The NHS turns 65
Elliot Bidgood, 9 July 2013
Friday saw the 65th anniversary of the founding of the NHS, a date marked in different ways by the health and political worlds last week. Civitas released a new report, After Francis, reviewing current evidence on NHS performance, the mood of the reform debate this year and how the service could go forward.
I was also fortunate enough to attend a fascinating RSA-Nuffield Trust debate, ‘NHS@65: Rejuvenate or Retire’, featuring a range of prominent health voices from across the spectrum. Respected health journalist Nicholas Timmins, for example, stressed that a key difference between the NHS’s 60th anniversary in 2008 (which Civitas Director David Green and trustee David Costain both contributed to a Nuffield book for) and this year’s was that the unexpected “storm” of the financial crisis has since fundamentally changed the fiscal landscape of British healthcare. He added that the challenge now was to see if the NHS can reform, integrate and reconfigure itself, and thus do in times of austerity what it missed a chance to do in times of plenty.
On Friday Survation and The Mirror also released an interesting poll on public attitudes to the NHS. 85% are satisfied with treatment and waits. 78% of the public back the service remaining free at the point of use. However, other results perhaps provide quantitative confirmation of some of the The King’s Fund’s qualitative findings about the nuances of public opinion on NHS funding – varying pluralities or majorities feel that smokers, non-citizens, injured drunks in A&E, breast reductions/enlargements (especially the latter), gastric band procedures, sex changes or tattoo removals could not always be fully covered. Of concern, a plurality (45%) lack faith in the Care Quality Commission to deal with failings and 57% fear that “the elderly are not treated with dignity within the NHS”.
Survation also explored how taxpayer-funded NHS services should be delivered – on this they found that while 34% felt that the NHS should use a mix of public and private providers or mostly use private providers, 45% preferred services to be “mainly or wholly” publicly provided. This differs starkly from our findings with ICM in March – we found that 83% agreed that “It shouldn’t matter whether hospitals or surgeries are run by the government, not-for-profit organisations or the private sector, provided that everyone including the least well off has access to care”. One explanation may lie in wording, as the Civitas/ICM question arguably made clear two crucial conditions that Survation perhaps implied, but doesn’t quite stipulate outright – that non-public providers can be not-for-profit entities as well as pure private ones and that although publicly-funded services could be under mixed ownership, this should always be on the condition that everyone has access regardless of ability to pay. This demonstrates that public opinion on this matter is complex and sensitive, as you would expect, and that our debates on it must be similarly nuanced.
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