‘Of course I support the NHS. Everybody supports the NHS, or says they do,’ poked the comedian Frankie Boyle in one of the many campaigns promoting the health service. To admit you don’t believe in this national institution is as taboo as not caring about Britishness, about goodness, about people. The public is keen to find evidence for this collective belief. Nigel Lawson famously said that ‘the NHS is the closest thing the English have to a national religion’ – words which tend to be heard as praise. But his comment was laced with criticism. He continued, ‘with those who practise in it regarding themselves as a priesthood. This made it quite extraordinarily difficult to reform.’ As a Conservative chancellor of the exchequer in the 1980s, Lawson was clamping down on perceived overspending. He might have been of the mind that, like religion, the NHS had become the opium of the masses: soothing for our pains and fears, but also a significant liability for reckless use and unfinanceable demand.
Everyone knows it’s the 75th anniversary of the health service, due to the number of opinion pieces and new books about what it means to love the NHS, who ruined it and how to save it. As Isabel Hardman’s brilliantly written and engrossing biography of the NHS shows, it has never been on a firm economic footing nor enjoyed a golden era of running smoothly. In the first nine months after its inception on ‘the appointed day’, 5 July 1948, the NHS went 60 per cent over budget. Unmet need far exceeded predictions. Charges were swiftly introduced for dentures, hearing aids and spectacles, as well as for prescriptions in England. But the founding principles remained: a nearly comprehensive service, free for all when needed and funded through general taxation.