The celebrations on 5 July were muted to put it mildly. Probably as restrained as those that greeted the foundation of the National Health Service 75 years earlier and a pale substitute for the hype-fest that would have been laid on had the NHS’s 75th birthday fallen in, say, 2019. Back in 1948, the NHS’s first day was met with indifference from the public and scepticism bordering on hostility from medical professionals.
Public indifference was soon to change. Within a year, a pattern was established that has persisted unfailingly for the ensuing 74 years – demand for healthcare services always runs ahead of supply. Sir William Beveridge, he of the famous Beveridge Report, was sure that, after a bulge, demand for state-funded healthcare services would drop as the nation became healthier. Not quite. By 1950, as healthcare budgets were smashed, even the arch-instigator of the NHS and the health minister, Aneurin Bevan, was moaning about the “cascades of medicine pouring down British throats – and they don’t even bring the bottles back”.
If present day concerns about the demands for – and the costs of – healthcare are even more fevered that’s because, in the shadow of Covid-19, the NHS paradigm has flipped; the notion of global best-in-class has been replaced by rich-world also-ran. Take one simple, but damning, statistic: among member states of the OECD, a club of mostly affluent nations, the UK’s ranking for life expectancy in 2020 was 23rd out of 37, with Greece and Portugal among those with better figures. In 10 years, that’s a drop of 12 places; in 2010, the UK ranked 11th out of 38. Similarly, take the stat for the proportion of a nation’s population aged over 15 whose health is labelled ‘bad’. In 2019, the most recent year for which UK data is available, the UK ranked 13 out of 32, but in 2010 it ranked 10th. Worse, between 2010 and 2019 the proportion of adults in bad health in the OECD fell from 10.4 per cent to 8.6 per cent, but in the UK it increased from 5.8 per cent to 7.4 per cent.