Our NHS: A History of Britain's Best Loved Institution

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Our NHS has received positive coverage in The Financial Times, The Guardian, The New York Times, The Times Literary Supplement, The Lancet, and The Literary Review. In his even-handed analysis, Seaton argues that what is remarkable about the NHS is that it has, to all intents and purposes, survived ‘the tsunami of attempts to marketise’ it. In Our NHS, Andrew Seaton explores how the National Health Service, a great achievement for Aneurin Bevan and the left, became a national institution commanding widespread support. Instead, I sought to remain attentive to the alternative roads that the service might have gone down. An engaging, inclusive history of the NHS, exploring its surprising survival—and the people who have kept it running.

I could gain some critical distance from the two predominant narratives about the service that circulated in the media and in everyday conversation: that it was a natural part of what made Britain special and/or that it stood on the precipice of collapse. At the next general election, Keir Starmer will, as usual, warn the country not to trust the Tories with the NHS.Though I learned first-hand about the serious challenges facing the service from doctors and patients in my audiences as I spoke about the book after its publication, I also encountered public attachment to the NHS that reminded me why it had lasted through other periods of crisis.

For most people in the middle it is just there, an immovable feature of the landscape, like a mighty river or majestic forest. He traces how the service has changed and adapted, bringing together the experiences of patients, staff from Britain and abroad, and the service's wider supporters and opponents. By highlighting these dynamics, I build on insights from prior historical scholarship (often informed by social science) that explained the resilience of welfare states through structural factors like the advantages of pooling risks or the power of ‘path dependence’ in social policy. The two authors are aligned in their analysis, covering much of the same material and identifying many of the same recurrent patterns: the constant pressure for innovation provoking fear of core NHS principles being abandoned; tension between a consumer culture that increasingly expects customised choice and a system that functions by pooling resources on a principle of collective solidarity; the challenge of imposing minimum standards without the perverse, unintended consequences that rigid targets generate; the simple fact that there is never enough money, but also that more cash is not always the answer and Treasury pockets are not infinitely deep.Anenurin Bevan, Minister of Health, on the first day of the NHS (5th July 1948) at Park Hospital, Davyhulme, via University of Liverpool.

Battles fought on that front – for safe maternity care; for reproductive rights – provide some of the most compelling passages in Hardman’s deftly constructed and powerfully told narrative. It is my hope that Our NHS can complement work currently being undertaken by other scholars that also illuminates the past of this world-famous institution, whether through smaller case studies or in macro terms.Our NHSinsists that neither the institution’s acclaim nor its survival were automatic or pre-ordained.