THE BLOG

We Love The NHS So Much It's Killing Us

29/11/2016 16:52

Nigel Lawson is famously quoted as saying that the NHS is the closest thing the English have to a religion. It is alarming how far this parallel goes. The national consensus that has developed around the NHS is so strong that it causes affront when someone calls into question even the smallest part of it. A poll in 2012 found that only 3% of us think that the NHS needs reform, while these numbers may have grown a little, they are still far behind similar numbers in other European countries.

It is, however, a dangerous environment in which criticism becomes sacrilegious and reasonable debate about the future of the NHS is shut down. As someone who has only recently moved to the UK, it always strikes me as odd that Brits view the NHS as something remarkable and unprecedented; that it is somehow ahead of what happens in other nations. I've even heard people argue that the very idea of a universal healthcare system - to be looked after regardless of income - is something uniquely British that only happens here.

This is simply untrue. Universal healthcare is not uniquely British, nor indeed is modern medicine. Other western countries manage to keep people alive and, dare I say it, they actually perform rather better on this all important score. It may be blasphemous, but the NHS is no longer the envy of the World, nor has it been for quite some time. For example, 3,200 people die from bowel cancer every year, who had not died had they lived in the Netherlands; or the 3,000 who die from a stroke who would not have died if they lived in Switzerland.

Public love for the NHS is admirable, and you may say it's no bad thing that we have a high regard for our health system. I'm afraid, however, that our love for the NHS is damaging us in two important ways. First, it is damaging because love for the NHS hampers our ability to question it. The debate surrounding the NHS so often boils down to money. "If only we could fill the £22bn black hole and healthcare would be fine" is the chorus, but I'm afraid it's not that simple. The NHS needs dramatic structural changes if it is to be prepared for the challenges it faces. And our affection for it hampers proper debate about how to do this.

Worse, our unexamined affection ultimately detracts focus from the other aspects of the health system that lack the branding power of 'the NHS'. It's for this reason that Cameron can have a poster saying, "I'll cut the deficit. Not the NHS.", and yet not be made to account for the dramatic cuts to social care and public health budgets. The last six consecutive years of cuts to local authority budgets alone have resulted in 26% fewer people getting help. Unless this is the kind of future we desire, we must be passionate about protecting both the NHS and the social care system -- the system responsible for looking after vulnerable individuals and keeping them out of hospital in the first place.

We need to talk about not only the NHS, but also the language we use about the NHS. Criticising the NHS is too often conflated with criticising the staff who do a marvellous job for the NHS. They are doing fantastic things, but it's often in spite of rather than because of the structure in which they work. Criticising the NHS is not to criticise the doctor who saved your mother's life or the value of modern medicine. This kind of rhetoric undermines our ability to talk sensibly about our healthcare system. We need to talk openly about the serious problems facing the NHS, and not be blinded by our affection for it.

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