Personal measures taken to prevent COVID-19 virus contamination Great Britain 2020.
Source: Statista, licence
Like in Italy and in Spain, also in the UK the country rallied behind doctors and nurses, which embody the real heroes of this fight against the virus, struggling daily in the front line and trying to save as many lives they can. Paradoxically their task has been made more difficult right by the same government that is asking people to limit their freedoms in order to protect healthcare workers. And when the NHS is at stake Britons get emotional. The passion that link Britons to their NHS is way stronger than anywhere else on the continent. For example, when Mr. Hancock asked for 250,000 volunteers to help the NHS through the crisis, three times that number signed up and 11,700 retired doctors and nurses have already offered to return to work. As a matter of fact, the NHS has been the key of success for many politicians and it is the magic tool for whoever aspires to a leadership role in the UK. A former Chancellor of the Exchequer Nigel Dawson, even argued that NHS is the closest thing British have to a religion.
However, in the last decade the NHS had a troublesome relationship with the successive Tory governments and the debate around public services dominated British media and newspapers. But no other leader before has politicized the issue as much as Boris Johnson did. Everybody has still in mind when back in 2016, during the Brexit campaign, Boris Johnson pledged extra cash for Britain’s NHS if the country voted to leave the European Union. The slogan displayed on the side of the famous red buses stated: “We send the EU 350 million pounds a week. Let’s fund our NHS instead.” There is little point in stressing the fact that the potential impact of Brexit on the NHS was hardly discussed during the EU referendum campaign and no many seems really concerned by the fact that Johnson’s airy promises turned to be fake news. At the time the future prime minister was wholly aware that NHS card was a great opportunity to launch him in the race for the Tory’s leadership and now is evident that the accuses of those who criticised him for using a delicate issue only to seek a personal advantage came to naught.

Last year Boris Johnson finally admitted his ‘£350m a week’ claim was wrong
Source: Gina Gina Power/Shutterstock
As expected, instead of being a dividend for the NHS, Brexit, and the economic slowdown and unsureness caused by it, resulted in even fewer funds for the healthcare. On the top of that, if the economic impact of Brexit at the end of the transition period does hit the public finances in the way that has been predicted this will make it even more difficult to fund the NHS properly in the foreseeable future. Obviously, in the speech after his victory in last December's election, Johnson said the NHS would be his government's first priority after delivering Brexit, but very much of his attention for the public service will depend on the deal he will be able to reach with the EU. While the NHS problems currently seem to be strictly connected to Brexit they didn’t begin with it.
Over the last 10 years the British healthcare system came under more pressure than at any time since it was founded in the aftermath of World War II by the Labour government of Clement Attlee with the aim to provide “treatment free of charge for all.” In fact, from 2009 the policies of the successive Tory governments perpetrated a gradual and shocking privatisation of the health care sector and a steady and substantial cut in funding. Health care spending has grown just 1.4% a year in real terms since 2009-10, compared with annual growth of 3.7% in the previous decade. Two particular issues stand out as emblems of the abovementioned Tory decade: the cuts of hospital beds and the record shortage of personnel. When it comes to beds, it is true that many countries have reduced their number as medical care advances, but Britain has cut more than most. Since 2010, the number of NHS hospital beds had fallen dramatically and the UK would currently be the 27th out of 28 EU countries per number of beds, and 20th per number of critical care beds. Health Secretary Matt Hancock recently said that 5,000 more intensive care beds will be soon created and while his efforts have been partially successful so far, with 2,295 more units available, this figure needs to be put in a wider perspective. In fact, an increase in beds is not going to represent a substantial change in the situation if there are not enough trained nurses and doctors in the country. Just suffice to say that it takes over four years of study and specialized training to become a qualified intensive care nurse and currently the system has, only in England, about 41,000 unfilled nursing positions and fewer doctors as a percentage of the population than countries such as France, Germany and Italy. Brexit made the picture even bleaker and the number of nurses applying to join the British nursing register fell by around 96% in the aftermath of the referendum and since then many of them decided to leave. Moreover, since the austerity supported by the Tory government—as a result of the 2008 economic crisis—was imposed in 2010, health workers’ incomes had eroded by up to 15%. It is emblematic that when a proposal for 1% pay-rise cap for nurses was presented in 2017 in the parliament, the Boris Johnson who today is praising the “unbeatable” NHS which he says saved his life, is the same Boris Johnson who voted against the bill and then cheered when the pay rise was eventually blocked. As for the doctors, the UK has a greater proportion of doctors who qualified abroad than any other European country, except Ireland and Norway. Around 200,000 EU27 citizens work in the healthcare sectors, including 10% of all NHS England doctors, 100,000 social care staff and 20,000 NHS England nurses, meaning that any limitation in the free movement following Brexit will exacerbate existing workforce shortages. In fact, the future immigration system (as presented by Johnson at the beginning of the year) will be too restrictive to bring in the skills the NHS needs and the British government’s commitment to reduce low-skilled immigration could affect large sectors of NHS jobs. Thus, as the virus gets more entrenched in Britain, the question is not just whether the NHS can cope, but whether it will be able to cope enough.
It is certainly a good new that the government has decided to triple to over £14billion (€16billion) its emergency fund dedicated to public services—and so to NHS. But it is of uttermost importance to think properly about the future. In the coming years, a larger portion of reserves needs to be allocated and the pandemic might channel greater support among taxpayers for tax rises to fund higher levels of health spending. Once again, the NHS will be the focus of the political debate and very much of Boris Johnson’s political career will depend on his management of the current crisis. If the prime minister will decide to gamble once again with the NHS there will be no more no red buses or other tricks. From Winston Churchill to David Cameron is a short step.