The Hospice Comtesse, just north of the historic centre of Lille, opened in 1245, more than seven centuries before the formation of the NHS. It treated the sick for free, using income from its estates and donors, until 1796 when post-revolution reforms turned it into a hospice, a role it performed until 1939. As a tour of the buildings, now a museum, makes obvious, it was an explicitly Christian institution, with a chapel adjoining its huge dormitory ward and its healthcare provided by nuns.
The historic links between religion and healthcare are evident in language: today’s nurses, who are still called sisters and sometimes angels, are engaged in the work of saving the sick. But it seems that healthcare also now serves as a substitute for religion for many. It is the location of almost all births, which in most cases are no longer marked by a church service, and many deaths, which once might have been attended by a priest. It performs ‘miracles’ – cures which can be explained through science, but which would have appeared miraculous to the Hospice Comtesse’s mediaeval patients, and in many cases retain that aura today (think of the separations of conjoined twins).
It includes ritualistic activities such as the provision of medicines (which sometimes work even if they are only placebos) and is the recipient of charity, even if the manifestation has changed from an ex-voto painting (such as those shown above, on display at the Hospice Comtesse) to a marathon runner’s sponsorship, as a way to give thanks for a cure, or to remember one who was not.
It is sometimes said that shopping has replaced Christianity in national life, but it seems more accurate to agree with former Conservative chancellor Nigel Lawson that the NHS is the closest thing Britain has to a national religion. It has credos, initially expressed within William Beveridge’s aim of fighting the five evils of Want, Disease, Ignorance, Squalor and Idleness in his wartime report that recommended the NHS and the rest of the welfare state. Despite the fact that (with an echo of the King James Bible’s modern renderings) it is now less elegantly expressed as “healthcare free at the point of delivery”, it is still a powerful and simple belief: if I am sick, I shall be cared for.
Perhaps this helps explain the fury triggered by any changes to the NHS: they are a kind of blasphemy. Politicians of all parties carry out reforms of public services. These are often opposed by those working in those services, but rarely does this opposition spread to any great extent to the general public. Britain’s rail system has many friends and critics beyond its own workforce and a few of its stations are sometimes thought of as secular cathedrals, but despite the fundamental and often botched reforms the rail industry has suffered over the last two decades, transport secretaries do not tend to suffer quite as much as health secretaries do.
Healthcare is a difficult policy area, with fast-rising costs and expectations leading to a need for reforms. But while the NHS is treated by many as a kind of religion, that will be particularly tricky. All kinds of departments have ministers, but the health ones of all parties get more than their fair share of accusations of heresy.