million Brits are still covered by our system !!

Secondly, Trump's second modernisation has paved the way for US inclusion of millions of 'Hispanics in the US to enjoy their 'Americanisation' by being ring-fenced into the US by a wall across the Mexican border. Passports say a lot but conformity to the American way in your own backyard is power too ! Like in the NHS, what makes you British is made by one's absolute loyalty and identification to the NHS in Britain for not just the many or the few but for all. Caring for our caring system, to get stuck in, to give people the health they need to make the most of their lives! Migration brings new skill sets and new ventures and Britain could do far worse if it hypothetically opened only its borders to recruit future stars of the NHS!?! But is that 'over-spin, under-spin or unspun logic ? Perhaps the proof will be in the pudding!

So the NHS isn't a relic or a Trojan horse but a professional vocational 'health wealthy' and 'vocationally healthy' organisation of diversity that might have been warped? How ? It might have been serving only predominantly white, male........demarcation. Paradoxically that would amount to eligibility by exclusion or 'non eligibility', a de-selection' which would have excluded most of the general public of today's Britain !?! What a nightmare! But the NHS has steered itself well away from those rocks where its evolution has self-transformed into this mantra: Not for the few or many but for every Briton red or blue'! It is the only civil non-political organisation that has served with such pride and by such sacrifice at the front line against Covid-19 at a time of national and international terror. We should bloody cling to it and never let it go!

© 2020 Stephen Hornsby-Smith

Website by Otters Pool Studio