5 July 2013

Child of the NHS

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As the NHS turns 65, Sunder Katwala reflects on its history – and on the NHS's role in his own history too.

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I am a child of the NHS, which celebrates its 65th birthday this week. I took my first breath in an NHS hospital, like many millions of Britons. And, if it hadn’t been for the NHS, I wouldn’t have come to exist at all, writes Sunder Katwala.

I was born British, in a Yorkshire hospital, in the spring of 1974. Thirty years earlier, my parents had been born some 4,000 miles apart. It was the NHS that brought them both to Britain.

When my dad was born in Baroda, India, not so far away from Mahatma Gandhi’s Gujarati birthplace, he too was a British subject, for this was three years before Indian independence. Having become an Indian citizen before his fourth birthday, he has now come full circle and is British again. After studying at medical school, and working for a summer as a doctor on the Indian railways, he came over to England, 45 years ago, to work for the NHS.

A tribute to the NHS at the opening ceremony for the London 2012 Olympic Games. Photo: Sum_of_Marc
The tribute to the NHS at the opening ceremony for the London 2012 Olympic Games. Photo: Sum_of_Marc

County Cork in Ireland was certainly not British by the time my mother was born there in the late-1940s. But she did not need, or have, a passport to take the ferry from Cork to Holyhead, with a one-way ticket, then a coach south to Portsmouth, to begin her training as a nurse.

Their two journeys, among millions of others, reflect part of the story of how the NHS reaches its 65th birthday, having secured its status as Britain’s most cherished public institution. It ranks ahead of even the army, the monarchy and the Olympic team as a source of pride in being British, and the public selected its birthday as more popular than the Coronation as the 2013 anniversary that means most to people. Danny Boyle’s inclusion of the NHS in the Olympic opening ceremony as a source of British pride received overwhelming approval.

And there is also a clear public recognition that Britain’s most popular institution has depended upon immigration. ICM’s new polling for British Future found that most people agree the NHS would not survive in its current form without foreign doctors and nurses, with only 20% opposition to that statement. Despite broader public anxieties about immigration, its contribution in providing skills that the NHS needs is widely valued as being in our national interest. This makes the NHS a positive symbol of integration. Those who came to this country from overseas have contributed to something which we all value and use.

My Indian-Irish story reflects another, perhaps more neglected, way in which the NHS has contributed to integration in Britain’s increasingly diverse society. It was one of the first workplaces in Britain to have a significant level of diversity (partly reflecting more widespread discrimination in jobs outside the public sector). So it also helped to forge some of the earliest mixed race relationships in post-war Britain, in the decades before that became an unexceptional norm.

When my parents met around 1970, most people said they would be worried if their children wanted to marry across ethnic lines. (My grandparents did too, but my dad turned down his father’s offer to arrange a marriage for him back in Gujarat). Commentators worried earnestly about whether the children of such relationships could cope. Those anxieties have been proven baseless. The 2011 census showed a doubling to more than 1.2 million people of those ticking the “mixed race” box. The vast majority of people now see this a healthy indicator that people do mix in a diverse society. The proportion uncomfortable about mixed relationships has dropped from 50% to 15% in just 30 years. Whenever I bump into somebody who is a West Indian-Irish or Indian-Scot, I find that there is a good chance that the NHS figures somewhere in the family story of how their parents met. My twin sister now carries on that family tradition and has been nursing for the last 12 years. “I’m really proud to work for the NHS,” she says. “My experience is that most nurses do care about what they are doing and are passionate about it. We need to cherish that value of compassion in the NHS.”

Nobody thinks the NHS is perfect. The Stafford scandal and CQC cover-up have rightly seen sharp criticisms where it has failed. Yet this has done little to shake people’s bedrock commitment to the core principles and values of the NHS, but rather to demand that its ethos of care is properly upheld.

Away from the headlines, personal patient experiences are more often positive than negative. The NHS has frequently provided the backdrop, literally from cradle to grave, at the moments of greatest joy and sorrow in many of our lives.

Above all, the reassurance that the NHS is there, so that it is possible to get something checked out, without stress over the pressure of bills or whether an insurance policy will turn out to cover it, provides an important sense of serenity and security. As a parent of young children myself, I cannot imagine not being able to rely on high quality care that is free at the point of use. Taking my five-year-old on the adventure of a short drive in the dark to see the “night doctor” out-of-hours sparked many questions from him – how did the doctor manage to stay awake? Did they have to sleep in the morning? – but it also provided me with the answer that all parents want to hear: he’ll be fine.

His generation of children of the NHS may well face some difficult decisions about this much-loved institution in their lifetime but, as it celebrates this milestone birthday, let’s reflect on how much it has contributed to modern British life.

An edited version of this article appeared on Liberal Conspiracy.

Sunder Katwala is the director of British Future. 

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