“In your country, how do you pay when you go to hospital?” my consultant asked.
It was my last day of work in Tanzania. I had been told about the cost of medical treatment. I had seen the itemised bills that were filed right alongside clinical notes, making sure that patients would be billed for absolutely everything from use of an operating theatre down to the 1000TSh per swab used. I had known that they were the tip of a very large iceberg and I had thought about the people who didn’t even seek medical attention because they knew that they couldn’t afford it. And I stood in the middle of a hospital corridor and I tried to explain Aneurin Bevan’s vision to a man who had to work within this system.
“It’s free,” I said. “In my country, we have a thing called the National Health Service. It’s paid for out of our tax. It works so that everyone contributes what they can afford, according to how much they earn. You pay nothing directly. You aren’t charged when you go to hospital and you don’t get a bill later. It doesn’t matter whether you don’t have a job or you don’t earn much and only pay a little bit of tax or you have a very well paid job and pay a lot of tax, everyone is entitled to the same healthcare. There are some people who have private insurance, too, and that might mean that they get seen faster for things that aren’t emergencies. But, generally — ”
“No charge?” he asked. “If you need to see a doctor, you can see a doctor? And you can get treated? And you don’t have to pay for it?”
He looked at me as if I had just told him that I could prove the existence of God. “It’s a wonderful thing,” he said. “It’s an amazing thing. You’re very fortunate to live in such a country.”
I am. I know that I am.
I don’t pretend that the NHS is perfect. It has flaws and inefficiencies and is often tied up in entirely too much bureaucracy. But the things that it stands for are things that represent the very very best of us. It’s there for us when we need it. It’s never turned us away because we’ve had the wrong social standing or the wrong bank account or the wrong kind of insurance. It tries so very hard to be, as Bevan and Atlee wanted, a universal service based on clinical need. It is a hundred times better than the alternatives. It is a wonderful thing. And it is a national treasure.
I wonder if the 316 MPs who voted in favour of the Health and Social Care Bill yesterday realise that.