A National Health Service

Britain’s National Health Service was the single biggest social advance anywhere in the world in my lifetime. Introduced in 1948 by the then Labour Government it made a major contribution to the welfare and security of the country’s people, lengthened people’s tolerable lives and gave everyone equality in the area of health. It was, and is, free at the point of use. 

My good fortune was to sit at a table next to Aneurin Bevan and Michael Foot almost every weekday lunchtime for over a year in Brusa’s Restaurant, St Martin’s Lane, London while they hatched the scheme. Bevan was the architect of the NHS; Foot was a senior Labour politician, later (and briefly) became Leader of the Labour Party. I had myself had a serious childhood illness, so the subject was of personal interest. I was also fascinated by it politically. ‘Free’ anything from Government was unheard of in those days.

Today, the British NHS is in a state of panic that would never have been accepted as even possible at the outset. It is largely the fault of progress. Preventions and Cures, undreamt of in the 1950s, have emerged since then – both involving highly expensive equipment, staff and maintenance. Life has lengthened by more than anyone ever expected. The business of sickness has been both redefined and ruthlessly exploited. The concept of what matters in life has changed with health appearing at the top, both as a possibility and as a right. The world now generally expects that at least the poorest members of society shall have a reasonable medical service either free or at minimum cost. Quite right, too.

Eavesdropping on the planning of the NHS, I was, even then, startled at the concept of free at the point of delivery. Being in the market research side of the advertising business made me aware that free is a dangerous concept – because it isn’t true but many people will believe that it is. “Nothing creates waste as what is free. Look in your cupboards and you will see.” 

As a social advance it was, and is, in my opinion, the greatest in mylifetime. Just as humans have a right to air, water, food and hygiene, so too they have a right to good health care. Sadly, that cannot be regardless of cost. In our own mentoring, coaching and training business we do a lot of non-medical but mental work pro bono – but never totally free. Even the poorest must make a small contribution in money or work effort.

I think this applies to healthcare. The estimated waste in Britain’s NHS runs to many billions of pounds annually. A basic charge for first visits, or per time period, would reduce this and would have the added benefit of making the Health Service appreciated and treated in a way that I suspect it is not today. It would also encourage families to help with their old people’s years of decline. The politicians have decided that this is not politically doable. So there is a need for a leader who is not so weak-minded. But that need is there anyway.

For those countries starting subsidised and / or free healthcare, the UK story ought to be a warning. The brake on people’s spending is cost. You think about it when you have to pay. It’s a bit arbitrary, but then so are the interpretations of the Ten Commandments. Rather more adherence to them might also result in a better world. Political courage is not in vogue in many countries but political foolhardiness is. When a major country is able to start and continue an invasion of totally meretricious value of its neighbour but a sensible and sensitive country like the UK finds it impossible to finance a basic essential service we’ve got a lot of things completely upside down.

Let’s work and vote towards good, affordable healthcare for all. 

And may those who benefit from it appreciate what a precious and expensive gift it is.

Good morning

John Bittleston

john.bittleston@terrificmentors.com 

Any good suggestions as to how to pay for universal basic healthcare? We’d love to hear them. Email us at mentors@terrificmentors.com

And THANK YOU so much for your contributions to our thinking. Your thoughts make us aware of the mindfulness of so many people trying to make sense of the world. Per ardua ad astra.

16 December 2022