By Matt Bevan and Yasmin Parry for If You're Listening
ABC AUSTRALIA
Prime Minister Boris Johnson oversaw one of the deadliest periods in British history.(Reuters: Henry Nicholls)
The UK election is less than a week away and after 14 years in power, the Conservative Party is expected to lose.
The UK election is less than a week away and after 14 years in power, the Conservative Party is expected to lose.
PODCAST
Who broke the NHS?
Britain's National Health Service was in crisis when COVID arrived in the UK. How was it left to fall into disrepair, right as a catastrophe hit?
About
At the top of the public's list of grievances is the country's crumbling National Health Service and how it was desperately underfunded before the COVID-19 pandemic hit.
A massive inquiry is currently underway examining how the British government handled COVID-19, and former prime minister Boris Johnson has admitted "there were unquestionably things we should have done differently".
The COVID-19 years loom large as one of the most terrifying and deadly periods in British history — far deadlier than the German bombing raids during World War II.
Over 232,000 people died of the virus, wait times at hospitals hit record highs and the health system is still dealing with a backlog of patients.
But Britain's health system was already woefully underfunded and unprepared when the pandemic arrived.
So how was the NHS allowed to fall into disrepair and brought to the edge of collapse, right as a catastrophe hit?
At the top of the public's list of grievances is the country's crumbling National Health Service and how it was desperately underfunded before the COVID-19 pandemic hit.
A massive inquiry is currently underway examining how the British government handled COVID-19, and former prime minister Boris Johnson has admitted "there were unquestionably things we should have done differently".
The COVID-19 years loom large as one of the most terrifying and deadly periods in British history — far deadlier than the German bombing raids during World War II.
Over 232,000 people died of the virus, wait times at hospitals hit record highs and the health system is still dealing with a backlog of patients.
But Britain's health system was already woefully underfunded and unprepared when the pandemic arrived.
So how was the NHS allowed to fall into disrepair and brought to the edge of collapse, right as a catastrophe hit?
Nye Bevan's vision
Welsh socialist Aneurin Bevan oversaw the birth of the NHS.
(Supplied: National Portrait Gallery, London)
The NHS is beloved in Britain.
During COVID, Boris Johnson called it the country's greatest asset.
"…Our NHS is the beating heart of this country. It is the best of this country. It is unconquerable. It is powered by love."
Former chancellor Nigel Lawson called it "the closest thing the English people have to a national religion".
It was founded in 1948 by a Welshman named Aneurin Bevan — known to everyone as Nye.
He was a hardcore socialist and clashed with just about everyone who wasn't.
Winston Churchill famously described him as "a projectile discharged from the Welsh valleys".
After the Labour Party won a landslide election in 1945, Bevan was surprisingly appointed to the position of health minister.
The NHS is beloved in Britain.
During COVID, Boris Johnson called it the country's greatest asset.
"…Our NHS is the beating heart of this country. It is the best of this country. It is unconquerable. It is powered by love."
Former chancellor Nigel Lawson called it "the closest thing the English people have to a national religion".
It was founded in 1948 by a Welshman named Aneurin Bevan — known to everyone as Nye.
He was a hardcore socialist and clashed with just about everyone who wasn't.
Winston Churchill famously described him as "a projectile discharged from the Welsh valleys".
After the Labour Party won a landslide election in 1945, Bevan was surprisingly appointed to the position of health minister.
As minister of health, Aneurin Bevan had the daunting task of implementing the National Health Service.(Supplied: University of Liverpool Faculty of Health & Life Sciences under Creative Commons 2.0)
At the time, the British health system was a mess.
Some hospitals were run by charities, some were run by local governments, some were run by insurance companies.
It meant that richer parts of the country got far better care than poorer parts.
Nye Bevan was handed a blank cheque to fix this and his proposal was extraordinary — all of Britain's hospitals would be nationalised and come under the control of the health minister.
Using around 5 per cent of the government budget, health care would become free for everyone in Britain.
NHS's rise and Bevan's fall
Aneurin Bevan was known for speaking his mind.(Supplied: Llyfrgell Genedlaethol Cymru / The National Library of Wales under Creative Commons 1.0 Universal)
There was massive opposition to the NHS from doctors, specialists and hospitals, who up until this point were their own bosses, but with money and compromise, Bevan brought them around.
Nye Bevan was on the verge of becoming a national hero and had a real shot at becoming the next Labour prime minister.
"There is nowhere in any nation in the world — communist or capitalist — any health service to compare with [the NHS]," he said.
But on the 4th of July 1948 — the day before the NHS was due to begin — Nye Bevan reminded everyone of his rabble-rousing roots.
At a rally in Manchester, he said, "No amount of cajolery, and no attempts at ethical or social seduction, can eradicate from my heart a deep, burning hatred for the Tory Party.
"So far as I am concerned, they are lower than vermin."
It completely overshadowed Bevan's NHS achievement. Even newspapers in Australia reported on it.
For years, Winston Churchill hammered him with it every chance he got. Young Tories started "vermin clubs". The Labour PM publicly condemned him.
The NHS rollout was also not flawless.
It cost double what Bevan had initially projected, as millions of poor people with long-term ailments came out of the woodwork now that health care was free.
When the government tried to claw back some of the money by making people pay for half the cost of false teeth and eyeglasses, it was the last straw for Bevan.
He quit over dentures, but the NHS and his legacy endure.
Funding flatlines
Former prime minister David Cameron introduced a policy of austerity which had long lasting impacts on the NHS.(Reuters: David Moir)
Three things have been rising in parallel since the 1970s — Britain's median age, Britain's life expectancy and the cost of the NHS.
And yet as the need for services has gone up, the budget for the NHS has flatlined in recent years.
Politicians and the public alike defend the NHS passionately, yet British governments are constantly surprised by its cost and try desperately to find ways to make it cheaper.
When David Cameron took power in 2010, he assured the public he understood the importance of the NHS and could be trusted with it.
He promised to isolate the NHS from the austerity program he was rolling out across Britain.
"We said five years ago that we were the party of the NHS, and now in government, by protecting the NHS from spending cuts, we are showing precisely that priority we've talked about so much in our party."
But Britain's aging population meant that more doctors, nurses and funding were needed every year to maintain the same quality of care.
Waiting lists began to grow. Overworked staff began quitting and the NHS was unable to find replacements for them.
The Labour Party began to attack Cameron for creating a crisis in the NHS, which Cameron angrily denied.
Politicians and the public alike defend the NHS passionately, yet British governments are constantly surprised by its cost and try desperately to find ways to make it cheaper.
When David Cameron took power in 2010, he assured the public he understood the importance of the NHS and could be trusted with it.
He promised to isolate the NHS from the austerity program he was rolling out across Britain.
"We said five years ago that we were the party of the NHS, and now in government, by protecting the NHS from spending cuts, we are showing precisely that priority we've talked about so much in our party."
But Britain's aging population meant that more doctors, nurses and funding were needed every year to maintain the same quality of care.
Waiting lists began to grow. Overworked staff began quitting and the NHS was unable to find replacements for them.
The Labour Party began to attack Cameron for creating a crisis in the NHS, which Cameron angrily denied.
Percentage growth of UK median age, life expectancy and NHS cost since 1975.
(UK Government data)
But the figures speak for themselves.
The median waiting time in English emergency rooms went from 2 hours and 9 minutes in 2011 to 2 hours and 55 minutes in 2019.
The length of time cancer patients had to wait from diagnosis to treatment increased significantly.
For the first time in modern British history, life expectancy stopped going up. In fact, for Britain's poorest people — particularly poor women — it began to go down.
But the figures speak for themselves.
The median waiting time in English emergency rooms went from 2 hours and 9 minutes in 2011 to 2 hours and 55 minutes in 2019.
The length of time cancer patients had to wait from diagnosis to treatment increased significantly.
For the first time in modern British history, life expectancy stopped going up. In fact, for Britain's poorest people — particularly poor women — it began to go down.
Too little, too late
Boris Johnson met with frontline workers during the pandemic.(AP: Jeremy Selwyn)
Surprisingly, the person inside the Conservative Party who seemed most aware of the situation was Boris Johnson.
For years, he'd been demanding increases in NHS funding, often as a way to wedge his opponents inside the Conservative Party and further his campaign to become prime minister.
He took over as prime minister in July 2019, and his government laid out a plan for a boost in NHS funding
.
Hospitals were overwhelmed with patients during the height of the COVID pandemic.(AP: Yui Mok via PA)
"We are doing 20 new hospital upgrades in addition to the 34 billion [pounds] more going into the NHS."
But it was too late, and the NHS was in a state of crisis right as the pandemic struck.
The effects were enormous.
For the first year and a half of the pandemic, the UK had the highest COVID-19 death toll per capita of any major economy.
Non-elective surgeries were postponed, wait times ballooned.
There were too few beds, too few staff, and buildings unsuitable to effectively contain infection.
Hospitals were overwhelmed with patients during the height of the COVID pandemic.(AP: Yui Mok via PA)
"We are doing 20 new hospital upgrades in addition to the 34 billion [pounds] more going into the NHS."
But it was too late, and the NHS was in a state of crisis right as the pandemic struck.
The effects were enormous.
For the first year and a half of the pandemic, the UK had the highest COVID-19 death toll per capita of any major economy.
Non-elective surgeries were postponed, wait times ballooned.
There were too few beds, too few staff, and buildings unsuitable to effectively contain infection.
Boris Johnson also contracted COVID-19 during the pandemic while serving as prime minister.(Reuters: Frank Augstein)
Life expectancy — stagnant for a decade — actually began to go backwards for the entire population, thanks to COVID-19.
It's easy to blame Boris Johnson for the high death toll, and many people do. They say he waited too long before putting the country in lockdown and then relaxed restrictions too early.
His decision to attend office parties while the British public were confined to their homes made it particularly easy to hang the blame around his neck.
But the reality is, the NHS was already in crisis before the first COVID-19 patient arrived in England.
Ongoing problems
Former British prime minister Boris Johnson gave evidence at the COVID-19 Inquiry in 2023.(UK COVID-19 Inquiry via Reuters)
There is currently a massive inquiry underway into how the British government handled COVID-19.
Boris Johnson admitted his government made mistakes but defended its response.
At one point, four protesters stood up in court as Johnson spoke with signs that read, "The dead can't hear your apologies".
Demonstrators stood outside the COVID-19 Inquiry in London holding banners.(AP: Kirsty Wigglesworth)
More findings are due out in the next week, but regardless, it's clear the NHS is still under enormous strain.
There is a backlog of patients who weren't able to access care during the COVID years and the original underlying issues in the NHS are still yet to be resolved.
One thing is for certain — it's an issue that is sure to play a role when British voters go to the polls this week.
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