NHS Afterwards

The NHS: Dai Smith | Afterwards

Wales Arts Review asked some of Wales’s top writers to pen some thoughts on the future. This new series brings together a wide variety of perspectives and ideas in a vibrant array of styles and forms, expressing hopes for a new way of doing things when the Covid-19 coronavirus is finally overcome. Political, personal, sociological, ecological, cultural – this is an evolving tableau of ideas for the world as it is and how it might be. Here, Dai Smith delves in the history of the NHS,  the values that have sustained it, and what the future may hold post Covid-19.  

Whatever will come afterwards will be more about what we have been than what we may wish to become. That reality will be the first thing to confront if we are serious about effecting change beyond the vapours of ardent wish-fulfilment. Unpicking the cocoon of language and the quackery of ideology will be key to the necessary self-assessment required. We can start with considering the present crisis in which we are being smoke-bombed into intellectual somnolence by morale-tickling metaphors which have magicked a microbe into an Enemy.  A sinister Hidden Foe no less has made Heroes of dedicated professionals placed on the Front Line with no Weapons, and declared that Demobilised Populations are in it for The Duration.  Such moth-eaten Churchill-lite phraseology bears as much relation to the reality of a pandemic as any Tory government’s claim to any relationship with the National Health Service other than through the veils of hypocrisy and deceit.

The NHS emerged in 1948 largely thanks to the creativity of Nye Bevan’s imaginative policies and in the face of ferocious opposition from you-know-who. It was also the product not just of the unprecedented civilian sacrifices of a real war but also as a civilised riposte to decades of working-class immiseration and the endemic illnesses which accompanied that allegedly irretrievable state. All too readily forgotten if we ever dare to consider the NHS as “safe” in their hands, and thus ignore the mean managerialist bottom-line accountancy which has brought it, as is so apparent in this crisis, to such a parlous state of readiness. Now that it is too late to bail it out in time to be fit for purpose, we see instead the passionate commitment of those having to bail it out to save lives. If we are to spin out the bellicose comparators then, I think,we can only say that the NHS is having a brilliant Dunkirk with the Normandy Landings a distant prospect. To get there, to ensure its ongoing and secured centrality in our national life into the future, we will need to recall its disputed history and ditch the mythology of universal respect.

There will be other shibboleths, from the Left as well as the Right, to jettison if meaningful change is to be successfully embedded. Voodoo economics,ideological onanism, intellectual arrogance, complacent incompetence, narcissistic self-entitlement, ostrich posturing, self-righteous political preening, and plain lies in full sight, have all littered the path to our present predicament. It is one highlighted by the pandemic but also more deeply with us than just this passing danger. It is a hole in which we will soon be digging the graves of our human future once again as noise returns to the skies across the globe and city streets replace their present silence with the roar of traffic belching its filth into the atmosphere. One Globe should no longer mean the self-given right to fly where you want when you want, whether on a ski trip or to an exotic tourist destination or a faraway Literary Festival, or clog the world’s seas and waterways with the obese bathtub toys of overstuffed cruise ships. Fill in whichever blanks apply, but all of us have to act to end the pretence that the Earth’s resources are infinite, for they are as finite as our individual lives and the commonality of life, across the Globe we all inhabit, is the true and only lasting basis of individual human existence.

At home, in Wales, these future issues will be no respecter of artificial boundaries, geographical or constitutional, but we do have a history to explore in which, at our best, we did forge cultural and social means to combat the true destroyer of human hopes:material deprivation. People,often in struggle and through desperation, acted to find and sustain common values. This mostly swelled up from below rather than being delivered from above. And, yes, social class was a key factor in the institutional creation of bastions for these values despite the crabbed selfishness of vested interests. That purpose-driven Wales, at its best, was an intentionally divisive society not a theoretical unit of national identity. Such an enacted history did not confuse any tribalist populism with a sense of belonging. We need to recover that sophistication and embrace complexity. The roots of the NHS are certainly in that very history. The basis of the selflessness we have been witnessing and admiring over the past few months also resides there. We cannot go back to those historically-derived roots, for sure, and in any material sense we would not wish to do so,but if we do not fully take this opportunity to retain and refresh the residual values of our specific past by truly acknowledging our history then we will not move forward to shore up , together, a more decent, mutually engaged society.

If we can build hospitals in days, we can eradicate homelessness in months. If we can salute NHS workers and carers by clapping, then we can adequately reward and sustain them forever after. If we can crowdfund to maintain an essential creativity of being on life-support, then we can invest properly to make all forms of ongoing creativity a key component of Wales’ DNA. If we must, for a while yet, accept the relative impoverishment which will now surely affect even the comfortable amongst us, then , too, we must work ceaselessly to remove the stain of relative poverty which blights the lives of too many of us,and especially the existence of children. We must, in all ways possible and available, end the poverty of aspiration which has settled on us as a pall. How? Lifelong Learning. Redistribution of Resource. Social and Cultural Ambition. Public Pride and Civic Engagement. Active Localism. Redistribution of Life Chances. Heritage informed by History and not Sentiment or Myth. Forensic Intelligence allied to Mutual Love. Education of the Desire to become what it should mean to be Human.

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Professor Dai Smith is a novelist and historian, a former Pro Vice Chancellor of the University of Glamorgan and formerly Head of Broadcasting (English) at BBC Wales.