There’s much cheering on the left as we celebrate the the 70th birthday of the NHS. That celebration being, of course, partisan and decidedly one sided politically. For that NHS is the national religion and one just never does criticise those. It’s fine to attack, as so many stand ups do, actual God style religions just because few believe in them seriously any more. Thing that really are deep rooted beliefs don’t get joked about quite so much, do they?
But, you know, lefties:
In writing To Provide All People, I hoped to create a lyrical bridge between the birth of the most radical and beautiful idea we’ve ever made manifest and the people who embody that idea today: the staff and patients of the National Health Service. Moving between the story of its coming into being in 1948 and personal experiences of the service today, my aspiration was to paint a philosophical and emotional map of our NHS rather than a journalistic or political survey. I wanted to excavate what the idea of healthcare free at the point of delivery means for us as individuals and as a society. What are the patterns of psychological resonance of such a national act of compassion and how has the ethos of the idea informed and formed us, as individuals and as a country?
Well, yes, the rest of us might be more interested in the best method of getting our bunions fixed. But, you know, lefties. Like the BBC:
The history of the NHS in charts
Which doesn’t include what I regard as the most interesting thing about the NHS. Something which isn’t mentioned in any of the myriad pieces about this Glorious Revolution’s 70th Anniversary.
The NHS built its first hospital in 1963. As far as I know that was actually the first NHS built anything. What happened therefore was not that we created health care in the UK by creating the NHS. What we actually did was nationalise the already extant health care. All and every NHS treatment of anything at all between 1948 and 1963 was carried out in previously privately built space. In fact, near all of the estate was already extant – or obvious reasons – in 1939.
The NHS didn’t create, it took.
Which is an interesting thing, isn’t it? Because it means that every single NHS treatment from 1948 to 1963 could have been done if government just paid for it instead of owning and providing it. And, remarkably, that’s the way many European countries do run things. Government involvement in health care is to pay for it to a greater or lesser level. Actual nationalisation of the sector isn’t necessary.
Sure, you’re entirely at liberty to argue that it’s desirable. But that others get health care without it, that the UK got health care before the NHS, that the NHS only existed by taking over that extant system, does mean that the NHS = health care isn’t true.
Just to hammer this home, from the BBC:
Another factor is immunisation. The NHS was set up not simply to treat illness, but also to promote good health.
The introduction of the polio vaccine in the 1950s is a perfect example of this.
Before this programme, cases of polio could climb as high as 8,000 in epidemic years, but once people started getting immunised the numbers dropped quickly.
There is now a comprehensive vaccine programme in childhood with immunisations covering everything from meningitis and mumps to whooping cough.
Rather famously, the polio vaccine was developed in the US, nothing to do with the NHS. Equally famously, the immunisation campaign in the US was funded and pushed by the charity, March of Dimes, not by the NHS. Polio has been pretty much eradicated around the world now and we’re the only people who do have the NHS.
That is, medical care existed before the NHS, would exist without the NHS and in most of the world does without it. The NHS being therefore neither a necessary nor sufficient condition for anything at all.
And once we accept that we can have the necessary rational debate about whether we want to keep the NHS, can’t we?
In my home town there are still people alive who as little children dug into their own pocket to donate pennies and shillings to build our own hospital – in 1926.
The “radical and beautiful idea,” then, is a bureaucracy that can never be extinguished, because it comprises an army of people plying the false choice that no medicine could occur in its absence, and that reverting to personal responsibility would send someone a depressing message about What We Are Like.