Chapter abstracts

Broadcasting and the NHS in the Thatcherite 1980s: The Challenge to Public Service

Image of Margaret Thatcher giving a speech

Patricia Holland, with Hugh Chignell and Sherryl Wilson

A study of the ways in which the changes to the public services, and the shifts in the concept of ‘the public’ under Margaret Thatcher’s three Conservative governments were mediated by radio and television in the 1980s.

Prologue: echoes of the 1980s

The Prologue looks back at the 1980s from the perspective of the banking crisis of 2008-9. ‘Thatcherism’ brought significant shifts in the political, economic and ideological climate in the UK. The important concept of ‘public service’ was challenged by the Conservative governments in a move towards a market-driven economy. The book will trace the changes through the broadcast programmes of the decade on both radio and television. It will argue that there is a significant, but not straightforward, relationship between the broadcast output and the politics, and the following chapters will trace that relationship in relation to the major public services, broadcasting and the NHS. To help in this study, the authors compiled lists of relevant programmes across the broadcast genres.

Introduction: Thatcherism, the public and writing broadcasting history

The book deals with ‘mediatised history’: the relationship between culture and politics; the creation of mythologies and images and their relation to changing values. The Introduction explores this approach. Programmes dealing with politics and the NHS will be analysed according to the flow of information, their cultural creativity and their ‘conditions of possibility’. We will explore how the programmes are populated: in particular by individuals performing certain, clearly defined roles. The Introduction sets out the various approaches which could be mobilised across the broadcast genres (the ‘generic possibilities’). The mythology of Margaret Thatcher dominated the decade. Her notorious declaration that ‘there’s no such thing as society’ signalled a shrinking of the ‘public realm’, especially in relation to the National Health Service and broadcasting.

Chapter 1 is preceded by a chronology and list of programmes 1927-1970

Chapters 1, 2 and 3 set the stage for the Thatcherite 1980s by exploring the opposing ideologies of the 1970s as the ideas of ‘Thatcherism’ were first evolving.

Chapter 1 Myths of origin: Public service or the road to serfdom?

Chapter 1 traces the NHS and broadcasting prior to 1979, then looks at the rise of neoliberal ideas. It concludes with an account of BBC Radio 4’s current-affairs series, Analysis. Both the NHS and the BBC were founded with a commitment to serve the public at large. This remained their ‘myth of origin’, but both saw conflict and compromise. In 1955 commercial television, ITV, brought public-service commitments, but the NHS remained a mixed economy, facing constant problems with funding and commercial pressures. The 1970s was a turbulent time for both services. Meanwhile monetarist economics gained support across the political spectrum, promoted by think tanks, including the Institute for Economic Affairs. The ideas influenced Thatcher and her supporters, and many journalists, including some working on Analysis.

Chapter 2 is preceded by a chronology and list of programmes 1970-1980

Chapter 2 Freedom and the public: Campaigner, participant, consumer

Chapter 2 takes up the theme of ‘freedom’, expressed in the Conservative Party’s 1979 election broadcast, then discusses the counter culture and new social movements of the 1970s. Finally it suggests types of ‘public’ evoked by these debates, including traditionalist, pluralist and libertarian positions, where the ‘public’ are seen as individual consumers, exercising choice in the market place. The Chapter gives a detailed account of Free to Choose, (BBC2 1980) in which economist Milton Friedman laid out arguments for a free-market economy. The radical movements were also critical of institutions and professions, some from a socialist/democratic perspective, others from a rejection of institutionalised medicine, influenced by the writer Ivan Illich. The left-wing cultural theorist, Stuart Hall, detailed a ‘Great Moving Right Show’ (Marxism Today January 1979).

Chapter 3 Broadcasting into the 1980s

Chapter 3 describes the broadcast output in the 1970s, identifying trends, including the ‘radical’, the ‘popular’, the ‘challenging’ and the ‘informal’ -a more casual and intimate style across the genres. This included ‘access’ programmes, initiated by BBC’s Community Programme Unit, where members of the public participated in programme-making. It then discusses critiques of broadcasting from campaigners of the 1970s, including the Independent Filmmakers’ Association (IFA), and the role of academic studies. A ‘TV4’ campaign, set up to present evidence to the Annan Committee on the future of broadcasting, argued that the fourth television channel should be educational, community based or experimental. Annan recommended an ‘Open Broadcasting Authority’ commissioning independent producers. The Chapter concludes with an account of the General Election 1979 and Thatcher’s victory.

Chapter 4 is preceded by a chronology and list of programmes 1979-1983

Chapters 4, 5 and 6 trace the restructuring the three main roles in the medical encounter, workers, patients and professionals, in the early 1980s. This, we argue, was part of the Thatcherite project and contributed to the undermining of ‘public service’.

Chapter 4 Restructuring social class

Chapter 4 notes Margaret Thatcher’s dislike of Tory ‘grandees’ and her appeal to the ambitious working class. It describes current-affairs programmes on radio and television which dealt with strikes in the NHS and the role of the trade unions. It discusses the position of nurses, caught between the stereotype of ‘angels’ and their position as low-paid workers. The chapter discusses Thatcher’s own attacks on collective action, and the analysis of ‘Thatcherism’ by Shirley Robin Letwin who argued that its essence is in the ‘vigorous virtues’, individualism and competition, rather than participation and co-operation. It notes that ancillary workers rarely had the opportunity to speak for themselves on the airwaves. The chapter concludes with the class-based hospital comedy Only when I laugh Yorkshire/ITV 1979-82.

Chapter 5 From needs to wants: Restructuring audiences, restructuring patients

Chapter 5 illustrates contestation over the drive to reconstruct the public as ‘consumers’: a shift from patients’/viewers’ ‘needs’ towards their ‘wants’, expressed in the purchase of services. It discusses the Black Report, Inequalities in Health, and the 1980 BBC Reith Lectures where Ian Kennedy argued that ‘need’ should be paramount. There was an increase in medical programmes looking at health issues from the patient’s point of view. We look at this ‘humanist consumerism’ on the newly launched Channel Four, and argue that the concept of ‘public service’ in broadcasting was enriched by the Channel, which was charged with appealing to diverse tastes and interests. We conclude with Going Gently, a drama set in a hospice, where dying patients have only needs.

Chapter 6 Your life in whose hands? Restructuring professionals

The monetarist approach argued that professionals should be redefined as the sellers as services. Patients would be respected as ‘customers’ and monetary rewards would incentivise those who worked in the service. The series Your Life in Their Hands (1980) celebrated medical skill, but the professionalism was balanced by an emphasis on costs. Current-affairs programmes discussed moves towards privatisation of health provision and the discipline of money. The new Channel Four held an ambivalent position between encouraging the private enterprise of independent production companies and its commitment to a diverse public. Its drama The Nation’s Health (1983) was a bitter attack on professionals from a left libertarian position. The chapter concludes with a note on genre and the possibility of many different perspectives within the broadcast output.

Chapter 7 is preceded by a chronology and list of programmes 1983-1987

Chapters 7, 8 and 9 look at the middle years of the decade, when major government reports were produced on both broadcasting and health, and the AIDS epidemic made unprecedented demands.

Chapter 7 The Third Age and the fresh winds of market forces: Restructuring broadcasting

The debate about public service in broadcasting intensified as the multi-channel age dawned. There was a government report on cable and experiments with satellite. The BBC’s licence fee was criticised. Chapter 7 describes the Corporation’s dilemma -it must sustain audience appeal without abandoning ‘public service’ principles- and it looks at the role of the Light Entertainment department in relation to ‘public service-ness’. The Chapter explores different ways in which the concept of ‘public service’ was mobilised, and the influence on academic thinking of Jurgen Habermas’s concept of a ‘public sphere’. It concludes with the eight main principles of public service broadcasting contributed by the Broadcasting Research Unit.

Chapter 8 Griffiths, Peacock and restructuring public service

In the mid-1980s, government reports on the NHS and broadcasting recommended reorganisation along the lines of the private sector. Following Griffiths, current-affairs programmes explored the introduction of a new type of manager into the NHS. Peacock looked forward to ‘a full broadcasting market’. A Green Paper on Radio proposed deregulation of Independent Local Radio (ILR). Chapter 8 begins with the Thatcher government’s appeal to ‘popular capitalism’ with the sale of shares in newly privatised industries, and ends with the government’s undermining of the BBC through limiting the licence fee and appointing Conservative sympathisers as BBC Governors. In See For Yourself a three hour BBC1 programme, the new Chair of the Board of Governors and Director General gave an account of BBC activities and their costs.

Chapter 9 Aids and ‘the public’ at risk

With the coming of the AIDS epidemic, the nature of ‘the public’ needed to be re-assessed. Chapter 9 considers the pressures on the NHS, reported by current-affairs programmes, and the reflection of the epidemic across the broadcast output. It looks at the shift in emphasis from a gay problem to one which affected the whole population, and the unprecedented frankness in discussing sexual behaviour and contraception. It documents the government’s awareness campaign and ‘AIDS week’ with programmes across all channels (27.2-8.3 1987). It also discusses dissenting programmes: first a rejection of the government’s ‘safe sex’ approach, demanding the promotion of monogamy, then the argument that HIV could not cause AIDS, and an exploration of the vested interests behind the promotion of test kits and drugs.

Chapter 10 is preceded by a chronology and list of programmes 1986-1990

Chapters 10, 11 and 12 discuss development of popular programming towards the end of the decade, and ‘third term politics’ with two major Acts of Parliament in 1990.

Chapter 10 Who’s the casualty? Popular programmes

Chapter 10 takes up the development of popular programming towards the end of the decade, but points out that innovation and a critical approach remained. The BBC’s Casualty, which began in 1986, expressed the writers’ anger at the new managerial culture and the government’s attacks on the public-service commitment of the NHS. The Chapter looks at the first series of Casualty in detail, and compares it with a This Week report of a real A&E department. It also discusses the evolution of new popular genres as the broadcasting hours were extended, and includes producer, Nick Gray’s account of the docu-soap Jimmy’s (Yorkshire/ITV) which followed the daily life of a Leeds hospital.

Chapter 11 The NHS and third term politics

Chapter 11 begins with the ‘big bang’ in the city and Margaret Thatcher’s third election victory. Aspirational dramas and glitzy advertisements contrasted with the bleaker accounts from factual programmes. The NHS faced a financial crisis and programmes detailed delayed operations and managers closing wards and whole hospitals to save money. Kentucky Fried Medicine (C4 1988) compared the UK and American health systems and we explore the arguments it puts for and against private medical care. The Chapter traces the progress from the 1989 White Paper Working for Patients to the 1990 National Health Service and Community Care Act, which created an ‘internal market’, with self-managing trust hospitals and fund-holding general practitioners.

Chapter 12 ‘Quality’ and the Broadcasting White Paper

The 1988 White Paper on Broadcasting proposed that ITV licences should be ‘auctioned’ and the BBC should move to an ‘internal market’. Chapter 12 discusses the vigorous campaigns to protect a regulated system, mobilised amongst broadcasters, academics and others. An argument to preserve ‘quality’ became a campaigning tool: more flexible and easier to defend than ‘public service’. In response, concessions, including a ‘quality clause’ were inserted into the 1990 Broadcasting Act. Sky television was launched in March 1989, becoming BSkyB in November, and the Chapter concludes with an exploration of the multi-channel future of television. In The Television Village (Granada/C4), Waddington in Lancashire was wired to receive 34 channels. Villagers discussed their viewing and the local MP, Home Secretary David Waddington responded.

Concluding comments: public service or kitemark?

The concluding comments summarise the themes of the preceding chapters, and note the triumphalism of the right-wing think tanks, such as the Adam Smith Institute, who argued that a ‘culture of success’ had been created. Advertisements echoed that triumphalism. We also note that the public-service culture of the NHS and the broadcasting channels had been destabilised. More than two decades later, we are dealing with the consequences of the changes.