The NHS, Charitable Giving & What To Do When This Is Over?

6 min readApr 16, 2020

In functioning democracies, we are told, the people must be able to hold the government, whom they elect, to account. However, since the UK entered lockdown, it has become increasingly clear that the reverse is happening — the public are now being held to account by the government. The burden of responsibility for the success of the UK’s precarious navigation through this unprecedented crisis has been placed on the shoulders of its people by those elected to lead. Just six days ago Matt Hancock was criticised by health-care professionals for urging them not to overuse PPE (protective equipment).[1] The fact that the UK is unable to provide its healthcare workers with adequate equipment, despite having missed three opportunities to bulk-buy masks gowns and gloves as part of an EU initiative [2], is as shameful as the Government’s attempts to shift the responsibility for the management of its scarcity to front line workers, dozens of whom have now sadly died from COVID-19.[3]

That the government also suppressed a report published in 2016 demonstrating that the UK was woefully underprepared for a pandemic situation merely rubs salt into already gaping wounds[4]. And yet who would genuinely be surprised by the news that successive Tory administrations have treated matters of public safety with such recklessness, sacrificing its people’s wellbeing on the altar of an economy committed to relentless financialisation? The Conservative Party cares about nothing more than quick fixes and a PR operation designed to keep it in power and keep its donors happy. This was epitomised by its request to long-time Conservative member [5] Richard Dyson (who decided to move his company’s operations to Singapore following the “resolution” of Brexit[6]) to construct ventilators required by ailing ICUs. These promises have still to be realised.

Yet the public is no doubt aware of the impact that mismanagement by the Tories, Lib Dems, and in some respects New Labour, has had on the NHS, and consequently the wellbeing of both its patients and staff. Despite this, throughout this turbulent recent history of missed targets, growing waiting lists, scandalous photos of children treated on corridor floors, and a plateauing life expectancy for the first time in 100 years [7], the public’s support for the NHS has been unwavering.

The recent outpourings of support for the NHS should serve as a stark reminder to Conservative MPs, many of whom have publicly advocated in favour of its privatisation [8], of just how much the British people treasure this institution and its staff. However, we should also be wary that such over eagerness can be just as easily co-opted by the Conservative Party into another role-reversal of responsibility. Stories such as the fundraising efforts of 99 year-old Captain Tom Moore who, at the time of writing, has raised £14 million of donations[9] are of course heart-warming. If anything, the impact of this story can be found in its effect on national morale more than in its efficacy at plugging the funding shortfalls which beleaguer an institution affected by years of cuts and bureaucratic restructuring. Similarly, the weekly applause for NHS provides a genuinely touching moment of solidarity and recognition at a time when we, as a society, have never been more alienated from one other — physically, as well as politically. But applause will not fund protective equipment, ventilators or staffing costs, and Captain Moore’s £14 million equates to just 0.025% of the £55 billion owed by NHS trusts to insurers as a result of the catastrophic PFI initiatives introduced during the Blair era.[10]

Donations are not in themselves harmful. Indeed, generosity of spirit should be nurtured at all times, whether through financial contributions or acts of communal solidarity with fellow citizens. However, we should make abundantly clear the sheer amount of funding required to sustain the NHS. In 2019/2020 its budget was £140.4 billion. The £2.5 million raised so far through Virgin Money Giving’s “Run 5k for Heroes” [11] equates to 0.0018% of this, and it would be unsurprising if the financial benefits of this fundraiser will stem more from the health benefits of cardiovascular exercise than the financial contributions of the well intentioned public. That Virgin Money Giving forms a constituent part of Richard Branson’s business empire is nauseating given his unashamed litigious dealings with the NHS in the past.[12] Yet capitalist society is never short of its contradiction. Unfortunately, such enthusiasm for the NHS from the public must nevertheless be read alongside the same public’s decision to place more Conservative MPs in parliament than any other party for four consecutive general elections.

With an enormous Conservative majority in parliament and no election on the horizon for several years, those who value the NHS must remain vigilant in defending it once this situation has passed and lockdown has ended. The adequate funding and management of our Health Service, and indeed many other public institutions, will require a systemic shift in the way our economy functions, and for whom it functions. The government will eventually have to decide whether it wants to take some responsibility and choose who will bear the brunt of the impending recession and the toll that this could take on our public services. With the UK anticipating a 35% hit to GDP this quarter [13] and 9 million workers expected to be furloughed at some point this year[14], the UK is about to enter the most economically precarious situation that majority of its citizens will have seen in their lifetimes.

Should the Conservative party decide that further cuts are necessary to a country still suffering from the effects of a decade of austerity, we must resist the urge to continue dipping into our pockets, thinking our charitable loose change can make a tangible difference. Should the government ringfence the NHS, we must demand that this is not at the expense of other vital services, whether in social care, education or transport. It should be abundantly clear that the NHS cannot, and must never, rely on charity; institutions of this size can only be funded systemically. We can no longer allow for billions to flow offshore, for tax loopholes to be exploited, for the richest to expand their wealth and power while we suffer at the expense of their greed. For as long as there is enthusiasm for supporting the NHS there will be a willingness for the State to allow such visible support to mask the cracks in a fracturing system or to be manipulated into populist pledges such as the infamous £350 million Brexit bus.

So, what can we do? The UK’s recent history has demonstrated that marches achieve little — whether through their attempts to stop disastrous wars, or overturn referenda. Should the government continue to mismanage our public services in the aftermath of this crisis, we must shift our tactics, en masse, towards direct action. Yet strikes within public services, particularly those as essential as health care, are often treated with hostility (one only has to look at The Sun’s call to sack Junior Doctors as recently as 2016).[15] However, a general strike in solidarity with the NHS, a strike on behalf of our heroes, for not from our heroes would be far more effective in demonstrating our support and achieving change than a couple of quid donated online and perpetual applause. Until the British public learns to act, it will continue to reap the bitter fruits of Conservative government. However, in a time of unprecedented crisis, genuine bonds of solidarity with our public sector are starting to strengthen. Perhaps this can be the seed from which systemic change can grow.

[1] https://www.theguardian.com/society/2020/apr/10/matt-hancock-urges-public-not-to-overuse-ppe

[2] https://www.theguardian.com/world/2020/apr/13/uk-missed-three-chances-to-join-eu-scheme-to-bulk-buy-ppe

[3] https://www.itv.com/news/2020-04-16/official-nhs-staff-death-toll-rises-to-27/

[4] https://www.newstatesman.com/politics/health/2020/03/government-documents-show-no-planning-ventilators-event-pandemic

[5] https://www.forbes.com/sites/chloesorvino/2016/08/24/billionaire-inventor-james-dyson-politician-brexit/

[6] https://www.bbc.com/news/business-50596775

[7] https://www.bc-legal.co.uk/bcdn/214-195-life-expectancy-plateaus-for-the-first-time-in-100-years.html

[8] https://www.independent.co.uk/news/uk/politics/dominic-raab-nhs-privatisation-general-election-hospitals-conservatives-manifesto-a9230606.html

[9] https://www.bbc.co.uk/news/uk-england-beds-bucks-herts-52303859

[10] https://www.theguardian.com/politics/2019/sep/12/nhs-hospital-trusts-to-pay-out-further-55bn-under-pfi-scheme

[11] https://uk.virginmoneygiving.com/fundraiser-display/showROFundraiserPage?userUrl=RunForHeroes&pageUrl=5

[12] https://www.independent.co.uk/news/health/nhs-richard-branson-virgin-care-legal-settlement-tendering-contract-a8080961.html