When you look back at life before the NHS, at local newspaper reports of people who died because they couldn’t afford a doctor, the absence of indignation is palpable – indignation, that is, at the lack of free medical care. Powerful social movements and campaigning thinkers were at work, providing that indignation, but in the crowded small-font columns of the provincial press in the first half of the 20th century another world is visible, of middle English complacency and inertia, and a feeling that if children died it was their parents’ fault.
I’d like to think those attitudes have gone away; that the spirit of postwar communitarianism, of solidarity, in which the NHS was founded, prevails. But I’m not sure. Clearly a libertarian attitude of everyone for themselves isn’t solidarity; nor is a religious attitude of ‘God provides, God punishes, God rewards.’ But an assumption that if only the very richest people, whom most of us neither know nor meet, were made to stick their hands deeper in their pockets, the NHS would flourish – that doesn’t sound much like solidarity either. Even ‘save our hospital’ activists can be ambivalent. Campaigners against the closure of Lutterworth hospital assume it is a straightforward money-saving step, and ridicule the idea of replacing it with community care; there simply aren’t the funds to do it properly. But when I asked them whether they would personally be prepared to pay higher taxes to fund a better NHS, they equivocated. They began to talk about how much waste there was in the health service.