We still love our failing NHS

A new poll about the NHS, the Sunday Times tells us, has discovered ‘a decline in support’ for the National Health Service. The story spoke of ‘wide dissatisfaction about the state of the health service’, under the headline: ‘Britain falls out of love with the NHS’. The figures from the poll itself tell a slightly different story. The headline finding was that three people in five are now not confident that they would receive timely treatment were they to fall ill tomorrow.

But these three people in five aren’t necessarily saying they’ve ceased to approve of the NHS. It seems to me that they are simply affirming what they’ve read in the papers and heard about on telly and experienced, piecemeal, themselves. It’s bloody hard to get an in-person appointment with a GP. Waiting times for operations are on the rise. Ambulances run slower than rural bus routes and a trip to A&E is for life, not just for Christmas. To say that the health service is creaking – that it is demoralised and understaffed and underfunded (or, at least, struggling to fulfil its remit with the funds available) – is simply to concede a verifiable and widely reported fact. If you have a year’s headlines announcing, truthfully, that bears defecate in the woods, you can’t come over all surprised when you poll the general public and find they have decided views on ursine toilet habits.

When my dad had viral arthritis, spinal stenosis and dodgy knees, I certainly had what Sunday's report would have called wide dissatisfaction with the state of my father. I might have conceded that he wasn’t fit for purpose as a doubles partner in a game of tennis. But I hadn’t ‘fallen out of love’ with him. And I can’t see anything very much in the poll to suggest the case is otherwise with the NHS.

As the Sunday Times noted, when the NHS celebrated its 70th birthday four years ago, nine people in ten said they supported the founding principles of the service and three-quarters believed it should continue in its current form. If these questions were asked again in the current poll, the answers were not reported – and yet those are the questions whose answers might reasonably be said to tell us whether the public really has fallen out of love with the NHS. ‘Voters believe the NHS is still underfunded but oppose tax rises designed to pay for it,’ the poll discovered – well, isn’t that voters all over? What was it I was saying about ursine toilet habits?

It’s not all that long since people were standing on their doorsteps banging pots and pans in appreciation for the health service – which, sure, was perhaps a silly gesture but in its wide take-up seemed to me to indicate a good deal of public goodwill for the health workers who risked a lot and endured a lot to save lives in the pandemic. We can and should make a distinction between the institution and the people who staff it – it’s perfectly possible to believe that nurses are deserving of gratitude and respect and at the same time to believe that the NHS is an over-bureaucratised bloated shambles – but most of us, much of the time, make the distinction imperfectly. Identically pious references to ‘our NHS’ from politicians of every party are a sure sign that that is so.

Much as those who have ideological objections to the NHS would wish otherwise, the principle of a health service that’s free for everyone at the point of use continues to seem to a lot of people like a good idea. They look to the examples of the for-profit alternatives, in particular the United States, and they do not see a paradise of free-market efficiency and consumer value. They look, perhaps, at some of the private-sector interventions in our own system with at best-tempered enthusiasm too: PFI hospital contracts under New Labour; agencies supplying nursing cover at usurious rates; or have-a-go entrepreneurs who once shared a pint with Matt Hancock diversifying into PPE procurement during the pandemic and making a very profitable boggins of it. Perhaps all those people are terribly wrong-headed, or have fallen for a bunch of sentimental socialistic eyewash, but they are the voters and that’s politics.

It may well be that there is a planet-brain in a think-tank somewhere or a thyroidal junior wonk in Liz Truss’s back pocket who has a foolproof scheme for remaking the health service. This scheme would make it better value for the taxpayer and more effective in the care it offered. It would harness the profit motive and free-market competition in a way that would make the NHS better rather than extracting from the system. And good luck to them. Anyone not wedded on principle to a state-monopoly model of the health service should welcome such a scheme.

But the giant, inconvenient truth that the politics of any such scheme will have to negotiate is that, far from ‘falling out of love’ with the NHS, most people up and down the country think very well of it – and would wish it cherished and repaired rather than abolished.