The United Kingdom is this year celebrating the 60th anniversary of its National Health Service (NHS). In 1948, the inaugural government circular proudly proclaimed:
“Your New National Health Service begins on 5th July ... It will provide you with all medical, dental, and nursing care. Everyone -- rich or poor, man, woman or child -- can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. But it is not a “charity”. You are all paying for it, mainly as taxpayers, and it will relieve your money worries in time of illness.”*
* The new National Health Service. BMJ 2008; 337 (7660): cover.
Since those heady days, its principles of centrally funded health care, which is both universal and free at the point of delivery, have remained unchanged.
The NHS is now so firmly embedded in the prevailing zeitgeist of the British Isles that it has displaced religion as an article of faith. To quote a commentator:
“The National Health Service is the closest thing the English have to a religion, with those who practice in it regarding themselves as a priesthood. This made it quite extraordinarily difficult to reform.”
(Nigel Lawson, 1992)†
Like other religions, it has spread its tenets abroad -- to both Canada and Australia. But drawing parallels between religion and the NHS is hardly surprising. After all, modern medicine was founded in the temples of ancient Greece and nurtured in the monasteries of the Middle Ages.
Thus, our legacy of medicine as a modern religion remains alive and well in the UK’s NHS, for the
“model of health care as a secular church represents the tradition maintained and carefully tended over the decades by the disciples of [NHS founder and the then Minister of Health] Aneurin Bevan”
(Rudolf Klein, 1995).†
† Delamothe T. NHS at 60: a fairly happy birthday. BMJ 2008; 337: a524.
The same might be said of our own NHS clone, Medicare — like any religion, it is easy to call upon in time of need, but any notion of reform is heresy!
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