The Spectator’s Notes | 28 June 2018

Gordon Brown, echoing Aneurin Bevan, says that the greatest gift that the NHS brings to people is ‘serenity’. He is surely right that this is what it brought 70 years ago — for the simple, important reason that people would no longer need to say of treatment, ‘I just can’t afford it’. But comparable ‘serenity’ is provided, in different ways, in, for example, Germany, the Netherlands and Australia. Defenders of today’s NHS have to explain not why it is more serene than pre-1948, but whether it matches the current arrangements of comparable countries. ‘Serenity’ is not the word one would apply to many British hospitals today. In these Notes last week, I mentioned the fear felt by the old. I did not mention one key reason for it. In a nationalised bureaucratic system, each patient is a cost. So the NHS is exactly the opposite of, say, a restaurant or a plumbing business, which lives by getting more customers.