Reverence for our health service is out of line with its performance
In 1906, a shoemaker and ex-convict called Wilhelm Voigt pulled off an audacious con. Dressing himself as a military officer, he rounded up some soldiers and confiscated over 4,000 marks from a local treasury. Voigt entered legend as the “Captain of Köpenick”, and was eventually pardoned by the German Emperor. The story, meanwhile, illustrated the unhealthy reverence in which Prussian society held the Army.
Which institution would a modern-day Voigt imitate? It probably wouldn’t be the Armed Forces, at least not in Britain. After Newsnight’s bizarre, Pyongyang-style tribute to it on Tuesday night, there is surely little doubt that the feathers to borrow would be those of the NHS.
Like what you’re reading? Get the free UnHerd daily email
Already registered? Sign in
This country’s attitude towards the Health Service has long been a little weird. After the Second World War saw us eclipsed on the world stage by the United States, we sought solace in a new exceptionalist myth: that the aftermath of the war saw us build the best healthcare system in the world.
It has long been a comforting illusion, and perhaps never more so than today. Our reverence for the NHS is completely out of line with its actual performance, where on many outcome metrics it performs much worse than the systems of peer countries.
Yet as the reality has grown more disappointing, the mawkishness has been dialled up. The opening ceremony at the 2012 Olympics featured a martial parade of nurses in old-fashioned uniforms. Now we have choirs of children on the national broadcaster’s flagship current affairs show.
Isn’t this, as some suggest, a relatively benign phenomenon? If we need to place an institution on a pedestal, surely it is better that the icons are doctors and nurses, rather than soldiers?
No, as it happens. Counterintuitive as it might seem to some progressives, it is far better to venerate the Armed Forces than the Health Service. This is not just because soldiers continue, even in this more peaceful age, to take risks and make sacrifices on our behalf that we ask of nobody else. It’s because the military, at least in a stable and healthy democracy such as ours, doesn’t play an active role in our day-to-day lives.
Barring some unforeseen crisis, it is supremely unlikely that we will ever find our lives in the hands of a British soldier. But unless you and everyone you care about is rich enough to afford private care, it is all but certain that at some point NHS staff will have huge, perhaps even life-or-death power over us.
For that reason alone, it is essential that we can treat the Health Service with appropriate scepticism. Even in the current environment, it receives a negligence claim, on average, every 40 minutes, settling almost 87% of them. In the 2021/22 year, that led to a direct cost to the taxpayer of £13.6 billion, a figure that excludes the so-called “hidden” costs of actually investigating the claims. And if 13,070 settled claims is a statistic, remember that each one is a tragedy. It represents a life worsened, ruined, or even ended through malpractice.
Then there are the big-picture consequences. The NHS consumes a vast amount of Government spending, and that share is only set to rise. Easing strain on the Health Service serves as justification for rafts of authoritarian legislation, from smoking bans to sugar taxes to lockdowns. During the pandemic, we were told to “protect the NHS”. It is impossible to imagine the Army making such a demand: they would recognise that such a sentiment gets the protective relationship backwards.
One can agree or disagree with any of these measures, of course, as well as whether the NHS spends its huge budget wisely. Does it have too many admin staff, as Patricia Hewitt argues? Why has it not yet completely stopped offering homeopathy at public expense? Yet such debates can only be less effective if conducted in an atmosphere of worshipful reverence. For as long as the NHS is a British religion, the national discourse won’t be in good health.