Praise the staff, but do not fetishise the NHS

A“national moment” for the NHS is being proposed for July 5, the 72nd anniversary of its foundation. This is the latest, and likely the last, iteration of the “Clap for Carers” campaign, which encouraged people to stand on their doorsteps and applaud the work of frontline health care staff at the height of the pandemic. Those doctors, nurses and other employees who put themselves at risk are deserving of our praise and thanks, though it is debatable whether another public display is necessary.

One difficulty with these exercises is that, as well as acclaiming its staff, they fetishise the institution. Many people are keen to separate the two.

The NHS is an unwieldy bureaucracy and its response to the pandemic has been of mixed efficacy, to put it charitably. Some things it has done well, like setting up the Nightingale hospitals; others badly, such as not using these hospitals to relieve pressure on the rest of the system. To what extent the structure of the NHS contributed to the death toll in the UK will be a matter for the inevitable public inquiry.

While the acute areas of the system performed well, others were found wanting. The decision to cancel all non-emergency operations, delay cancer treatments and discourage people from visiting GPS, whose surgeries were closed for the most part, has created problems that will far outlast the threat from coronavirus. A report today from the Royal College of Paediatrics and Child Health suggests that more children died because they failed to get medical treatment for other ailments than succumbed to Covid.

It is estimated that by Christmas the NHS will face a waiting list of 10 million cases. If this coincides with a bad flu epidemic and an upsurge of Covid-19 in the autumn then hopes of preventing the NHS being “overwhelmed” will almost certainly be forlorn. Consultants and other practitioners are already reporting that the “can-do” spirit of the early weeks has been supplanted in the NHS by the default bureaucracy.

Ironically, the Government’s record in dealing with the pandemic is often compared unfavourably with Germany. Yet the same critics would never countenance setting up the insurance-based, decentralised system that let the Germans develop a more flexible response to the emergency.