The Welcome and Long Overdue Death of the Cult of the NHS

For most of the last seventy years the sacredness of the National Health Service has been an untouchable article of faith in British politics. Expressing even the slightest scepticism towards publicly provided healthcare has been framed, and may well have been, as career suicide and a guarantee of pariah status.

The otherwise radical Thatcher administrations shied away from any major tampering with the health service, and had to go out of their way to pretend that they had not even considered the possibility of serious reform. Opposing the current model of the NHS has long been treated as something to be ‘exposed’. And, much needed reforms under successive administrations has been consistently attacked as ‘stealth privatisation’ that undermines the ‘ethos’ of the NHS, with scant regard to what the reforms actually are.

It could be the case that the NHS was the ‘envy of the world’ (it isn’t and never was) that provides the best value for money of any healthcare service (it doesn’t and never did) and the highest quality of service (it doesn’t and never has). Even so, the quasi-religious status of the NHS developed would be unjustified, absurd, and dangerous. Cult-like deference and loyalty to any institution is problematic. Reasoned criticism and debate are shut out and dogmatism replaces evidence in defending it.

The state of the healthcare debate in this country is testament to the absurd pedastel the NHS has been placed on, as is illustrated by the hysterical cries of ‘privatisation’ induced by any reforms, no matter how minor or cosmetic. That universal healthcare can be delivered without a monolithic bureaucracy is apparently specialist knowledge. The debate has been skewed into the holy calling of defending ‘OUR-NHSTM’ on the one-hand and ‘selling it to Richard Branson and leaving poor people to die’ on the other.

This orthodoxy appears, however, to be being slowly eroded. In spite of Labour having run a campaign that was literally based on claiming that Conservative health policy would kill babies, the Tories managed to win the first government by-election victory since 1982 in a seat that Labour have held since the 1930s.  Whilst other factors were in play, it remains notable that the classic Labour trump card failed to work, in spite of a looming hospital closure in the constituency.

Given the wide recognition that the NHS faces unprecedented challenges in the face of an ageing population, not to mention declining public satisfaction with the service, the perception of the NHS being untouchable and sacred may be starting to crack. Hopefully this will be the catalyst for greater support for at least considering alternatives and not simply demanding that unlimited money be thrown at the problem indefinitely.