The NHS Religion

Prime Minister Boris Johnson thanks the NHS in a video message on Easter Sunday, London, England, April 12, 2020. (Pippa Fowles/Reuters)
In normal times, a government that worships the state is conservative in name only.

‘The NHS has saved my life, no question,” Boris Johnson said yesterday after being discharged from St. Thomas’s hospital in London, where he was treated for a serious case of coronavirus. The Prime Minister went further still, saying that the NHS is “the beating heart of this country.” While the Queen had, in her Easter address, invoked the transcendent, the “risen Christ,” Johnson made his own devotion to the British health-care system, which he said was “unconquerable” and “powered by love.”

It is quite natural that a person recovering from a life-threatening illness should feel indebted to those responsible for saving his life. But is it natural for a political leader to worship an institution of the state, to place it on a pedestal, above and beyond all criticism or talk of reform?

Though the National Health Service, launched by Clement Atlee’s post-war government in 1948, has socialist origins, conservatives have been running it for 44 of its 71 years. Prime minister Margaret Thatcher denationalized major industries, but would never touch the NHS. In 1982, the Iron Lady promised that the NHS was “safe in our hands.” Her biographer, Charles Moore, noted how she “never ceased to worry that the NHS had the potential to destroy her politically and electorally.” Failures have often been attributed to Tory mismanagement, whether through reforms privatizing certain sectors, or — the overwhelming criticism in recent years — by austerity.

By the time of Theresa May, conservatives were under heavy fire. In 2018, 50,000 patients’ treatments were cancelled because hospitals were overwhelmed with seasonal flu. Meanwhile, Britain’s reputation on accident and emergency (A&E) care and cancer treatment waiting times lagged horribly behind their European counterparts. In his pursuit of the top job, Johnson attempted to distance himself from these failures.

Last summer, in his Telegraph column, Johnson wrote that, while he isn’t “an excessively sentimental type,” he had been brought close to tears after one hospital visit where he experienced “a sort of vicarious pride in the whole system” and concluded that “we need to keep putting more money into the NHS.” In the run-up to December’s historic landslide victory, the Conservative manifesto promised the biggest spending splurge in the NHS’s history: an extra £33.9 billion by 2023-24. He even made the case for Brexit about the NHS with his notorious 2016 pledge that “we send the EU £350 million a week, let’s fund our NHS instead.”

In one narrow sense, the coronavirus has been a political gift to the Johnson government; an opportunity in the form of an emergency. Rather than mere pledges and gestures (or “airy promises of shedloads of money,” as Polly Toynbee accusingly wrote), they have been able to scrap £13 billions of NHS debt, starting April 1, wiped away like forgiven sins. As the prime minister choked up over his thanks to the nurses who saved his life, he also managed to draw attention to his government’s commitment to its biggest domestic-policy promise.

But the prime minister didn’t always think this way. In 1995, he hinted at the need for NHS reform. In an article for the Spectator, he wrote that “it seems reasonable that the middle classes should be required to stump up for non-essential service they can well afford.” And in 2002, he told the House of Commons that while “it’s all very well to treat the NHS as a religion, [it’s] legitimate for some of us to point out that, insofar as it is a religion, it is letting down its adherents very, very badly.”

Like other European countries, citizens of the U.K. have, during this pandemic, engaged in a morale-boosting ritual. Every night at the same time, they step outside and clap. But whereas in European countries, they clap for their frontline workers, in the U.K. they are encouraged to clap for the system itself. After surviving coronavirus, Johnson told the nation that “we’re making progress in this national battle because the British public formed a human shield around this country’s greatest national asset, our National Health Service.” The trouble is that, mixed up in all this, there is a heartfelt sentimentalism (understandable, given the circumstances) and political opportunism. This may have to do for now. But in normal times, a politician who worships the state is conservative in name only.


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