Podcast: listen to this debate from our Battle of Ideas archive.

Recorded at the Battle of Ideas 2015

We all love the NHS, don’t we? Despite the ubiquity of platitudes

about defending ‘our’ NHS, though, exactly what we are defending and

why?

The NHS has undergone significant changes since its inception in

1948. Shifts within patient demographics, combined with increased

patient demands and advances in technology and medical care, have

resulted in a system at breaking point. One million patients are seen

every 24 hours, at a cost of £2 billion each week. The kind of care

available and sums of money involved would surely astonish the

institution’s founders. Indeed, although often perceived as one

homogeneous care provider, high-profile scandals, such as those at Mid

Staffordshire and at the Morecambe Bay Maternity Unit, have illustrated

the variability in care across different hospitals – even within the

same trust. And on many important measures – for example, cancer

survival rates – the NHS seems to perform badly compared to health

services in comparable countries.

Nevertheless, the NHS is one of the few manifestations of the British

state that elicits strong and often positive feelings from significant

numbers of people. Politicians and parties often define themselves in

relation to the NHS and compete to be seen to be supporting it – even

when this can be difficult to reconcile with their policies and track

record. No major party seems willing to have a more fundamental

discussion about whether a taxpayer-funded health service, governed by

national and local government, is the best way to take care of the

nation’s health.

Yet, at the same time, the reality is that more and more publicly

funded healthcare is provided by profit-making or third-sector

organisations. The introduction of the Health and Social Care Act 2012,

particularly in relation to the commissioning of services from ‘any

willing provider’, has opened the doors to private and volunteer input,

often with variable results. Following the Conservatives’ victory in the

2015 general election, many supporters of the NHS fear that these

reforms will be pursued further.

Yet is the NHS everyone queues up to defend more national myth than

effective health care? Can it survive in its current form, and more

importantly, should it?