The Health Service

Labour’s election victory in 1945 paved the way for radical social reform and it was Aneurin Bevan, as Minister of Health, who steered the path to provide everyone, regardless of income, access to free, good quality health services.

It’s become such an intrinsic belief in our society that we have the right to free medical services that it’s difficult to conceive of it as the partisan revolution it must have been at the time – ‘pure socialism’ as Bevan called it. Of course there were detractors and opponents to such a ground-breaking proposal and not only from the political opposition but also from within the Labour party. Interestingly, the medical profession were one of the greatest challengers to the idea.

Bevan’s principle was based on the idea that a society couldn’t consider itself ‘civilised’ if it denied sick people medical attention because they were unable to pay for it. Personally, I think he had a point. He proposed that a free medical service was paid for through government income from taxes – hence more is paid for by those who earn more - and that there were no costs to any patient at the point of delivery. He was so adamant of this ideal that when the Chancellor of the Exchequer Hugh Gaitskill brought in prescription charges of one shilling in 1952, just four years after the NHS’ birth, Bevan resigned from his position as health minister. His iconic status as ‘father of the National Health Service’ stands nonetheless.

Poor Nye Bevan though, if he felt the need to resign at such news, he must surely be rolling around in his grave to see what’s become of the National Health Service in the sixty years since its inception. Not only at the news that prescription charges in the UK since April of this year are £7.10.

The NHS is in crisis. It’s understaffed, underfunded and staff morale has plummeted onto the filthy, unwashed floors of the wards.

Nursing is no longer considered a noble job. We have to appeal for nurses from overseas to fill the vacant jobs. The job itself is so undervalued and underpaid that nurses can’t buy their own homes.

Some of those in the know suggest that there are too many administrators and managers and nobody who is properly in charge: bring back the Matron, I’m told. The powers-that-be put the cleaning contract out to tender, go for the cheapest option, and wonder why nobody gives a toss about a proper job being done. The ‘superbugs’ are spreading. People are being discharged from hospital with illnesses they contracted in hospital. In 2006 it was estimated that superbugs cost the NHS £1 billion.

Despite the possibility of contracting something nasty, like MRSA or C Difficile it’s almost impossible to believe that the patients that make it into hospital are the lucky ones. But they are. The ‘postcode lottery’ as it’s been dubbed by the media, means that which health authority you live in can make the difference in good or bad chances of treatment and recovery. It can even mean the difference between what procedures are carried out. (In some health authorities couples can obtain a maximum of two IVF attempts; in other areas couples will receive none.) We are led to believe that the NHS is a glorious institution but there is definitely disparity in the service.

It’s easy with 20/20 hindsight to acknowledge that in those days it was an ideal that preventative health care would rule out disease. But advances in medical research - both identifying disease and developing treatments – and technology have increased exponentially since the birth of the NHS. I suspect our expectations of what we’re ‘entitled to’ have risen at roughly the same rate.

It does make me wonder what it will take to sort it out – if it can be sorted out. I suspect it will be radical though, just as it was when Aneurin Bevan first introduced the idea.