The NHS: in gratitude on its 70th birthday

Today is the 70th birthday of the National Health Service. Services and celebrations are happening across the nation. We are right to honour this great institution and be profoundly thankful for it.

I'm not one of those with a dramatic life-and-death story to tell about the NHS. I've not troubled my GPs overmuch in my lifetime. Most of my ailments have been small beer compared to what many others have had to face: childhood infections and abrasions, adolescent allergies, the odd broken limb, hypertension, mild atrial fibrillation, psoriasis. I've undergone a vasectomy, a prostate op and keyhole surgery for hernias. I have NHS hearing aids. Too much information? I suspect that for a man coming to the end of his seventh decade, it's pretty standard fare.

The Archers, the NHS and I are almost exact contemporaries. After the war, my mother became a nurse at the old Charing Cross Hospital in central London where I was born. Neither she nor my father were people of faith, but they did instil in me from a very early age a kind of hushed reverence for the NHS. (The Archers had to wait a few more years.) Our GP in north London was an elderly German-Jewish exile called Dr Landstein. I recall him quite clearly from the mid-1950s: kindly, compassionate, wise. Nothing was too much trouble for him. He enjoyed home visits and chats with my mother who like him had also survived the Holocaust. It felt like a family bereavement when he retired. I remember his successor too, Dr Giwelb. He was younger, less priestlike, more professionalised, more "modern", but he too was among the gods of my childhood pantheon (where they were flanked by Miss Bull, my primary school headmistress, and Owen Brannigan who lived three doors away on our street). Between them, they shaped my expectations of healthcare for a lifetime. And they have been abundantly fulfilled in adulthood. I'm thinking especially of two marvellous GPs had in Sheffield and Durham. Perhaps they know who they are.

When I was a parish priest, I was also the official chaplain to the town's infirmary, paid by the NHS. I learned a lot about healthcare in those years, not least when I was involved in the in-service training of doctors, nurses, administrators and support staff. I was proud to be a tiny part of that exemplary hospital, proud to have a role in an institution that was so valued in the community. If I ever entertained doubts about the virtue of universal healthcare (I'm not sure that I did), my experience in that place of truth and love quickly dispelled them.

So I understand why Polly Toynbee writes as she does about the NHS as a kind of surrogate religion. It's simply there, like the good old C of E, a benign institution that we're glad exists to bless our nation and provide for it at times of need, even if we rarely have to trouble it ourselves. For my generation and for everyone younger, it has hatched us, patched us up and dispatched us. We've felt safe and cared for. We've never known anything else. We can't quite understand why the whole world doesn't emulate the NHS, why the United States, for instance, has struggled so hard to provide even the rudimentary ObamaCare for the most needy that is now being unravelled by Donald Trump.

But we know for ourselves how politicised health care has become. No government has dared to tamper with the idea of universal healthcare free at the point of use. It would be a certain vote-loser. And yet the sustainability of the NHS is under threat in a way that would have been inconceivable even a quarter of a century ago. Conservative administrations have been reluctant for decades to say openly that excellence in healthcare requires that we all put our hands in our pockets to pay for it through our taxes. Only now is there a belated acknowledgment of this in the Prime Minister's £20 billion funding commitment. It's a welcome start. But it's nowhere near enough if the NHS is to be stabilised. It's now an urgent case of playing catch-up. Years of chronic underfunding must be put right if the founding vision of the NHS is to be honoured in our day. To achieve this, our leaders have to believe in it. Back to the NHS as a quasi-religion that needs vision and faith if it's to serve us well and flourish.

I recently read Adam Kay's book This is Going to Hurt. He was a junior hospital doctor specialising in obstetrics. He loved his work and showed every sign of going on to a promising career as a consultant. But the pressures on him as a healthcare professional became intense - not because of any failure of his, but because of "the system": impossible working hours, lack of resources, an absence of proper rigorous supervision, the ever-increasing likelihood of making a life-threatening mistake. So he resigned his position and is now a writer. His book is candid about his experience. It is by turns very funny and extremely alarming. We've known for years what GPs and junior hospital doctors have to contend with. But when you read something as personal and vivid as this, you begin to worry. You wonder how on earth the NHS can carry on as a viable institution, let alone have a future.

Like so many other things - the environment, arms sales, ethical trade, reform of our financial structures, the benefits system, Brexit, it comes down to the political will. Do we really want a future in which the founding vision of the NHS continues to play a central part in the welfare of our people? If so, are we willing to pay for it? Our politicians must come clean. And while we're on the subject, that applies to social care for the elderly too. We baby-boomers are getting old. Demographic projections show how our demands on the NHS will put it under ever-increasing strain until our generation has died out. Before that, we are going to need social care that is beyond the means of many people to afford. For those who are "just about managing" or not managing at all, the prospect of ageing is bleak and even terrifying. After a lifetime of looking after others, who will look after them?

Today we celebrate the vision and courage of those pioneers of 70 years ago who believed that the nation should look after its people from cradle to grave. That's not about setting up unhealthy dependencies so much as creating structures of mutual giving and receiving so that those who need care have access to it and need not fear that it will be denied them. It's old-fashioned to speak of "the idea of a Christian society". Yet I profoundly believe in this ideal of a public caring institution which is for all people, and from which no-one is excluded. It's a practical expression of the great commandment to love our neighbour as ourselves. On this NHS birthday, and out of gratitude for all that it represents, I believe we must renew our heartfelt political commitment to it so that our children and grandchildren may benefit as we have done.

But a birthday is for celebrating and being thankful. The NHS is not a perfect institution but I want to say, unhesitatingly, that it is a great one So this is a day to be glad and set our hopes high. As the Archbishop of Canterbury tweeted today, "The NHS is an expression of our deepest shared values. Whatever its challenges, it’s about us living out our concern for solidarity and the common good. It reflects God’s concern for every person without exception. Today let's pray, give thanks and recommit our support. The NHS can be proud of its first seven decades." Indeed.  Floreat!

Immigration: a view on the ward

We've been in London for a while to be with a close elderly relative who was suddenly taken into hospital. This was not where we had planned to be during June, but it was of course right to be here at this testing time for her and for the family.

But being in London for a couple of weeks has given me the unexpected chance to reconnect with my home city. I've thought of myself as a North-Easterner for many years because it's where we have lived for much of our working life, and it's where we have chosen to make our permanent home. God willing, we hope one day to die there. But I'm a Londoner by origin and you can never take London out of a Londoner. And as Dr Johnson famously said, when you are tired of London, you are tired of life.

I didn't need to be reminded that London is the most cosmopolitan city in the world. But it's one thing to know it, quite another to experience it from the inside. Maybe it doesn't strike Londoners as worth remarking on any more: they (by which I mean those who live and work here) are simply used to hearing every language under the sun spoken on the bus and tube, in city street and corner shop, in the workplace, school and church and across th garden fence. 

But although I've frequently come back to London throughout my life, I don't think I've been exposed to it in quite this way before. And this cosmopolitan diversity has struck me forcibly this month, not least in the hospital we've been visiting. True there were plenty of immigrants in the 1950s and 60s too - not only people from Commonwealth countries but also Europeans like the German-Jewish war refugees who had settled in north London where I lived. My mother's family belonged to this community, as I've written before, and it was perfectly normal for British children brought up in that milieu to be bilingual. I was lucky enough to be one of them until I stopped speaking German the day I started school. I suppose I must have felt in an obscure way that it didn't do to speak German in public less than a decade after the end of the war. But I soon regretted losing my fluency in that language, one of the things I hope I may put right again in retirement.

What's remarkable is not the prominence of immigrant communities in a great city. Having lived and worked in Coventry and Sheffield for several years, both highly diverse vibrant cities and proud of it, it was strange to find myself in the more monochrome (i.e. "whiter" Anglo-Saxon) environment that I found when we went back to North East England, even if the strongly internationally-minded University of Durham partly made up for it. No, it's the sheer "reach" of geographical, ethnic, linguistic, religious and cultural diversity that now characterises London. It has become home to every race and culture on the planet, a market place of global possibilities and opportunities. 

And yet, as someone whose provenance this great city is, I still recognise it as "my" place. That's not about loving it - I think part of me fell out of love with the blandness of suburbia's net curtains and privet (though that's changed too now, much for the better) and with the over-stimulation and hectic pace of big-city life. Gridlocked in London traffic on the top deck of a bus that is going nowhere I could lose the will to live. Instead we have opted for the more tranquil lifestyle of the rural north and its warm, genuine communities that have made us so welcome there. Well - no doubt personal temperament comes into things. Millions of people wouldn't live anywhere else but London, and why should they if they love it here? It's one of the world's great cities.

No, what I mean when I say that I still "recognise" it is that rather to my surprise, the "soul" of London does not seem to me to have changed vastly as a result of the huge transformations that have altered almost every aspect of its visible face. (I realise as I write this that some my not feel the same way.) This is still the UK's proud capital city. There is a familiarity about walking the streets and parks, visiting churches and museums, travelling by public transport. You may not understand what the people around you are saying to one another (and sometimes to you!) or speaking into their mobile phones. But to me at least, far from feeling alienating, it is all just part of the unending and marvellous variety of London life. London has always been that way. Cities should be places for all people to belong to. London is spectacularly successful in this respect.

Back to the hospital ward. My relative is being cared for by an excellent team of NHS professionals for whom nothing is too much trouble. Very few of them are native Brits. Some are from other EU countries, though the majority on her ward at least seem to come from outside Europe. In the febrile atmosphere of the EU referendum campaign, it doesn't do to ask too many personal questions about how many are EU migrant workers, or have permanent residence, or are naturalised UK citizens. In an important way, that isn't the point. What impresses me is how this team of men and women, working so well together, exercising such good care of their patients, are a harmonious microcosm of an incredibly diverse world. 

The other day I spoke to the ward housekeeper who is from Latin America. She has lived in the UK for many years and one of her children was born here. She is a warm, kind woman who loves what she does. She has a strong Latino accent, a wry sense of humour, a bent for philosophy, and well developed political antennae. We spoke about the EU referendum. She hadn't made up her mind which way to vote, though the consequences not only for herself as an immigrant but for the NHS that she cared deeply about were weighing heavily in her thinking. 

I came away thinking: what a gift such a person is to our health service and to our country. Wherever would the NHS be without many thousands of such good people? Where would our local authorities and social services, our schools, businesses and transport be? Immigration is good for a nation. It's a sign of how attractive our country is, and indeed, how flourishing not just economically but in a hundred other ways that help people flourish. We should be proud that so many want to come to the UK. And proud of the success London and other cities have made of creating wholesome international communities that embrace diversity as one of God's gifts to humanity. 

And how much we have to learn from those who make their home among us! They give us the chance to have our horizons stretched, to travel across the globe in mind and imagination to hear other perspectives and gain fresh insights. "If you never travel, you think mother is the only cook" goes a Bantu proverb. What's more, I'm finding that London is a friendlier city than I remember it being half a century ago. Is this thanks to those who have come from other lands to live and work in our country? I wouldn't be surprised.  

The much admired Jo Cox MP, so terribly murdered this week, said in her maiden speech in Parliament last year: "Our communities have been deeply enhanced by immigration, be it of Irish Catholics across the constituency or of Muslims from Gujarat in India or from Pakistan, principally from Kashmir. While we celebrate our diversity, what surprises me time and time again as I travel around the constituency is that we are far more united and have far more in common with each other than things that divide us."

Of course we can turn our back on them and go on living in the nostalgic fantasy-world we islanders are prone to. But it isn't real life. And to turn our back on our fellow human beings is fundamentally an act of self-hatred. So open your eyes to the teeming life of this great city and see the rainbow world as it really is. This is the London, indeed the Europe of today and tomorrow. Embrace it. Welcome it. Love it. For God's sake, who so loved the world.