Today the British public- those of us who’ve noticed- celebrate the 65th anniversary of the launch of the National Health Service. The jewel in the crown of the welfare state and a source of intense national pride, the NHS is the symbol of the socialist idealism that rebuilt Britain as the nation strived to realize its vision of a New Jerusalem in a peaceful and harmonious Europe. Though that idealism was washed away over the following quarter of a century, the welfare state was eroded and the collectivist spirit is just a distant memory, the NHS remains in place.
It has experienced its fair share of problems and crises, some of them self-inflicted. There was myopic underinvestment by the Treasury in the service during the 90s that led to snaking waiting lists. The scandal of Mid Staffordshire is burned into the national consciousness. And with the gradual fragmentation of the service into a loose federation of semi-marketised trusts, consortia and groups, there have been times where patients have lost out due to internal politics. However, most of us would agree that it’s the greatest healthcare system in the world.
In the US in particular, there is tremendous scaremongering about our system of “socialised medicine”. All the claims I’ve heard are entirely false. When you take a minute to reflect on the sheer brilliance of what we’ve achieved, you’d see why. We’ve the only system in the world where money simply isn’t a worry for the patient. No waving of insurance cards, no bills, no phonecalls to an HMO, no claim forms… Not even the Nordic countries can say that. The sole object is the restoration of the patient to full health, and that mentality can only be achieved when healthcare is an entitlement, not a commodity. In the US, patients have been known to be forced to choose which of their detached fingers should be restored. The dumping of vulnerable and uninsured patients by commercial hospitals on the street outside compassionate-minded rivals is not unknown, if fairly rare.
Unfortunately, successive Conservative and New Labour governments have allowed elements of capitalism to creep into the NHS. Cleaning, catering and administration has been outsourced, with a massive fall in standards as a result. The introduction of commissioning groups and GP consortia by the Coalition this April have the potential to see private operators administer entire services. Whilst the NHS remains free at the point of use (90% of the public want it to remain so) we don’t know what implications this could have. That’s why we have to remain vocal about the costs of marketisation, and hold the Labour Party to its promise to reverse the Coalition’s reforms if it is elected in 2015. We’re celebrating 65 years of a wonderful institution today, but should remember we’ll have to fight hard if we want to keep it over the next 65.