NHS In Crisis: UK’s COVID-19 Response Exposes Long-Term Under-funding Of Healthcare System


“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.” This statement by Aneurin Bevan, founder of the National Health Service (NHS), underlines the core principle of the UK’s universal healthcare system.

The creation of a tax-funded public health system in 1948 revolutionized post-World War Two Britain, providing equal access to healthcare for all. Labour MP Aneurin Bevan had to overcome vehement opposition from the Conservative government in order to pass the 1946 National Health Service Act and, in recent years, the NHS has suffered from drastic funding cuts as a result of Conservative austerity measures. Despite its turbulent history, the NHS has been widely cherished as a staple British institution and is still viewed by many as the ‘envy of the world.’

In response to the COVID-19 pandemic, the NHS has received a surge of public admiration and support, and millions of pounds have been raised through charity campaigns. However, with the coronavirus death toll standing at 27, 500 as of 2 May, there are reports that the UK could be the worst affected country in Europe. Out of this figure, it is estimated that over 100 NHS and healthcare workers have died from the virus. The UK government is facing criticism for its failure to protect NHS staff, and critics are questioning why hospitals are relying on public donations to pay for basic necessities.

The UK’s COVID-19 response

The government has been accused of ignoring advice from the World Health Organisation (WHO) by failing to order extra stocks of ventilators, personal protective equipment (PPE) and virus testing kits, before the pandemic hit the UK.

On 28 April, a BBC investigation found that the government had consistently failed to buy crucial protective equipment to cope with a pandemic, ignoring advice from health officials. This comes after reports that the government refused to join an EU scheme that issues orders for medical equipment until 19 March, due to a ‘political decision’ made by ministers. Due to the shortages, NHS staff have been told to treat COVID-19 patients without protective gear, in opposition to official guidance from Public Health England (PHE) and the WHO.

The government has also come under fire for not making testing kits available earlier in the pandemic. Testing was eventually made available for NHS staff and key workers in April, after a number of NHS workers had already succumbed to the virus. NHS Providers, the membership organisation for NHS trusts, have accused the government of lacking a long-term strategy on testing.

Meanwhile, the general public have been raising funds for NHS Charities Together, an organisation which already provides the NHS with hundreds of millions of pounds every year. Captain Tom Moore, the 100-year-old war veteran who completed 100 laps of his garden, has raised more than £30m for NHS workers, while the Run for Heroes campaign has raised over £5 million. The charity OneMillionClaps was set up to allow members of the public to make donations as they take to the streets each week to applaud frontline workers. Communities have clubbed together to provide local hospitals with homemade gowns and scrubs, while schools have been asked to provide protective goggles.

Government ministers have commended the generosity of British people, lauding their efforts to provide much-needed funding for the NHS. In his first speech since his recovery from the virus outside Downing Street on 27 April, Prime Minister Boris Johnson urged British people to mirror the ‘spirit of optimism and energy’ of Captain Tom Moore.

Government’s response ‘utterly hypocritical,’ says UN poverty expert

However, some have viewed the government’s rhetoric with cynicism. Philip Alston, the United Nations’ poverty expert, has attacked the UK’s coronavirus response as “utterly hypocritical.” Alston told the Guardian on Sunday 26 April that globally, “the most vulnerable have been short-changed or excluded” by official responses to the disease. Alston said that it was hypocritical of the UK government to “now abandon ‘austerity’ with such alacrity, after all the harm and misery caused to individuals and the fatal weakening of the community’s capacity to cope and respond over the past 10 years.”

Indeed, the NHS has been put under extreme pressure by inadequate levels of funding since 2010, when the Conservative government introduced drastic cuts to public funding of health and social care. Alston criticized these measures back in 2018, stating in his report that the Conservatives’ welfare policy has inflicted “great misery” on British people.

These are unprecedented times, and a crisis such as the COVID-19 pandemic is bound to push any health and social care system to its limits. However, it is clear that a decade of cuts to essential public services in the UK has put the country at a huge disadvantage.

A study by the Institute for Public Policy Research (IPPR) think-tank revealed that food banks, which give out at least 1.6m parcels a year, have lacked supplies during the crisis, while care homes, where thousands are reported to have died from the virus, have struggled to acquire essentials including PPE. Meanwhile, cuts to the NHS have led to an increase in waiting times, huge staffing shortages, and critical care capacity at lower levels than most European countries, according to a report by Politico, meaning the service was under immense strain even before the virus hit the UK.


The NHS is not a charity

In light of this systematic undermining of the national healthcare system, the fact that a pensioner has raised millions to provide the NHS with essential equipment during the crisis ought to be a source of shame for the government. There is bitter irony in the fact that ministers are now commending the public for propping up the very institution that previous governments have been under-funding for a decade.

Charities are valuable in providing much-needed support to vulnerable people in society, but they should not be subsidizing areas which should be covered by the state. In one of the richest nations in the world, it is disgraceful that the most basic needs of society – the health and social care of its citizens – are struggling to be met due to funding cuts.

Now more than ever, it is important to remember that the NHS is not a charity. In fact, the service was put in place to counter the very notion of relying on donations and self-funded healthcare. Since it began operation in 1948, it has provided reassurance and guaranteed universal healthcare for every member of society.

This crisis has starkly shown the extent to which Britain relies on the NHS, despite its flaws. The healthcare workers who are putting their lives on the line to treat patients deserve a public inquiry into the government’s mismanagement of the crisis, which could have led to avoidable deaths. An inquiry will be the first step, but after the crisis there needs to be an overhaul of the government’s approach to the health and welfare system of the UK. It is crucial that the British people hold the government to account, not just for their response to the virus, but for the systematic undermining of the NHS over the past decade.

It is inspiring to see millions across the country applauding each week to show their gratitude to key workers. However, the NHS cannot survive on applause and donations alone. In the words of its founder, “The NHS will last as long as there are folk with the faith to fight for it.” Looking ahead, Britain must stand resolute in the face of any threat to the health system that, at its core, represents the key principles of care and compassion that have come to define the public’s response to the pandemic.


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3 thoughts on “NHS In Crisis: UK’s COVID-19 Response Exposes Long-Term Under-funding Of Healthcare System

  • billellson

    All parties agreed the 1944 NHS white paper that formed basis of the 1946 NHS Act, before Bevan got involved. Conservatives opposed nationalisation of hospitals, only the BMA opposed the principle of the NHS.

    ‘last as long..’ not Bevan, but a line from BBC Wales 1997 TV drama ‘Food for Ravens’ written by Trevor Griffiths

  • Jen

    Hi Bill, thanks for your comment.

    You’re right that Tory MP Willink published the initial White Paper outlining plans for a national health service, but for many reasons, this pales in comparison to the Act put forward by Bevan which created the NHS we know today – the Act which was opposed by the Conversatives over 20 times. I would also argue that a key principle of the NHS is the nationalisation of hospitals which, as you say, the Conservatives opposed.

    Ideally, I would have discussed the BMA’s objections to the Act too (many of which were supported by a number of Tory MPs), but unfortunately with 1000 words to work with, I couldn’t cover every aspect. I wanted to focus on the current government’s attack on the NHS, so it was relevant to provide a brief reference to the Conversative Party’s initial opposition to the Act which established the health service we have today.

    As for the quote- I just looked it up and it seems to be a widely misattributed statement. Griffiths said he heard miners using it in the 80s who attributed it to Bevan – but as it’s not definite that Bevan actually said it, I will change it in my report (once I’ve figured out how to do that). Seems I’ve fallen victim to the Mandela Effect there as I always assumed this was directly from Bevan!

  • billellson

    @jen Thank you for your reply.

    The 1944 NHS white paper was ‘Presented by the Minister of Health and the Secretary of State for Scotland’ i.e. Henry Willink (Con) & Tom Johnson (Lab). (Much of the work done by their predecessor (in both jobs) Ernest Brown (Lib).)

    Nationalisation of hospitals, which Conservatives opposed, was simply Bevan caving in to empire building civil servants. Nationalisation of hospitals was a disaster. Hospitals whether local gov or voluntary (charitable foundations) had been built by local fundraising and endowments, all of which stopped. Bevan failed to provide any alternative funding mechanism = no new hospitals until 1960s. By 1954 Bevan had realised his mistake and wrote in the Municipal Journal of returning hospitals to local government

    The principle of the NHS was set out by Winston Churchill speaking at a Royal College of Physicians luncheon 2 Mar 1944 (reported in The Times 3 Mar 1944):
    “Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services”

    Separate practice (remaining private businesses) for NHS GPs agreed by Brown in 1943 and set out in 1944 white paper. BMA opposition afterwards purely ideological. BMA only gave up in 1948 when they realised that most of their members were signing up as NHS contractors.

    ‘Folk’ not in Bevan’s lexicon and, given his speech impediment, he would never have attempted 3 successive ‘f’s. Griffiths admitted authorship to me (His claim to Dr Ben White that NB said it to the miners was made more than two years later.)