The NHS: even more cherished than the monarchy and the army

New polling by British Future shows that while attitudes to the NHS have fluctuated, commitment to its founding principles has remained remarkably consistent.

January often heralds a couple of weeks of absent mindedly getting the year wrong, but it has been easier than usual to remember that it is not 2012 anymore. 2013 feels like an altogether more ordinary year, after the exuberance of the Olympics, as attention returns to the long slog through the economic crunch.

Yet it turns out that the national events of 2012, gently satirised as the year of the "Jubilympics", do not represent the main sources of national pride in Britain.

The NHS beat both the monarchy and the Olympics to take gold in the patriotism stakes, as Ipsos-Mori's polling for British Future's new State of the Nation 2013 report, published today, shows. The army ranked second, when pollsters asked people which institutions made people proudest to be British, with Team GB taking bronze, nudging the royals off the podium altogether.

The NHS was most popular with Britons from all backgrounds, being top for both white and non-white Britons, and across social classes, though the oldest segment of the population put the monarchy first, and the under-24s the army.

Seventy two per cent of people declared the NHS to be "a symbol of what is great about Britain and we must do everything we can to maintain it" while one in five (21 per cent) saw it as "a great project for its time, but we probably can not maintain its current form".

That helps to explain why the 65th birthday of the NHS also provides the anniversary of 2013 which is most cherished by the public, proving more popular (on 54 per cent) than the 60th anniversary of the Coronation (43 per cent) with the discovery of the structure of DNA (29 per cent). Anniversaries of the London Underground  (15 per cent), the Beatles (15 per cent), Jane Austen's Pride and Prejudice (11 per cent) and the Football Association (eight per cent) and Doctor Who (seven per cent) trailed. The 40th anniversary of EEC membership did worst of all, with just three per cent of people choosing that as a source of British pride.

Firstly, the NHS fully merited its place in Danny Boyle's Olympic opening ceremony. While attitudes on the performance of the NHS have fluctuated a great deal - affected by events, funding and political controversies -  commitment to its founding principles has remained remarkably consistent.

Secondly, there is a message for politicians here too. Politicians or wonks who want a radical overhaul of the NHS often express frustration at the level of public sentiment behind it, reflected in Nigel Lawson's famous rueful description of the NHS as "the closest thing the English have to a religion". The debate has echoes of that over the monarchy, with many of the roles reversed, as liberal-left defenders draw on a reservoir of symbolic sentiment, while right-of-centre wonks mutter about the difficulty of breaking through with a "rational debate" given the resonance of that frame.

The poll shows why it made a lot of sense for David Cameron to seek to define himself, in opposition, as a champion of the NHS, though the polarised controversy over the motives and outcomes of the coalition's NHS reforms made that a deeply contested question. The breadth of support for the NHS as a symbol in this poll underlines the lesson that support for change to the NHS depends on securing trust about motivation and intention. Any reform, from whatever poltical perspective, will have a chance of public support if changes are understood to be upholding the core NHS principles. They will be treated with suspicion if thought to be subverting them.  Those who want to change the NHS may need to learn to love it first.

But if the NHS represents a now deeply entrenched fairness ideal - that healthcare should not depend on the ability to pay - I suspect the strength of attachment to the NHS goes well beyond the politics of healthcare, and is much more personal, reflecting its presence on some of the most important days of our lives.

I am a child of the NHS. I feel a particular connection to it because I wouldn't exist without it.  I was born in a hospital, the Doncaster Royal Infirmary, in spring 1974, under the care of the NHS, because my parents, born 4,000 miles apart in Guajarat, India and Cork, Ireland, had both come to this country to work for the NHS. That is also the everyday story of how our most cherished national institution has always depended on immigration, and integration, to be able to offer its public service.

But my main memories of the NHS are that its hospitals are also where my children were born. It is where we have the serenity of knowing that we can go - once or twice on an  adventure to drive out to see the "night doctor" in the middle of the night - to check everything is OK. We cherish the NHS because it turns the idea of "cradle to grave" from a metaphor into a reality.

The only cloud on the horizon was a dip in support among the under-24s, who placed the army ahead of the NHS as a source of pride. That reflects a broader inter-generational erosion of support for ideas of welfare and social solidarity more generally, set out in Ipsos-Mori's work on attitudes shifts across generations.

There will be wide support for celebrating the 65th birthday of the NHS this year - but it may be an open question whether the moment could be used to extend its appeal for several more generations to come.

British Futures's new report, State of the Nation: Where is bittersweet Britain heading?, can be read here.

"The NHS fully merited its place in Danny Boyle's Olympic opening ceremony". Photograph: Getty Images.

Sunder Katwala is director of British Future and former general secretary of the Fabian Society.

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A new German law wants to force mothers to reveal their child’s biological father

The so-called “milkmen’s kids law” would seek protection for men who feel they have been duped into raising children they believe are not biologically theirs – at the expense of women’s rights.

The German press call them “Kuckuckskinder”, which translates literally as “cuckoo children” – parasite offspring being raised by an unsuspecting innocent, alien creatures growing fat at the expense of the host species’ own kind. The British press have opted for the more Benny Hill-esque “milkmen’s kids”, prompting images of bored Seventies housewives answering the door in negligées before inviting Robin Asquith lookalikes up to their suburban boudoirs. Nine months later their henpecked husbands are presented with bawling brats and the poor sods remain none the wiser.

Neither image is particularly flattering to the children involved, but then who cares about them? This is a story about men, women and the redressing of a legal – or is it biological? – injustice. The children are incidental.

This week German Justice Minister Heiko Maas introduced a proposal aimed at to providing greater legal protection for “Scheinväter” – men who are duped into raising children whom they falsely believe to be biologically theirs. This is in response to a 2015 case in which Germany’s highest court ruled that a woman who had told her ex-husband that her child may have been conceived with another man could not be compelled to name the latter. This would, the court decided, be an infringement of the woman’s right to privacy. Nonetheless, the decision was seen to highlight the need for further legislation to clarify and strengthen the position of the Scheinvater.

Maas’ proposal, announced on Monday, examines the problem carefully and sensitively before merrily throwing a woman’s right to privacy out of the window. It would compel a woman to name every man she had sexual intercourse with during the time when her child may have been conceived. She would only have the right to remain silent in cases should there be serious reasons for her not to name the biological father (it would be for the court to decide whether a woman’s reasons were serious enough). It is not yet clear what form of punishment a woman would face were she not to name names (I’m thinking a scarlet letter would be in keeping with the classy, retro “man who was present at the moment of conception” wording). In cases where it did transpire that another man was a child’s biological father, he would be obliged to pay compensation to the man “duped” into supporting the child for up to two years.

It is not clear what happens thereafter. Perhaps the two men shake hands, pat each other on the back, maybe even share a beer or two. It is, after all, a kind of gentlemen’s agreement, a transaction which takes place over the heads of both mother and child once the latter’s paternity has been established. The “true” father compensates the “false” one for having maintained his property in his absence. In some cases there may be bitterness and resentment but perhaps in others one will witness a kind of honourable partnership. You can’t trust women, but DNA tests, money and your fellow man won’t let you down.

Even if it achieves nothing else, this proposal brings us right back to the heart of what patriarchy is all about: paternity and ownership. In April this year a German court ruled that men cannot be forced to take paternity tests by children who suspect them of being their fathers. It has to be their decision. Women, meanwhile, can only access abortion on demand in the first trimester of pregnancy, and even then counselling is mandatory (thereafter the approval of two doctors is required, similar to in the UK). One class of people can be forced to gestate and give birth; another can’t even be forced to take a DNA test. One class of people can be compelled to name any man whose sperm may have ventured beyond their cervix; another is allowed to have a body whose business is entirely its own. And yes, one can argue that forcing men to pay money for the raising of children evens up the score. Men have always argued that, but they’re wrong.

Individual men (sometimes) pay for the raising of individual children because the system we call patriarchy has chosen to make fatherhood about individual ownership. Women have little choice but to go along with this as long as men exploit our labour, restrict our access to material resources and threaten us with violence. We live in a world in which it is almost universally assumed that women “owe” individual men the reassurance that it was their precious sperm that impregnated us, lest we put ourselves and our offspring at risk of poverty and isolation. Rarely do any of us dare to protest. We pretend it is a fair deal, even that reproductive differences barely affect our lives at all. But the sex binary – the fact that sperm is not egg and egg is not sperm – affects all of us.

The original 2015 ruling got it right. The male demand for reassurance regarding paternity is an infringement of a woman’s right to privacy. Moreover, it is important to see this in the context of all the other ways in which men have sought to limit women’s sexual activity, freedom of movement and financial independence in order to ensure that children are truly “theirs”.  Anxiety over paternity is fundamentally linked to anxiety over female sexuality and women’s access to public space. Yet unless all women are kept under lock and key at all times, men will never, ever have the reassurance they crave. Even then, the abstract knowledge that you are the only person to have had the opportunity to impregnate a particular woman cannot rival the physical knowledge of gestation.

We have had millennia of pandering to men’s existential anxieties and treating all matters related to human reproduction, from sex to childbirth, as exceptional cases meaning women cannot have full human rights. Isn’t it about time we tried something new? How about understanding fatherhood not as winning gold in an Olympic sperm race, but as a contract endlessly renewed?

What each of us receives when a child is born is not a biological entity to do with as we choose. It is a relationship, with all of its complexities and risks. It is something worth contributing to and fighting for. Truly, if a man cannot understand that, then any money wasted on a Kuckuckskind – a living, breathing child he could get to know – has got to be the least of his worries. 

Glosswitch is a feminist mother of three who works in publishing.