Editorials

The Irish Times view on the 75th anniversary of the NHS: a system under strain

Public support in the UK remains strong, but the service is in crisis, requiring significant investment

A ward at the Royal Liverpool University Hospital, Liverpool. Public support in the UK for the NHS as it reaches its 75th anniversary is solid, but the service require significant investment, leading health think tanks have warned. (Photo: Peter Byrne/PA Wire )

Sun Jul 9 2023 - 20:15

Introducing the National Health Service Bill in the Commons in March 1946, British minister for health Nye Bevan promised it would “lift the shadow from millions of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering”. As importantly, it would eliminate money worries in time of serious illness.

While, in 1948, men on average died at 66 and women at 71, now, as the UK marks the NHS’s 75th birthday they live on average to 80 and 84 respectively. But that success is overstretching a service buckling under the demands of an older, larger population and new expensive treatments.

Its central organising principle, that healthcare is for all, rich and poor, free at the point of delivery, has continued to ensure, as a comparative study by the King’s Fund reports, that “the UK protecting its population from the financial consequences of ill health or injury”. But its performance in terms of lifesaving, beds, technology, and doctors and nurses per capita, lags behind other advanced economies, including Ireland.

The service is in crisis. Waiting lists for elective treatment have risen to nine million, while five-year survival rates for common cancers are among the worst in wealthy countries. It is operating with 154,000 fewer full-time staff than it needs, not least because pay erosion has fuelled catastrophic retention problems.

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But that universality of provision remains central to the affection and pride, and sense of ownership, the British public has for the NHS. The social democratic principle of collective responsibility for the sick is so firmly embedded in British political culture that protecting it is an article of faith across the political spectrum – in theory anyway.

While polls show satisfaction with the NHS has slumped from a 2010 record 70 per cent to 29 per cent, 72 per cent nevertheless believe it crucial to British society and should remain free at the point of use. Eighty per cent think it needs increased funding. The model of free provision has much to commend it, but it is – by its nature – expensive, a point also relevant in the policy debate in Ireland.

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