Who really “hates the NHS”?

Yesterday (Saturday) I saw, on the front page of the BBC’s News app, an article by Laura Kuenssberg titled “Like it or hate it, the NHS is here to stay”. Kuenssberg is a BBC reporter and commentator who became notorious for perceived pro-government bias during the Cameron years, and there were attempts to derail criticism of her bias by drawing attention to the fact that her critics acknowledged that she was a woman (see this entry from that time). In this article, she opens by claiming that “The British have a love-hate relationship with the NHS”, based on a survey from 2022 that found that it has a public satisfaction rate of only 29%, yet 90% agree that it should be “free and available to everyone”. She states that “the public’s attachment to the concept of the NHS remains extremely strong” and that “voters are in no mood for a discussion about changing its core principles – despite all the problems”, something politicians clearly see as a problem. The article discusses the difficulties of rationing healthcare and of the impact of poor social care on the NHS.

The fact that Kuenssberg thinks the general public have a “love-hate relationship” with the NHS gives away her own privilege, but perhaps betrays widespread ignorance about what the NHS is and what it isn’t. The NHS is a funding model; it’s what ensures that healthcare is paid for out of public taxation rather than private insurance. It’s possible to hate a particular arrogant, know-it-all doctor or other uncaring health professional, or an abusive institution such as a locked mental hospital, or one aspect of its bureaucracy such as a particular health trust or board, without believing that publicly-funded healthcare is a bad thing. All the bad things found in the NHS can be found in mixed or insurance-funded healthcare systems in both Europe and the USA; the difference is that in the USA, you will be sent the bill even if the care was substandard, harmful, unwanted or all three.

Even the low figure of 90% who believe the NHS should be free could be explained by doubts over who is meant by ‘everyone’ (whether this includes new immigrants, let alone those here illegally) and disagreements over whether this should include things like fertility treatment or gender reassignment. I can’t imagine anyone really thinks we should abandon the NHS for an American model, even if this is what some of our politicians, with their backgrounds in major finance corporations, might prefer. No class in the UK is exempt from ever needing the NHS; although private healthcare exists, and enables the wealthy to jump NHS queues and access primary healthcare, dental care and some elective treatments more quickly, there is no such thing as a private accident and emergency department, for example; if you are in an accident, you will be taken to an NHS hospital. If people are frustrated by the NHS, the reasons are likely to be found in political decisions and the way to affect change is to vote; the only people who actually hate the NHS per se are people who would prefer to run hospitals for profit, or to become gatekeepers of care for profit, such as health insurers.