The NHS needs its Reformation

The government has promised that from next year everyone aged between 40 and 75 will be offered an ‘MOT’ of their health. The patient most in need of a health check, however, was 60 this week: the NHS itself. To a limited extent the government has recognised the inadequacies of what for its first three or so decades tended to be called ‘the envy of the world’ by using the anniversary to publish the NHS Next Stage Review, written by Lord Darzi, a junior health minister and eminent surgeon. The document is less celebratory than defensive, effectively admitting that the patient has often become lost in an organisation which is one of the world’s largest employers after China’s Red Army. Sadly, much of what it goes on to propose will, in fact, entrench that very bureaucracy.

At the outset, one should recognise what is good about the NHS. The principle of universal healthcare for all, regardless of the patient’s ability to pay, caught the public’s imagination in the 1940s, gave institutional expression to the social solidarity of the war years, and remains dear to patients to this day.