This 5th July marks the 75th anniversary of the NHS. But while there’s much to celebrate about this amazing institution, there’s something else we must do as we arrive at this important milestone. We must take this opportunity to hold politicians to account, because the NHS is in the worst state it has ever been, and we have reached this point due to political decisions. Decisions made by those who could, and should, have done better. 

The current government has done many things which have undermined the functioning of the service: treated staff terribly (leading to widespread understaffing and low morale); failed to invest in the infrastructure of service; funnelled large sums of public money into the private sector while underfunding the public service; and enabled the infiltration of privatisation into the service in many ways. 

But the conversation shouldn’t be limited to the actions of ministers since 2010. Legislative changes have been pushed through by various governments since the 1980s, bringing us to where we are today. These changes have built a competitive marketplace within our public healthcare system, and have loaded the service up with many billions of pounds of debt through PFI contracts (which we’re still paying off, and will be for decades). They have enabled the outsourcing of NHS services, leading to a situation where thousands of NHS services are run by external providers including private companies. Most recently, there has been the sell-off of dozens of GP surgeries to an American healthcare insurance provider. 

The changes have been stepwise, insidious, and mostly obscured from view, because the media has largely failed to shine a spotlight on politicians’ actions, and failed to provide the necessary discussion, debate and analysis to hold decision-makers to account. 

And now? Decades on from the inception of these changes, the NHS is collapsing in many areas. This winter was the worst NHS winter on record. Up to 500 patients died unnecessarily every single week because of their inability to access urgent healthcare. The situation was horrifying. Many patients called for ambulances which were severely delayed, or in some instances did not arrive at all, leading to patients suffering in their most vulnerable moments without the support and attention of healthcare workers. Those who reached A and E departments were often met with scenes of chaos; patients receiving life-saving treatment in the waiting room, or in non-clinical areas like cupboards, or overcrowded and understaffed wards. It was a humanitarian crisis which did not receive the attention it deserved. It was terrible for everybody; the hard-working staff who tried as hard as they could to keep patients safe, and the patients, who were profoundly failed by politicians. 

It is now June, when historically things get slightly quieter in the NHS, and staff are able to catch up and clear backlogs. But that isn’t happening this year. Despite Rishi Sunak’s promise at the beginning of the year that NHS waiting lists were one of his top 5 priorities, the NHS waiting lists are growing. 7.4 million people are waiting for treatment in England alone. We are now missing at least 124,000 full-time NHS staff. One might ask what the government is doing to shore up the workforce and ensure maximum capacity to tackle the problems. The truth is that they’re doing very little. The government is currently locked into pay disputes with NHS staff. Staff who have endured significant real-terms pay cuts for many years, endured the stress and strain of the pandemic, and are now leaving the service in large numbers. 

It is imperative that the government end these pay disputes by finally paying staff properly. In the short term, it is one of the things which would have the maximum impact on improving the situation in the NHS. Having done that, they should invest the money needed to fix NHS repairs. The situation has been neglected for far too long, and the repair bill now sits at £10 billion in England. It’s a terrible situation, with crumbling buildings, situations which are placing NHS patients and staff at risk. There have been hundreds of recent sewage leaks into A and E departments, cancer wards and maternity units. 

In the longer-term, politicians need to make radical changes if they are to fulfil the promise of the NHS. Millions of patients are currently unable to access the care that they need within a system which they pay for through their taxes. Politicians should eliminate privatisation from the service, which has fragmented the NHS and broken down its inherent architecture. The bureaucracy and admin of tendering contracts creates additional work for NHS facilities, and the churn of short-term contracts affects staff-patient relationships, especially for those with chronic conditions. The situation is pressing and deeply concerning. An observational study published in The Lancet in 2022 suggests that NHS outsourcing to private companies may even be leading to patient harm. 

Yet politicians are unlikely to make these changes unless they are put under pressure to do so. And so as we approach the NHS’s 75th anniversary, an extraordinary milestone for an extraordinary institution, it is time for us to share facts, spread awareness, come together and hold politicians to account. The service has been transformative for our country, a safety net for so many for so many years. It can be again; we can rebuild it. But if we want that to happen, we’ll need to speak up for it together. 

Pre-order Critical, Julia’s new book, here.

About the Author 

Dr Julia Grace Patterson is the founder and chief executive of EveryDoctor. The non-profit campaigning organisation was established in 2019 with the belief that doctors have the power to end the NHS crisis, collectively using their voices to highlight matters of national importance and demand an overturn of the broken system they work within. They brought the UK government to court along with Good Law Project, proving the existence of the VIP PPE

lane. Through numerous dynamic national campaigns, they have helped to secure important policy changes to safeguard lives and have put the future of the NHS high on the agenda. 

Julia qualified as a doctor in 2010 but is not working clinically, having devoted herself full-time to advocacy work since 2020. She won a Marie Claire Future Shaper award in 2021 and speaks to hundreds of thousands of people online every day about the NHS and its future. 

Critical is her first book.