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THE creation of Britain’s National Health Service is probably the Labour Party’s proudest legacy. About to celebrate its 70th anniversary, the NHS remains one of the country’s most trusted institutions. And yet, scarcely a day goes by without a newspaper report about some patient suffering from poor care, or the problems the health service is facing with insufficient funds. On the other hand, health is the second biggest single item in the UK budget of 829 billion pounds with an allocation of £150 billion. This is just slightly lower than the spending on public pensions at £165 billion. Defence’s share trails far behind at £47 billion, much lower than state education that was allotted £85 billion.
Such spending priorities are unthinkable in Pakistan where defence spending and debt servicing consume the lion’s share of the national budget. In the UK, the massive expenditure on public pensions, education and health is the result of a national cross-party consensus that is widely supported by the public whose taxes fund these services. This is the positive side of democracies where voters can express their priorities, and politicians can only ignore them at the cost of their careers.
The substantial allocation for the NHS represents just half of what it had demanded for the current year. Small wonder, then, that the NHS is struggling to meet the cost of looking after an ageing population. With growing numbers becoming obese, thanks to cola drinks and fast food, diabetes is widespread. The prices of patented drugs as well as hospital equipment are rising rapidly, and an impending Brexit has caused many EU health workers to return to their home countries.
The shortage of doctors — 10 per cent of the approved posts — has been exacerbated by growing difficulties in recruiting in the EU states, and tough visa requirements for non-EU citizens. A few months ago, 100 Indian doctors selected for the NHS were refused visas by the Home Office.
Many of my English friends have complained of their experiences at the NHS, but I tell them that being from a country with a ramshackle public health system, I can appreciate their marvellous service more than they can. As a UK resident, I am entitled to treatment in NHS facilities, and have been hugely impressed by the professionalism and courtesy of the staff, the orderly manner in which patients are treated, and the fact that most of its services are free. Above all, this being England, nobody jumps the queue, and nor are there special facilities for so-called VIPs.
It’s true that NHS hospitals and clinics in large cities like London and Manchester are under great pressure from increasing numbers of patients, and often it can take several days to get an appointment with the local GP. To see a specialist consultant can take weeks, and operations — unless they are of an urgent nature — can take months to schedule. All this is despite the fact that there are currently 109,000 doctors working in the NHS.
All these delays and long waiting periods feed into an anti-immigrant narrative that drove the Leave campaign in the Brexit campaign. Many Brits feel their tax money that supports the NHS is being spent on foreigners who, they allege, have large families and are a drain on medical resources. The same applies to state schools and housing. And yet, the figures show that immigrants tend to be young workers who pay their taxes. But in politics, it is the perception that counts more than the reality.
Despite the criticism and the complaints, the NHS is the envy of the world for its comprehensive coverage and its cost-effective treatment. From childbirth to cancer, NHS doctors and nursing staff care for millions of patients every year. Of course, well-off Brits can buy medical insurance that pays for private care. However, given the quality and range of the free medical services available on the NHS, relatively few go to private clinics that can be very expensive.
However, despite the NHS’s many successes over the years, there is a cash crunch coming. According to one report, austerity cuts imposed by the Conservatives in 2010 across the social sector have begun to bite, with NHS staff complaining that their outdated equipment cannot be replaced, new medical kit cannot be ordered, and old ambulances keep breaking down.
Currently, British citizens can request treatment in other EU countries, with France being a popular destination for patients who don’t want to wait for weeks or months to see a consultant or have an operation. But this route will close next year when the UK exits from the EU. As it is, Brexit will cause a huge setback to the NHS with fresh medical staff from EU countries being ineligible to work in Britain. Although there is a proposal to allow EU citizens currently in the UK to apply for residency, many in the medical profession see no future for themselves or their children in a post-Brexit Britain.
Last winter was exceptionally cold, and many suffered from chest infections of various kinds, putting the NHS under enormous strain. Nevertheless, the system coped even though in some cases, patients had to wait for attention on trolleys for hours. But just as there are complaints and criticism, there is also a lot of praise for the NHS. Few politicians dare attack the service because of its popularity, and Theresa May has promised an annual increase in the NHS budget over the life of this Parliament. With Labour neck and neck with the ruling Tories in the polls, accusations of neglect of the NHS can be politically damaging. Whatever its flaws, Brits have good reason to be proud of their remarkable health service.
Published in Dawn, May 28th, 2018
