As any foreigner who has spent more than a few weeks in this country can testify, we Brits are not exactly known for rattling away. Our ghastly binge drinking sessions aside, we tend to be as mild as they come. Wars, disasters, national failures, personal heartaches: all are met with naught but a slight quivering of the lip, and even at the best of times, we’re an uptight bunch of sods. Lately though, there’s something that’s been upsetting our famous reserve: namely, the insinuation by some American commentators and action groups that our most beloved of institutions, the National Health Service, is substandard has been causing tempers to rise. Forgetting an embarrassing loss in some cricket match or other, we’ve gone overboard in expressing our outrage, effusively sharing experiences and taking to twitter to combat the myths surrounding ‘socialised medicine’. Prime Minister Gordon Brown and his wife Sarah joined the foray early last week, and on Friday Leader of the Opposition David Cameron jumped on the bandwagon, rubbishing the extremist comments of one of his colleagues in an effort to make voters forget his party’s ambivalence towards the NHS, along with a round of cost-cutting measures his finance spokesman has proposed which will seriously endanger health spending for the first time in decades.
But is this wild abandon justified? Does state-provided healthcare this side of the pond really live up to the praise that’s been heaped on it these past days? Like many of my countrymen, I think so. And here’s why.
Firstly, the NHS is free at the point of need. Much like the Canadian system, where government covers the cost of an individual’s insurance, the state pays for your treatment and in theory has budgeted for it over decades. Everything from chemotherapy to tonsil removal operations do not result in the patient being serviced with a bill for their treatment, and prescription charges, long a source of sound and fury in British politics, are broadly qualified to protect the vulnerable. Constraints placed on public finances by the economic crisis and an aging population raises serious questions about how long such an arrangement can continue in the future, but there is something psychologically important about this kind of model that makes it attractive and difficult to dismantle. The elderly do not regard getting help for an illness or a condition as an underhand way of destroying their hard-earned retirement, and the poorest have no need to fear hospitals and GP surgeries as giant cash machines threatening to swallow their live-savings.
Second, frontline services are of a high standard. Increased spending on healthcare demanded by voters and delivered by politicians means government can purchase decent enough personnel and resources, and most people who have used the NHS here will agree they have witnessed high levels of professionalism and medication. Polls show consumer satisfaction is high, and having worked as a porter through my student days, I can testify that the praise is well-deserved, even in two of the worst hospitals in the entire of England. It should be noted that acquiring excellent equipment and staff entail doubling down on costs elsewhere (e.g. cutting food budgets, rationing the purchase of drugs), and MRSA, a hospital superbug resultant of poor hygiene has entered the national consciousness as a serious problem inherent within the healthcare system. But neither phenomenon should detract from the excellent standard of care patients receive here if they fall ill or suffer an accident: the relevant statistics are powerful indicators of its efficiency and ability to get results.
Then there is our programme of preventative care, perhaps the crucial factor in why healthcare costs are as low as they are in the UK. Root causes of health inequalities such as smoking have come under attack from governments and authorities that have made it harder for people to get their hands on addictive substances, and new challenges such as obesity are increasingly in the sights of the healthcare system, with restrictions on advertising junk food and efforts to get schoolchildren to eat a balanced diet now underway. Right-wing opinion formers frequently rail against such measures, and a future Tory government dominated by unpleasant individualists might try to curtail such efforts in a bid to shut down the ‘nanny state.’ Yet the savings the NHS makes from educating people about the need to live well are likely to make an incoming Conservative administration think twice about such a move, and the fact the the public largely approve of health education will keep it on the political agenda for a long time to come.
Finally, there is the NHS’s commitment to the principle of genuine equality. Designed to mitigate the excesses of what founder Anuerin Bevan called the ‘hedonism of capitalist society’, state healthcare in Britain is committed to safeguarding the rights of every section of the British population. Women have their right to choose protected. Those with physical and mental disabilities such as autism have whole care strategies devoted to them. Couples unable to conceive have some access to IVF. And transgendered individual can usually get access to treatment despite the prejudice they still face among the wider population. A series of reforms introduced by the Blair government aimed at increasing ‘choice’ have entailed the prevalence of postcode lotteries, and a situation does now exist where those living in socially conservative parts of the country are unable to access the same services as those living in more liberal areas. But awareness of this problem is relatively strong, and the commitment to leaving no man or woman behind is likely to remain enshrined for several generations yet despite elite enthusiasm for decentralisation and handing ‘power to the people’ no matter what they might do with it.
Sure, the NHS has its faults. And undoubtedly, the idea of directly imposing what works in a country as homogeneous and geographically small as the UK on a country as diverse and large as the United States is fraught with difficulty. But to dismiss the benefits of state-provided healthcare ad nauseum is not only misguided: it is to reject one of the noblest experiments in our country’s history, to decry a progressive endeavour that still holds Britain up as a little bit Great and its inhabitants as worth more than the reserved exteriors would suggest. Knock it at your peril.
Larry Smith is a buttoned-down Englishman
