Few countries are as devoted to their health system as Britain. During the opening ceremony of the London Olympics in 2012, jiving nurses enthralled a stadium—and bemused a global television audience—proclaiming their pride in the National Health Service (nhs). In adverts broadcast during the covid-19 pandemic the British government urged the public to lock down not only to save lives but, in larger letters, to “protect the NHS”. The health service will play an even bigger role than usual in the general election expected in 2024.
But it will take centre stage for all the wrong reasons. The year will begin with another terrible winter: not enough ambulances, and old ladies dying on trolleys in hospital corridors. Nurses will not be jiving for the NHS but handing in their notice, continuing a trend of record departures. Waiting lists will continue to tick up. Calls for further privatisation will be steadfastly ignored, but taken a little more seriously than they were before. At some point Britons will start to notice that patient outcomes, already bad, worsen whenever doctors go on strike (as they have done intermittently since March, with no resolution in sight).
The NHS is not the only public service in crisis. Crumbling schools, prisons and courts will all worsen in 2024. These problems typically build up beyond the glare of flashing blue lights, though many of the underlying causes—a lack of predictable funding, cuts to capital expenditure—are the same. In a stagnant economy and with little political benefit, long-term investment is unappealing to a government. Solutions, it follows, tend to be short-term patches.
If it wins the election, the Labour Party will have some difficult decisions to make over which parts of the wider health system—general practice, social care or capital projects—need the cash most. In theory, the service will remain free at the point of use. In practice, a growing number of Britons are not getting the treatment they need. The political toll that takes is likely to become clear. ■
Georgia Banjo, Britain correspondent, The Economist
