Many readers will have watched the opening ceremony of the London Olympics. Some may have been surprised by the section about Great Ormond Street Hospital and the National Health Service (NHS). Not what you might normally expect at the start of a global sporting event — but its inclusion says much about the importance that Britons attach to our healthcare system.
Britain’s Industrial Revolution ushered in huge social change, with dramatic leaps in development and prosperity. However, in health, equality of access remained a problem. During the Second World War the UK committed itself to radical change. The publication in 1942 of the Beveridge Report envisioned a future for all “free of disease, ignorance, squalor, idleness and want” and the dream of building “a new Jerusalem.” Universal healthcare was at the heart of this new social contract between the state and its citizens.
This lofty aspiration became fact on July 5, 1948. Aneurin Bevan, the Health Minister and chief architect of the NHS, said “no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.” The NHS was established with three core principles — universal access, free at the point of delivery (and funded by general taxation) and treatment based on need, not patients’ ability to pay. Those principles remain the bedrock of the British approach.
One of the world’s largest employers, with 1.7 million staff, it cares for rich and poor, from cradle to grave. It covers everything from routine treatments provided by general practitioners to open heart surgery in state-of-the-art hospitals. As well as repairing us when things go wrong, the NHS tries to keep us healthy by providing information and access to services in family planning, vaccinations and services to give up smoking. Many of the dedicated healthcare professionals in the NHS are Filipinos. I am sure that some of them will have been nominated as “NHS Heroes,” under a special programme to recognise the work of NHS staff and volunteers who go the extra mile.
The NHS is widely regarded as one of Britain’s most popular institutions. But despite its successes it has to keep evolving, including to keep pace with advances in medical technology and an ageing population. Right from its foundation Bevan predicted that “the service must always be changing, growing and improving.” Ensuring the NHS meets the needs of contemporary society is always high on the British political agenda. While everything in 1948 was built and run by government, the British economy is now better at utilising the skills and capital of the private sector. New hospitals have been built and managed through public-private partnerships. Private sector companies also provide services for the NHS, which deliver extra capacity while remaining free at the point of use for patients.
An idea born in the middle of war is now woven into the fabric of British society. Revamped and re-tooled to benefit from both public and private capital and skills it will continue to be one of the essential platforms for both the health and prosperity of the country. Bevan talked of civilisation. But it is also true that no country can be truly prosperous without an effective healthcare system.
(Stephen Lillie is the British Ambassador to the Philippines.)