At a time when British national identity appears more fragile than it has been for a very long time, the National Health Service bids fair to become the only major national institution that expresses the unity and commands the undivided loyalty of all but a tiny minority of the people living in this country. Shorn of empire, of economic pre-eminence, of religious certainty and racial separateness, many of them have nevertheless come to see the NHS as something peculiar and intrinsic to the British way of life: a sort of utilitarian church, mediating the beliefs and presiding over the rituals of a society incapable of advancing any more metaphysical conception. For the past thirty years foreign observers cited in Charles Webster's study have perceived the NHS as an 'integral part of the total pattern of the British state', as an 'altogether natural feature of the British landscape', and 'almost a part of the Constitution'. In contemporary British mythology the NHS is perhaps the last institutional survivor of the fabled 'Dunkirk spirit'. Even in Mrs Thatcher's Britain most of us take comfort from the thought that, though individually we are required to be competitive and self-regarding, nevertheless somehow and somewhere our collective organic self is being caring and altruistic on our behalf.

LRB 23 June 1988 | PDF Download