I have spent a lot of time in a National Health Service (NHS) hospital in the southwest of England recently because my mother has been seriously ill. Without the treatment and care she received there, she would not have survived. The NHS is the universal health care system that takes care of millions of people across Britain. Since 1948, British people have had access to all levels of health care through the system and no payment is required at point of service. Individuals contribute to the NHS during their working years through tax and National Insurance payments, and the system also receives government funding. The NHS doesn’t discriminate by class. Anyone can receive treatment, from those with no income at all to the wealthiest. In hospital, my mother is treated exactly the same as any other patient; her very low income has no bearing on the care she receives. Everyone is equal on the hospital ward (although those with a higher income can avail themselves of some extra entertainment services such as pay per use TV).
My mother considers the NHS a marvel. She has used the service since it began, and she is full of appreciation for the treatment she has received from the nurses and doctors as well as the kindness shown by the supporting staff who keep the hospitals clean and the patients fed, among other things. Despite some debilitating illnesses, she has been treated with the utmost dignity and good humour, and this matters to her as a low-income working-class woman. She’s never been looked down on because of where she lives or what she earns. NHS staff show concern for her welfare and suggest ways for her to access services that she can afford once discharged from the hospital. She can relate to the many staff who also come from working-class backgrounds from around the world who, like her, are concerned about the futures of their families. The NHS has saved the lives of millions of poor, working-class people, and for this we are grateful.
But the NHS has been under attack for some time now from the current Tory government, who seem ideologically opposed to the system of universal health care that keeps working-class people healthy and alive. Tories would like to replace the NHS with a system of private insurance and private provision of services that would see hospitals and services run for profit rather than for the benefit of the public. This would be a disaster for working-class people, who would no longer have access to the health services they require.
The Tories have already made significant cuts to NHS funding since they were elected in 2010, and the system is currently experiencing a crisis. There are shortages of beds and of staff, and resources are being stretched to their limits. Patients wait hours to be treated in emergency rooms – known as Accident and Emergency (A&E) in Britain – and non-emergency surgery is being cancelled and postponed. Nursing staff must care for more patients and are run off their feet as they try to provide quality treatment.
Ambulance services are also suffering, with too few crews available to meet demand and increasing waiting times. In some hospitals, patients have to wait on ambulance trollies for hours before they are assessed by doctors in A&E. When my mother was taken into hospital by ambulance, I observed a corridor full of patients waiting to be seen – a backlog that holds up the ambulance crews, who can’t respond to other calls until their patients have been handed over to hospital staff. Patients who can’t afford to ‘jump the queues’ by going to private hospitals and clinics must wait due to lack of adequate resourcing from the government. My mother’s assessment was halted as all the emergency doctors were called in to treat a patient in cardiac arrest. It’s a grim picture: patients suffering and even dying as they wait for treatment.
The true marvel of the NHS are the people who work in the system. Advances in medical science and technology are wonderful, but the most sophisticated treatments need people to administer them and to look after patients on a daily basis. As illustrated by a recent BBC documentary, Hospital, every person who works on the frontline with patients is essential, regardless of what they do. My mother has deep admiration for the doctors and surgeons, but her warmest praise is for the nursing and auxiliary staff who look after her. During her most recent lengthy stay she observed how the nurses managed complicated treatment schedules in wards where there one nurse might be responsible for 8 patients. Nursing assistants took blood pressure readings and monitored patients’ stats, but they also changed bedding and helped patients to wash and to use the toilet. They sat with patients who were lonely or distressed and helped patients locate their glasses or slippers. Housekeeping staff kept the wards spotless and made sure patients had fresh water and good food. The staff displayed genuine care for the patients, and despite being short staffed and overworked, they maintained their professionalism and went about their work with good humour, helping to lift the spirits of patients battling illness and injury.
For my mother, the staff at the busy hospital are heroes, and it saddens her to think of the NHS, the great institution beloved by so many working-class people, struggling under the current government’s policies. She wouldn’t be alive without the NHS, which has remained a constant despite the hardships she’s faced during her life. She knows she can rely on the service, but she never takes it for granted. She thanks the NHS and hopes that those well enough to fight for its continued existence on her behalf will continue to do so until its future is secured.
I like your post. I hope your mother is well. My only comment refers to your statement that ” … the current Tory government, who seem ideologically opposed to the system of universal health care …” “Seem”? The creation of the NHS in 1948 was the greatest achievement of the greatest British government of the last century i.e. The Labour government of 1945-51. Is it any wonder that Tories have neglected or abused it for so long?
I intuit from your post that your mother’s health has been restored, and for that we can all be thankful.
In general, I would be on the opposite side from your advocacy for any system like NHS, but this is probably not the place for that debate.
I would quibble with your antagonism to seeing “hospitals and services run for profit”. Specifically, I strongly suspect we hold different conceptualizations of what “for profit” means.
Hospitals and services make heavy use of capital (buildings, ambulances, CAT scanners, etc.). Profit is the compensation paid to private suppliers of that capital. “Profit” is the residual left over after all of the bills (including wages) have been paid. It makes social sense to pay the capitalists *after* we’ve paid the workers and suppliers if we assume that the capitalists are wealthier than the workers, etc. We assume that, due to their greater wealth, they will be better able to withstand any rough patch wherein the available funds don’t quite stretch all the way to their interests.
With non-profit organizations, typically the community supplies that capital without any expectation of monetary recompense: Their “payment” comes from having such health services available in their community. There is still a cost for capital; it is just that in the non-profit case, the suppliers of the capital (i.e., the community) don’t receive any cash compensation for the public’s use of their funds.
I see two problems with the non-profit approach: (1) Some communities don’t have the funds to volunteer. They, at least, would be better off with a for-profit hospital in their community than none at all. (2) Capital (e.g., those buildings, ambulances, EMRS’s, etc.) wear out and/or become obsolete. Hence they must eventually be replaced. Part of the profits paid private investors are there to cover this wasting-away of capital. In the non-profit situation, we must keep coming back to the community and asking for *more* capital — this time, replacement capital.
Too often, the non-profit has not been charging enough to repair or replace this wasting capital as we go. Then we have to ask the community to come up with the cash. And too often that community grows weary of our chronic “neediness.” At that point, our non-profit community hospital starts to fall behind: It becomes old, worn, “state of the art circa 1950.”
The problem, then, is the one you reference in your post: Namely, the voters don’t seem willing to pay the costs of good-quality services. The only solution I can see is to abandon democracy and don’t let the voters decide.