If you live in the U.K. there are three new stories that have been impossible to avoid this week: the England team scraping past Colombia in the World Cup; another Novichok poisoning in Wiltshire; and the National Health Service (NHS) turning 70.
Yes, the NHS came into existence on 5th July 1948. It remains one of the greatest achievements of any government of any persuasion in the U.K. (and probably in the world). It was the crowning glory of the post-War Labour government and remains, to this day, at the heart of British society from birth to death.
I am very grateful to the NHS for a number of things over the years including the births of my three children, looking after my Dad when he had cancer and my two recent hip replacement operations.
The general public love the NHS – who can forget the sequence in Danny Boyleh’s opening ceremony of the 2012 Olympics which celebrated the NHS accompanied by the music of Mike Oldfield?
However, in the euphoria and public pronouncements marking the anniversary we mustn’t lose sight of the fact that the NHS isn’t perfect – it is flawed, it was designed for a very different time (back in the years following those six years of hardship during the Second World War), there were mistakes made setting it up and it has, today, grown bigger than anyone can have imagined.
The other issue is that, since the Thatcherite revolution of the 1980s, there is the cancer of personal greed and selfishness that pervades society, people don’t want to pay for things like the NHS unless they can see they are personally “getting their money’s worth” – this is awful, selfish and, of course, very shortsighted.
So, to me, the mistakes when the NHS was created were contractual; dentists and GPs should, like others, have been forced to come under the auspices of the NHS as employees and not in effect remained as self-employed contractors. Also, doctors and surgeons should have had to sign contracts insisting they work exclusively for the NHS (or, at the very least, insisting their NHS work takes priority).
Today the NHS has grown enormously. Developments in science and medicine mean more and more conditions and illnesses can be beaten and people live very much longer (but require a lot more assistance in later life).
This is all good, if it can be afforded.
The Conservatives want to cut back on non-essential things that the NHS currently do (and there’s a part of me that sympathises with this). Whether the list of “self-curing” conditions is right or not isn’t for me, as a layman to judge but, I think I agree, the NHS can’t do everything. Can it?
So much more needs to be done away from medical centres and hospitals to keep people healthier. Surely it’s time that cigarettes (and vaping, which while pretending to help people stop smoking is, surely, just a way to keep them going until they fall back on their need for nicotine?) we’re finally outlawed?
(I hear all the arguments about the quantities of tax paid by smokers (and even the arguments about personal choice) but there has to come a point when enough is enough. If cigarettes were invented as a new product today, would they be made legal? I very much doubt it.)
And we need to educate about lifestyle and encourage exercise and make healthy foods cheaper and tax unhealthy foods much more harshly.
Ultimately, though, the NHS is unwieldy. It is a colossus.
It’s all too easy to say that there are too many administrators and managers – maybe there is, but those tasks are important if the NHS is yo function. And it’s way too tabloid to get all sentimental and say that nurses are underpaid and work too many hours – maybe they are, but the average nurse isn’t paid a poverty wage either.
After 70 years, instead of continual tinkering each time a new party comes to power in Westminster, and instead of slicing up the NHS and monetising it, I genuinely think it’s time for two things:
- To give the NHS independence from political meddling (just as the Bank of England is independent from government).
- A blank piece of paper and an NHS 2.0 – a new plan about what we, as a nation, need and can afford from our health service for the next 70-100 years.
Added to this, how the NHS survives Brexit if staff return to their home country…..
Let’s celebrate what a great thing the NHS is, but let’s make sure it is ready and fit for purpose for the next century.
And, if it needs to be funded better, let’s all be happy to pay for it with increased taxation. After all, very few of us will go through life never needing a doctor or nurse.
Robert Steadman: composer 