Politicians must be honest about the NHS

If the NHS is “the envy of the world”, why is it always said to be in crisis? If it is the jewel in the crown of the welfare state, why after 70 years is it creaking at the seams, held together by bodged reforms and emergency cash injections? The Labour Party would have us believe that it is all to do with a lack of funding, as if the past 50 years had simply never happened. The fact is that the nation’s entire wealth could be poured into the NHS and still there would be shortages and rationing. Demand for health care is growing exponentially with a population that is both far greater in number and older than had been expected just 30 years ago.

Even though people are healthier than ever, they are suffering now more from the diseases of prosperity than of privation, such as obesity and diabetes, or of longevity, such as dementia. These bring new challenges to policy makers trying to deliver nationalised health care to a consumerist country, one that expects the sort of service they would get from Amazon or Tesco – always available and delivered when they want.

Yet when are these challenges ever debated? An election campaign might be thought to be a good time to do so but the politicians daren’t. They know that an infelicitous proposal taken out of context will be mercilessly used against them. And the reason they know this is because it has happened at almost every election of recent times.

Chris Hopson, the chief executive of NHS Providers, has urged politicians not to make “empty promises” or create “unrealistic expectations” during the campaign; but he might as well be talking to the wall. “Over-dramatising or distorting the difficulties for political ends will do nothing to help those frontline staff who are working flat-out for patients,” he said.

This statement betrays something about the producer-centric attitudes within the NHS and was echoed by John Mcdonnell, the shadow chancellor, who said frontline staff needed more respect. But, first and foremost, the NHS is for patients not staff. If GPS are overworked and nurses exhausted it is because the system has not adapted to the requirements of the modern world.

The NHS should not be off-limits during the campaign, but politicians must be honest about the limitations of an ostensibly “free” service, funded almost entirely by direct taxes to meet the demands placed upon it.