Lord Darzi’s Independent Investigation of the NHS Is What Orwell Warned About
The misuse of “independence,” drawing on Orwell’s 1984 to expose the report as a biased, self-serving narrative wrapped in scientific theatre.
“NHS Is Health”: Why Lord Darzi’s Report Echoes Orwell, Not Reform
Lord Darzi’s 2024 “Independent Investigation” into the NHS is a bureaucratic fable: full of evidence-sounding language, politically convenient timelines, and conclusions that bend logic to serve the institution.
In Orwell’s world, War is Peace. In ours, NHS is Health — an institution whose name now justifies its own failure.
This isn’t a policy review. It’s a 163-page excuse.
I’ve published a full critique, available as a downloadable PDF:
Or read it here:
Lord Darzi's report on the state of the National Health Service in England, published in September 2024, is a tragic example of how our institutions are failing the public. It illustrates how the UK health system has become a corrupt and dysfunctional organisation — incapable of reform and increasingly insulated from the control it desperately requires.
The government’s use of the word “independent” to describe this investigation is Orwellian: it signals one thing while delivering the opposite. Orwell’s Ministry of Truth famously declared that “War is Peace,” “Freedom is Slavery,” and “Ignorance is Strength.” That’s the essence of Newspeak — language that obscures, distorts, or reverses meaning in the service of power.
This report adopts the same mechanism. It exploits public trust in words like “science,” “evidence,” and “review,” while failing to meet the standards those words imply. What it delivers is a biased, misleading, and contrived narrative in which insiders examine their own handiwork, declare it heroic in intention, tragically undermined by external misfortune, and conclude that the only solution is more money and less scrutiny.
Accountability for performance is never questioned. Systemic flaws are reframed as circumstantial failures. And the NHS, though responsible for delivering outcomes, is cast solely as a victim — of politics, of pandemics, of rising public demand — never of its own design, incentives, or long-standing institutional inertia.
In Orwell’s world, “War is Peace.”
In ours, that logic has evolved.
NHS is Health.
Timeline Tampering — Lord Darzi Cherry-Picks Data That Fit the Story
In a report that claims to be evidence-led, the choice of baseline years is oddly unscientific. 2009, 2010, 2010/11, 2013, 2019 — each appears depending on what makes the narrative look most urgent. But the report never explains why one year is chosen over another. This isn't analysis. It’s storytelling.
When satisfaction is the topic, he starts in 2009 — the high-water mark.
When funding is discussed, 2000–2010 becomes the “golden era.”
When workforce recovery is mentioned, 2010 is the convenient return point — to show we’ve “only just recovered” despite years of growth.
Nowhere is the choice of baseline justified. It’s simply whatever makes the present look worse and the past (under his party) look better.
Abuse of Data — Misleading Claims Masquerading as Evidence
Darzi frequently cites data as if it proves a point — but closer inspection shows the charts often contradict the text, or rely on selectively chosen numbers and definitions.
Several graphs change methodology mid-series, but this is never disclosed in the narrative.
Year-on-year fluctuations of 1–2 percentage points are described as “collapses” or “dramatic declines,” even when well within normal statistical noise.
A drop from 58% to 56% is called alarming. A rise from 56% to 58% is dismissed as insufficient.
This isn’t evidence. It’s emotional calibration.
Charts aren’t used to explore or test a hypothesis — they’re used to decorate foregone conclusions.
Science as Performance — Pseudotechnocratic Language Without Method
Words like “evidence,” “data-driven,” and “science-based” appear repeatedly throughout the report. But there’s no stated methodology. No definitions of terms. No hypothesis to test. No counterfactuals. No causal logic. Just handpicked statistics and vague thematic claims.
The only consistent model it presents is the untested belief that more funding equals better outcomes — a political position dressed as a scientific conclusion.
The numbers presented are chosen by Lord Darzi himself, with no explanation of inclusion criteria, source selection, or analytical framework. There is no objectivity. None.
This is not science.
It’s theatrical empiricism — where data is a costume, not a tool.
When the Light Is Red, He Says It's Yellow — And When It’s Green, He Still Says It’s Yellow
Lord Darzi’s report interprets all data as pointing in the same direction — even when the signals contradict each other. Whether the indicators show decline or improvement, pressure or relief, failure or recovery — the conclusion is always the same. The NHS needs more space. More time. More trust. More investment.
Productivity falls despite rising staff?
That means we need more staff.Technology failed to deliver?
That means we need more technology.Funding rose and outcomes didn’t improve?
That means we need to fund differently — but definitely not less.
It’s like watching someone declare that the traffic light is yellow, no matter what colour it actually is. Red? Yellow. Green? Still yellow. The facts are bent to serve the story.
This isn’t interpretation.
It’s a closed-loop narrative — where no outcome ever challenges the premise.
This isn’t a broken system. It’s a functioning deflection system.
What we’re dealing with is not corruption in the brown-envelope sense.
It’s epistemic corruption—a rot in how we define, evaluate, and discuss the system itself. And it goes unchallenged because our checks and balances have failed: media, academia, and advocacy groups defend their own position within the illusion.
Darzi tells us management is hard because 126 organisations have authority over the NHS. But he offers no remedy—no structural reform, no prioritisation, no clear accounting of who these actors are or why they exist.
Quantum theory tells us that when particles interact, they form a combined system. You can no longer understand the behaviour of one particle in isolation—it depends on the state of the whole. By Darzi’s own admission, the NHS exists in such a combined system. It cannot be reformed without accounting for the overlapping influence of these 126 bodies. Yet his report treats this complexity as an excuse, not a problem to be solved.
He gestures vaguely at the chaos. And then stops. No media outlet questions this. No stakeholder challenges the emptiness. It is a report filled with symptoms and posturing—without a diagnosis. Drafted by someone who may be dedicated to healthcare, but who seems unable to articulate what is structurally going wrong.
The NHS has become a stage.
Patient care is no longer the outcome.
What’s measured is whether the performance holds.
It’s a clown show.