… it is a matter of common experience that members of the middle classes are far better able to derive benefits from the system than the lower classes. They complain where the lower orders swear, and bureaucrats are aware that articulacy is a more dangerous enemy than assaults on staff can ever be.
The interesting question of why the NHS should continue to hold the affection of the British people, when it is at best mediocre in its performance and frequently unpleasant to deal with, is one that should be of interest to all political scientists. The answer is not pleasing to those who believe in human rationality.
The affection represents the triumph of rhetoric over reality. This rhetoric contains an implicit historiography, in which the pre-NHS era is akin to that of jahiliyya, the era of ignorance before the advent of Muhammad, in Islamic historiography: in short, that there was no healthcare for most of the population before the NHS. This historiography has for decades been continuously and successfully insinuated into the minds of the population. It has been Britain’s pale imitation of totalitarian propaganda. Intentionally or not, Boris Johnson recently reinforced the mythological status of the NHS. And when, in the present crisis, retired doctors such as I were asked to return to work if they were able, it was to help the NHS. This was like asking a soldier to lay down his life for the sake of the Ministry of Defence. It says something about the credulity of the public that the response to slogans like “protect the NHS” was dull compliance, rather than outraged demands as to why it wasn’t protecting us.
I suspect also that the sheer unpleasantness of the NHS is reassuring to the British population. It evokes the Dunkirk spirit: we are all stranded on the beach of illness together. And if we cannot all live in luxury, we can at least all die in squalor. Justice is served.
Theodore Dalrymple, “Empire of conformists”, The Critic, 2020-04-29.
August 1, 2025
July 24, 2025
QotD: Migrant farm workers
It is certainly true that the fruit-pickers would not be well-paid. Moreover, their accommodation during their stay would almost certainly be uncomfortable and overcrowded. The work they would do would be hard and possibly back breaking. It is certainly not the kind of work I should want to do myself, though I might have thought of it as a bit of an adventure for a couple of weeks to earn some pocket money when I was nineteen. But the Romanian workers are not coming for a bit of youthful adventure: they are coming because they are poor and need the money to live.
The fruit season is short. If the fruit is not picked, it will rot where it grows. Prices are such that farmers cannot offer high wages, and it is surely a good thing that fruit is available at a price that everyone can afford. There have been appeals to the British unemployed (in whose numbers there has been a sudden and great increase) to do the work, but they have not responded. The wages are not such as to attract them, and their economic situation would probably have to be considerably worse before the wages did attract them — and if their situation were to worsen to such an extent, they might choose crime, riot, disorder and looting rather than fruit-picking as a means of getting by economically. As for coercing the unemployed to take the work that is theoretically available to them, for example by withdrawing their social security unless they agreed to do it, the political repercussions would be too terrible to contemplate. It is easy to see in the abstract how our system of social security distorts the labour market, such that we have to import labour to perform such unskilled tasks as fruit-picking, but now is not a propitious moment at which to try radical reform. In politics as in life, you are always starting out from where you are, not from where you should have been had your past conduct been wiser or more prudent.
Theodore Dalrymple, “Contradictions of Labor”, New English Review, 2020-05-05.
Update, 26 July: Original link replaced. Link rot is sadly real.
June 30, 2025
QotD: Britons and their NHS
I have to run a gamut of procedures to do so and face a receptionist who treats me as a fraud trying to get something to which I am not entitled, and I have no practitioner whom I can call my doctor. The NHS has crowded out private competition, and the nearest private doctor is 25 miles away. Suffice it to say that, if I want to see a doctor, it is easier, quicker and more pleasant for me to go to France than to the health centre about 300 yards from my house in England.
I cannot in all honesty say, however, that my health has suffered in any measurable way as a result of this unpleasantness, because my health is good and I am not a doctor-botherer. But it does reveal something about Britain that is not true in France: in our dealings with the NHS, we are a nation of paupers who must accept what we are given by grace and favour of the system. It may be good or it may be bad, but we have to accept it.
Furthermore, under the NHS doctors themselves are becoming ever less members of a liberal profession and ever more executors of orders from on high, with little leeway to consider whether these orders are good or bad in the case of the individual case before them.
This is a problem in all systems in which a third party pays for patients’ treatment, but it is particularly acute in a highly-centralised and dirigiste system such as the NHS, in which uniformity is the goal, even if it be uniformity of error. And increasingly, it creates an atmosphere of technical, managerial and ethical conformity.
Theodore Dalrymple, “Empire of conformists”, The Critic, 2020-04-29.
June 15, 2025
QotD: Four stages of revolutions
Professor Chirot writes extremely well and is never less than clear. He uses no jargon and he has a gift for condensing complex historical events into a short compass without resort to procrustean simplification. I would imagine that he is an excellent teacher.
He does not claim to have found a universal law of history that applies at all times and in all places, but he says that large-scale revolutions in the modern world have had a tendency to go through four discernible stages. First, an outmoded governing power refuses to accept that change is necessary and consequently refuses to make the necessary concessions to save itself. This leads to overthrow by relatively moderate leaders who would once have accepted compromise but see that change can only come about by revolution. Second, there is a counter-revolutionary reaction by those who do not accept their loss of power and who provoke a civil war or call for foreign intervention, or both. As a result, much more radical revolutionary leaders come to the fore and defend the revolution by increasing repression of enemies or supposed enemies. Third, the radical leaders, because they hold extreme views and are imbued with unrealistic notions of the complete redemption of mankind from all its earthly ills, impose experimentation on the population which is economically and socially disastrous. Fourth, in the case of its evident failure, the revolutionary regime loses its ideological ardour, and settles down to a kind of routine and less violent authoritarianism accompanied by large-scale corruption and cronyism.
Theodore Dalrymple, “Longing for Revolution”, Law & Liberty, 2020-05-13.
May 20, 2025
QotD: The autohagiography of the NHS
I grew up, for example, in the inculcated belief that the National Health Service was, according to the slogan of the time, “the envy of the world”. Millions of people believed this, and indeed it was an assertion heard for many years whenever the subject of health care came up. The slogan was last wheeled out in any force in 2008 for the 60th anniversary of its founding.
Oddly enough, it never occurred to the people who repeated the slogan to examine the basis of the claim. Who, exactly, were the people doing the envying — not just one or two of them, but en masse? It is no doubt true that immigrants from very poor countries were pleased enough to receive care under the NHS, comparing it with what they would have received at home. But is it really much of an achievement for a developed country to have health care better than that offered in Somalia or Bangladesh?
A war of anecdotes, while always gratifying to the human mind, is not the way to decide important questions such as the superiority or inferiority of a system of health care.
It never occurred to those who repeated the “envy” slogan to look to comparable countries across the Channel or North Sea to see whether, in fact, those countries had anything to envy. In fact, between 1948 and 1975, even Spain under Franco performed better in the matter of improving the health of the population than did Britain. In most respects, in fact, Britain lagged or limped behind other countries, always in the rear and struggling to catch up.
What eventually struck me, then, was the willingness of so many people to repeat and believe a slogan without any compulsion whatever to do so, and without the slightest inclination to examine its truth — indeed without any awareness of the need for such an examination. There was no oppressive force to prevent or deter them from intellectual inquiry, but they preferred the comfort the slogan offered to the effort and possible discomfort of finding the truth. The NHS, or rather the idea of the NHS, played the role of teddy bear to a population with many anxieties.
True enough, many individuals may have experienced deficiencies in the service — long waiting times, offhand or disagreeable interactions with the bureaucracy, etc. But like Russian peasants of old who believed that the Tsar knew nothing of the oppression which they suffered, and would have put an end to it if he had known, the British continued to believe that the National Health Service had been born with original virtue and that the defects they experienced were exceptions. Repeated scandals of gross neglect or sub-standard treatment were shrugged off in the same way. And in a certain dog-in-the-manger way, the British were inclined to believe that if the NHS was unpleasant to negotiate, at least (being more or less a monopoly) it was equally unpleasant for everyone. Fairness and justice were equated with equal misery. Anyway, being ill is always unpleasant, so what did anyone expect?
Theodore Dalrymple, “Worshipping the NHS”, New English Review, 2020-05-07.
May 16, 2025
QotD: Marxist and socialist revolutions
The collapse of communist regimes in Eastern Europe, which he is happy to call revolutionary, also does not support his rough schema. It is not that the communist regime refused to reform, it is that it was incapable of reform for the same reason that a woman can’t be a little bit pregnant. If a regime makes the kind of claims for itself that the communist regime made, even if the leaders had themselves long since ceased to believe them, namely that it is the ineluctable denouement of all history, if not that of the universe itself, it cannot retreat, all the more so because its crimes, which one could and would have been claimed as a step in the march of history, would thereafter be seen for what they were: the choices of fanatical psychopaths avid for total power.
Professor Chirot seems to have a slight soft spot (admittedly only implicit) for socialism, that is to say for something more than mere social democracy. In his discussion of the case of Angola, in which a revolutionary movement emerged triumphant, but whose post-revolutionary regime was a pure kleptocracy under cover of Marxist rhetoric, he says: “Much more could have been done through either a market-friendly or a genuinely more socialist approach to economic development”.
This surely implies that somewhere, at some time, there was a socialist regime that would have handled Angola’s oil bonanza better, in which case one would have liked an example that it might have followed. Norway, perhaps? But Norway is not socialist, it is social democratic. Besides, Norwegians and Angolans are scarcely the same in a very large number of ways. I would have thought that the chances of Angola following the Norwegian model were, and are, approximately, and perhaps even exactly, zero.
Theodore Dalrymple, “Longing for Revolution”, New English Review, 2020-05-13.
May 2, 2025
QotD: The Victorian attitude toward illegitimacy
I am still shocked by the recollection that, as late as the early 1990s, there were still a few women in psychiatric hospitals in Britain who were there principally because they had been admitted seventy years earlier after having given birth to an illegitimate child. No doubt they had quickly become institutionalised and could scarcely have coped with life outside; but to think of a long human life passed in this impoverished way (the wards for “chronics” had beds so close together that they allowed for no privacy whatever) as a kind of punishment for what is now no longer regarded even as an indiscretion, reminds one of La Rochefoucauld’s dictum that neither the sun nor death can be stared at for long. One cannot fix one’s mind on such a horrible injustice for long.
Of course, it was stigma like this that gave stigma itself a bad name — stigmatised so to speak, in fact, to such a degree or effect that the very name of stigma has a completely negative valency. No one has a good word to say for it, though whether there ever was, or could be, a society completely without it, I am unsure.
Theodore Dalrymple, “The Situational Nature of Scorn and Stigma”, New English Review, 2020-04-28.
April 11, 2025
QotD: Teaching in modern universities
In two sentences, Leys has pinned, like a butterfly to an entomologist’s board, the bureaucratic sickness that has overtaken our institutions of higher learning (and not only those institutions). There is no madness more difficult to treat than that which believes itself sane, and there is no irrationality greater than that which believes itself perfect. It is no surprise that Leys retired early from his university chair because the university no longer bore any resemblance to what it had once been and misled students and the rest of society into believing it still was. A community of scholars had become an organization of foremen on a production line.
Theodore Dalrymple, “Rare and Common Sense”, First Things, 2017-11.
March 24, 2025
QotD: Communism and western intellectuals
Mao Zedong was the blank page or screen upon which they could project the fantasies that they thought beautiful. China was a long way off, its hundreds of millions of peasants inscrutable but known to be impoverished and oppressed by history; its culture was impenetrable to Westerners without many years of dedicated and mind-consuming study; Western sinologists, almost to a man, upheld the Maoist version of the world, some of them for fear of losing their access to China if they did not, and thereby created the impression that Maoism was intellectually and morally respectable; and so perfect conditions were laid for the most willing and total suspension of disbelief. Mao’s Thoughts — that is to say, clichés, platitudes, and lies — were treated by intelligent and educated people as if they were more profound, and contained more mental and spiritual sustenance, than Pascal’s. As so often before, mere reality as experienced by scores of millions of people was of little interest to intellectuals by comparison with the schemata in their minds and their own self-conception. “Let the heavens fall so long as I feel good about myself” was their motto. One didn’t know whether to laugh or cry.
Theodore Dalrymple, “Rare and Common Sense”, First Things, 2017-11.
December 15, 2024
The fall of the house of Assad
In the New English Review, Theodore Dalrymple considers the fall of Syria’s dictator as the al-Assad family is finally toppled from power:
When I saw video clips of the joyful toppling of statues of Bashar al-Assad, as well as the tearing from walls of his ubiquitous portrait, I wondered what it must be like to be a dictator and see images of yourself everywhere (not that I have any ambitions myself in that direction).
Do you come to imagine, for example, that they are a manifestation of genuine popular affection for yourself, or are you like the Nicaraguan dictator Anastasio Somoza, of the poem by Ernesto Cardenal “Somoza Unveils a Statue of Somoza in the Somoza Stadium” (the fact that Cardenal, a Nicaraguan priest, was a commie doesn’t mean that he wasn’t a good poet).
The Somoza of the poem is perfectly clear-sighted. He knows that people didn’t erect the statue spontaneously, out of love for him, because he knows that he himself ordered it to be erected. Nor does he think that it will be a perpetual monument to himself because he knows also that the people will tear it down as soon as they can. No, he had it erected because he knew that the people would hate it, in other words that it would humiliate them, and a humiliated people is easy to cow into submission, at least until — to use a word of slightly different zoological connotation — the worm turns. (A note to pedants before they write in: I do not think that the verb to cow has any etymological link with the female herbivore known as the cow.)
It seems to me, however, that Cardenal may have simplified a little. Such is the complexity and potential dishonesty of the human mind that a dictator would be perfectly capable of imagining that a statue of himself is a manifestation of people’s affection for him and that there are people plotting to bring down both the statue and him because they hate him. This is not totally irrational or impossible. After all, as Americans know, even in a free democracy some people love the leader and some people hate him (usually more of the latter after he has been in power for some time).
Assad junior, it seems to me, is a living refutation of Solzhenitsyn’s famous remark that Macbeth was capable of killing only a handful of people because he was motivated by no ideology, and it requires an ideology to bring about hecatombs of the Nazis or Communists. Assad junior had a self-justification for his rule, no doubt, as every ruler and dictator has and must have, but he did not really possess a full-blown ideology in Solzhenitsyn’s sense. His trajectory is worth recalling.
The son of a monstrous dictator, he seems at first to have had no inclinations in that direction himself. Among other things, he didn’t seem to have the physical attributes of a dictator, but rather of someone pliant and weak, more herbivore than carnivore, more giraffe rather lion (though giraffes can kick a lion to death). And it spoke rather well of him that he should qualify as a doctor, apparently quite genuinely so, and wish to become an ophthalmologist, to which end he studied in London, where his conduct was not that of a spoilt brat but by all accounts rather modest — laudably so, in the circumstances.
December 11, 2024
QotD: Simon Leys on George Orwell
What Leys wrote in 1984 in a short book about George Orwell might just as well have been written about him: “In contrast to certified specialists and senior academics, he saw the evidence in front of his eyes; in contrast to wily politicians and fashionable intellectuals, he was not afraid to give it a name; and in contrast to the sociologists and political scientists, he knew how to spell it out in understandable language.”
Leys drew a distinction between simplicity and simplification: Orwell had the first without indulgence in the second. Again, the same might be said of Leys — who, of course, like Orwell, had taken a pseudonym, and with whose work there were many parallels in his own.
But immense as was Leys’s achievement in destroying the ridiculous illusions of Western intellectuals, as Orwell had tried to do before him, it was a task thrust upon him by circumstance rather than one that he would have chosen for himself. He was by nature an aesthete and a man of letters, and I confess that great was my surprise (and pleasurable awe) when I discovered that he was, in addition to being a great sinologist, a great literary essayist.
Theodore Dalrymple, “Rare and Common Sense”, First Things, 2017-11.
December 3, 2024
QotD: Old fashioned communists
Theodore Dalrymple, “A Matter of Respect”, Taki’s Magazine, 2019-12-31.
September 22, 2024
QotD: The work of Le Corbusier
Theodore Dalrymple, “Architectural Dystopia: A Book Review”, New English Review, 2018-10-04.
June 25, 2024
QotD: Progress and decline
So progress must have occurred in the intervening time, despite the pessimism that infects those who, like me, are of retrospective temperament and hypersensitive to deterioration. It is not hard to enumerate many things that have improved. They relate principally, but not only, to material conditions. My best friend when I was very young was one of the last children in Britain to suffer from polio, which paralyzed him from the waist down. The quickest form of written communication was then the telegram, and anything other than local telephone calls had to go through an operator. To call across the Atlantic required a reservation and was ferociously expensive; the resultant conversation always seemed to take place during a violent storm. In England, the food was generally disgusting, and meals were to be endured as a regrettable necessity instead of enjoyed (it puzzles me still how people could have cooked so badly). Cars broke down frequently, and every November, pollution produced fogs so thick that you couldn’t see the hand in front of your face (I loved them). Rationing continued for eight years after the war, and disused bomb shelters, present in every park, were where illicit sexual fumbles and smoking took place. Incidentally, for an adult male not to smoke was unusual (75 percent did so); we must have lived in a perpetual fog of foul-smelling tobacco, to judge by the distaste caused by even a single lit cigarette in these virtuous times. Poverty, as raw necessity, still existed. Murderers were sometimes hanged — as well as, more rarely, the innocent. Overt racial prejudice was, if not quite the norm, certainly prevalent.
Yet not everything has improved, though the deterioration has been less tangible than the progress. To give one example: by age 11, I was free to roam London, or at least its better areas, by myself or with a friend of the same age. The sight of an 11-year-old child wandering the city on his own did not suggest to anyone that he was neglected or abused. I remember, too, the evening papers piled up at newsstands; people would throw coins on top of the pile and take their copy. It never occurred to anyone that the money might get stolen; nowadays, it would never occur to anyone that the money would not be stolen. The crime statistics bear out this sea change in national character.
Theodore Dalrymple, “What Seventy Years Have Wrought”, New English Review, 2019-10-26.
May 21, 2024
“Modern pop music is to the West what speeches by [Dear Leader] are to North Korea, namely inescapable”
Poor Theodore Dalrymple is finding that everyone around him seems to be actively imposing their questionable music choices on him no matter how he tries to decline the offer:
Whenever I try to escape pop music relayed in public places at high volume — which is often, though considerably less often with success — the thought comes into my mind that the harnessing of electricity was a disaster, if not for humanity, at least for civilization if good taste be part of that much-derided entity.
Modern pop music is to the West what speeches by North Korea’s greatest scientist, composer of operas, huntsman, industrial chemist, engineer, poet, agronomist, philosopher, economist, military strategist — in short, its present leader — are to North Korea, namely inescapable. If I were an absolute dictator, which fortunately for me among others I am not, I would forbid the public relay of such music under pain of death by deprivation of sleep.
Unnecessary noise should be regarded in the same way as cigarette smoke now is, a pollutant that infringes the rights of anyone subjected involuntarily to it. My sensitivity to cigarette smoke, incidentally, is now very acute: The other day, in the open street, there was a man sitting on a low wall smoking a cigarette a few yards from me, and I began to cough. This was not merely a psychosomatic reaction; I began to cough before I saw the source of what caused me to do so.
I must have grown up in a world that smelt like an ashtray, so great was the proportion of the population that smoked, but I did not notice it, any more than I noticed the air itself. Every curtain, every carpet, must have been saturated with such smoke, now stale, to say nothing of the fug created by cigarettes under current use. I remember the days when you could smoke on trains and airplanes. At the back of the cabin of the planes were the seats for smokers, not separated off from the rest of the fuselage, and if you were a nonsmoker such as I, you were often (so it seemed) allocated the row just in front of the first of the smokers’ seats, such that you might as well have been in the midst of them. Cigarette smoke on flights was as inescapable as crying babies now seem to be.
