ONE of the most memorable experiences of my time in Parliament was five years ago, when I visited the parliamentary archives to view the original copy of the National Health Service (Scotland) Act 1947, which came into effect on July 5, 1948, and created what we now know as the NHS.
It was awe-inspiring to hold that thinly bound, yellowing sheaf of papers that brought about the greatest social advance in this country’s history; an advance that has improved and saved millions of lives.
This week, as we celebrate the 75th anniversary of our nation’s crown jewel, it is right that we reflect not only on its significance and importance, but on the challenges it faces today.
It is all too easy to forget the tumultuous circumstances in which the NHS was born. Total war, blitz-shattered cities and absolute poverty had resulted in hardship and squalor for millions with the national debt peaking in 1947 at a staggering 238% of annual economic output.
Despite those severe privations, the pioneering Labour government of 1945 didn’t embark on the self-defeating austerity measures that had caused so much misery in the 1920s and 1930s. Instead, it raised the nation’s ambitions by building the NHS as an antidote to those societal and economic woes.
The idea was simple: if we could mobilise the entire nation to fight fascist tyranny, then we could mobilise the nation again to fight the common enemy of illness and disease at home too.
The improvement in quality of life that this and other transformational socialist policies ushered in helped sustain a prolonged period of economic growth, rising living standards and near full employment until the late 1970s, and the rise of Thatcherism.
Aneurin Bevan, the Labour minister for health responsible for the creation of the NHS, talked of ‘taking the shame out of need’ and with those words gone were the days where doctors had to check your wallet before they checked your pulse.
What followed was an understanding that healthcare is a basic human right available to all, not a privilege determined by an individual’s ability to pay. That tenet remains as true today as it did then, with a universal commitment to ensuring that the NHS remains free at the point of use; albeit the veracity with which that fundamental principle is defended varies.
Despite the universal support for the NHS amongst today’s elected politicians, its introduction in 1948 was not without controversy or opposition. As the National Health Service Bill made its way through the parliamentary process, it was opposed tooth and nail by the Tory Party who most absurdly claimed that it undermined the autonomy of local government while simultaneously wrecking the voluntary hospital system.
That opposition must not be forgotten and should be the lens through which we view the insincere claims made by the Tories that they are the party of the NHS. We may live in an era of fake news, but facts are stubborn things and no falsification of history can change that demonstrable reality.
Fundamentally the NHS and its universality runs contrary to the Tory principles of personal liberty, free markets and small government. We see that in the actions of the past 13 years where austerity and back door privatisation has left the jewel in Britain’s crown looking more tarnished than ever.
That is despite the best efforts of a workforce we should all be in awe of. Regardless of what is thrown at them they respond with a characteristic resilience and fortitude, determined to uphold those founding principles and ensure that we never return to the days of profit before people.
The actions of previous Labour governments prove our commitment to the NHS. Labour created the NHS while the last Labour government strengthened the NHS by more than doubling its budget, recruiting 30,000 more doctors, 80,000 more nurses and embarking on the biggest hospital building programme in NHS history.
But the fight to restore the NHS to its former glory is greater now than it has ever been. The Overton Window, the model for understanding how ideas shift over time and consequently the range of political policies acceptable to the mainstream population at any given time, has begun to move to the right.
Ideas that would previously have been deemed unthinkable; privatisation of certain NHS services, an insurance-based approach to healthcare, or charges for certain procedures, have slowly begun to creep into public debate couched in the language of reform or revival.
They are all consequences of a slow, but deliberate, degradation of the NHS and are part of what Chomsky calls The Privatisation Technique – a four step process whereby a public service is defunded, deliberately undermined so that it is unable to function effectively, anger and resentment towards it builds, and finally it is handed over for private capital to drain profit out of it.
If certain actors have their way, this will be the fate of our NHS, and the consequences do not bare countenancing. While the services provided by the NHS improve and save the lives of millions, its wider significance should not be overlooked.
Its very existence is a shining beacon that healthcare in Britain is a right. Not a private profit-making enterprise, but a public service; and not a market commodity, but a vital lifeline upon which we all rely.
As Bevan once said: “The NHS will last as long as there’s folk with faith left to fight for it.”
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