NHS turns 75. But can it survive to 100?

Britain’s cherished NHS turns 75 today and, in a further sign that it has all but replaced the Church of England as our national religion, its birthday was marked by a service at Westminster Abbey.

Prime Minister Rishi Sunak and Labour leader Keir Starmer both gave bible readings during the service, competing – as ever – to prove they are a safer pair of hands to preside over the country’s most treasured national institution. 

Free healthcare for all, introduced by post-war British prime minister Clement Atlee, embodies, as the FT’s Sarah Neville puts it, “the most visceral form of security: eliminating money worries in time of serious illness.” 

Meaning today is a moment to celebrate the taxpayer-funded NHS’s many achievements. Yet, as it marks three quarters of a century, our national health service is suffering from some ailments. 

Some critics would argue that it is the holier than thou reverence afforded to the NHS by politicians and so many other observers – as witnessed by today’s service – that means there can never be any profound cross-party diagnosis of its problems, or therefore, a realistic prognosis.  

Indeed, three health think-tank chiefs marked the occasion with warnings that the NHS won’t make it to 100 without significant investment and reform.

The NHS was created at a time when men died on average at 66 and women at 71, largely to treat injury and infection. Cradle to grave coverage has different implications today for our ageing population. An estimated seven out of every £10 spent in the NHS now goes to the vast numbers of Brits living with chronic health problems, such as heart disease, dementia and diabetes. 

What’s more, the number of patients stuck on waiting lists has reached a record 7.4 million – a rise of 200,000 even since Sunak made tackling the backlog one of his five priorities. And the doctors strike over 15 years of pay erosion remains unresolved. 

While most agree that our national health service is poorly, fewer can agree on the suitable treatment to meet the nation’s future health needs. 

There is a glaring mismatch between demand and resources yet many argue that pouring more money at the NHS cannot be the only solution. 

Some insist we need to swallow our national pride and take heed of overseas models. For example, some European countries partially fund healthcare through social insurance systems, which – unlike in the US – manage to cover everyone. It’s worth adding that Germany has three times the UK’s beds per head of population and France more than double.

Former PM Tony Blair and former Health Secretary Sajid Javid have both proposed some controversial birthday reforms for the NHS – with Javid floating the idea of charging to see a GP and Blair calling today for consumers to have the option to pay for speedier treatment. 

These proposals have been rejected by Health Secretary Steve Barclay, who insists he is committed to ensuring the NHS remains free at the point of care. Barclay chose instead to highlight the government’s newly launched 15 year plan to deliver the biggest ever workforce training expansion in NHS history.

Meanwhile, Wes Streeting, shadow health secretary, stressed the need to harness technology to improve NHS efficiency. 

But perhaps we also need to have an honest debate about where to prioritise spending. Prof Sir David Haslam, former chair of the National Institute of Health and Care Excellence, which decides what treatments should be made available on the NHS, worries that we have “over-medicalised the end of life.”

In other words, there is too much focus on costly drugs that simply extend life rather than services that support people to live in good health. This is “not about rationing care,” he argues. Rather, “it’s about providing rational care.”

Of course, an ageing population driving the need for evermore health funding isn’t a a uniquely British challenge. But, according to Anita Charlesworth from the Health Foundation, it’s one that feeds into the wider problem of stagnation: “Increasing investment in the NHS is going to require economic growth – without that, you have to cut other services or increase taxation.”

Yet Charlesworth also points to the rise of the long-term sick – with roughly one in every 13 Brits currently economically inactive due to illness – as evidence that we shouldn’t just view healthcare spending as a “cost”. It’s an investment in the country. 

Write to us with your comments to be considered for publication at letters@reaction.life