The Covid-19 pandemic has brought the cherished national institution known by its three-letter acronym even further to the center of British life. Chronically underfunded and stretched to its limits even during normal times, the health service has never been under so much pressure. It has also never received more praise, love and gratitude from the public.
“There is this huge level of deep-rooted affection for the institution and pride in it and what we’re seeing now is that affection being manifested,” Dan Wellings, senior fellow at the King’s Fund, a healthcare think tank, told CNN.
It’s hard to pinpoint an exact reason for this affection. “It’s not in data or numbers and evidence, it’s feelings and emotions and all the things that people can’t explain very well,” said Laura Duffell, a matron at King’s College Hospital London. Duffell works for the NHS and said she “wouldn’t work anywhere else.”
“It feels like you’re part of a family in all the different hospitals and all the different teams that I’ve worked in, the team spirit is always there.”
The government is tapping into those feelings to reinforce its strict social distancing measures. That messaging is clear: Stay at Home, Protect the NHS, Save Lives. The slogan is on every information leaflet the government has printed. It’s even on the lectern from which the country’s top officials — standing in for Prime Minister Boris Johnson who is himself recovering from Covid-19 — deliver their daily updates.
The NHS is not unique. Many other European countries have publicly funded health systems that provide free medical care for everyone. But none can claim the NHS’s level of appreciation.
The origin story
The NHS was founded in 1948 as part of a huge national rebuilding effort following World War II. Since then, it has become an integral part of British society and the country’s biggest employer.
It’s partly its origin story that makes the NHS so important to many.
“There’s a sort of folk memory of it … people wanted a really big change and the NHS was part of it,” John Appleby, the director of research and chief economist at the health think tank the Nuffield Trust, told CNN.
Wellings added that the sense of post-war collectivism is still a big part of how people view the NHS. “There are some values that are attached to it which play very strongly to a sense of Britishness: fairness, available to all, it’s equal, it’s primarily funded through taxation and it’s free at the point of need.” The branding is great too. “It’s so clear. The fact that it says ‘national,'” Wellings said.
The NHS, everyone agrees, is part of Britain’s national psyche.
The key principle of the service is simple: medical care should be free for everyone. Whether it’s a routine check, chemotherapy or a hospital birth, patients do not need to worry about pulling out their credit cards when getting treated. A few parts, including dentistry, optical care and pharmacy have been privatized over the years, but the bulk of the service is public. Prescription drugs are free, but most people need to pay an prescription charge of £9.15 ($11.45).
“Virtually everybody contributes to the NHS in some way, there is no special NHS tax, it is not just funded out of income tax, it is funded out of all taxes, so everybody is putting in something, and the deal is, no matter who you are, whether you’re the Queen or me, there’s equal access to the things you need when you need them, and it’s decided not on your income but on your healthcare needs,” Appleby said.
After the 2008 financial crash, the government’s tax revenues have suffered, and so did NHS funding. Health think tanks such as the King’s Fund say the NHS is now particularly vulnerable, as under previous Conservative governments, its funding did not match the increasing demand for healthcare. That led to longer waiting times, reduced availability and staffing shortages, according to research by the think tank.
Many Brits are acutely aware of the pressures the NHS is facing. When the call came for volunteers to help with the current crisis, nearly 1 million people signed up. There’s also been a huge spike in donations to charities that support the NHS and its staff.
But not everyone is comfortable with the idea that the NHS should rely on charity. “The response to these fundraisers is a little bit split, depending on one’s politics … if you’re more left wing, you feel there should be no question that this money should come from central government … at the same time, people want to help, and they want to treasure the service and to keep it running, especially in a time of crisis,” Flyn said.
In the UK, the NHS seems sacred and the resistance to overhauling it in a major way cuts across the British society — most people said they would pay more tax if the NHS needed it, according to the surveys.
As the grim reports of death and suffering keep coming in, day in day out, many in the UK are looking to the future, hoping the crisis will bring change to the way the NHS and its staff are treated.
“But perhaps on the other side of the coronavirus it will give them, their unions and so on enough ammunition to campaign for more money. I think there would be a lot of public support for that,” Flyn said.
Duffell, who is active in the RCN, the nursing union, is less optimistic. “I would love to see the government investing in the National Health Service to the extent it should, but I just don’t think it’s going to happen, I don’t see it changing which is a big big shame.”