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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To heal Britain’s cracks, it’s time for us northern graduates in London to return home

Isn’t it time for people like me, who’ve had privileges and experiences not open to everyone, to start heading back to our local communities, rather than reinforcing London’s suffocating dominance?

I’m from Warrington. The least cultured town in the UK. My town.

I moved to London almost exactly five years ago. Not because I particularly wanted to. Not because I wanted to depart the raucous northern town that I still call home. Because it was my only choice, really. I’d done my stint in the call centres and had some fun. But that couldn’t, surely, be my lot?

After university, I’d already started feeling a little weird and out of place back in Wazza. There were fewer and fewer people who didn’t look at me like I’d just fallen off a futuristic space flight that’d given me a different accent and lofty ideals.

Of course, that’s because most people like me had already skipped town without looking back and were all in the capital trying to strike beyond the ordinary.

The young, the cities, the metropolitan elite are still reeling after last week’s vote and wondering how people, half of our people, have got it so horribly wrong. We’re different, divided, done for.  

One thing I’ve clung onto while I’ve been in London is the fact that I’m from Warrington and proud. It might not be a cultured town, but it’s my town.

But I wasn’t proud of the outcome of the EU referendum that saw my town vote 54.3 per cent to 45.7 per cent to leave.

To be fair, even in my new “home” borough of Hackney, east London, the place with the third-largest Remain vote, one in five people voted for Brexit.

Yes, in one of London’s hottest and most international neighbourhoods, there are quite a lot of people who don’t feel like they’re being taken along to the discotheque.

Perversely, it was the poorest places in the UK that voted in largest numbers to leave the EU – that’s the same EU that provides big chunks of funding to try to save those local economies from ruin.

In many ways, of course, I understand the feelings of those people back in the place I still sometimes think of as home.

Compared to many suffering places in the UK, Warrington is a “boom town” and was one of the only places that grew during the last recession.

It’s a hub for telecoms and logistics companies, because, ironically, its good transport links make it an easy place to leave.

But there are many people who aren’t “living the dream” and, like anywhere else, they aren’t immune from the newspaper headlines that penetrate our brains with stories of strivers and scroungers.

Warrington is one of the whitest places in the UK, and I’m sure, to many locals, that means those immigrants are only a few towns away. There’s already a Polski sklep or two. And a few foreign taxi drivers. Those enterprising bastards.

We have never seriously addressed the economic imbalance in our economy. The gaping north-south divide. The post-industrial problem that politicians in Westminster have handily ignored, allowing the gap to be filled by those who find it quick and easy to blame immigrants.

When schemes like HS2, which is plotted to smash right through the place I grew up, are pushed against all of the evidence, instead of a much-needed, intercity Leeds to Liverpool investment to replace the two-carriage hourly service, it’s like positively sticking two fingers up to the north.

But I am also a big problem. People like me, who get educated and quickly head off to London when things aren’t going our way. We invested in ourselves, sometimes at state expense, and never really thought about putting that back into the places where we grew up.

There weren’t the right opportunities back home and that still stands. But, rather than doing something about that, people like me lazily joined the gravy train for London and now we’re surprised we feel more kinship with a 20-something from Norway than we do with someone who we used to knock on for when we should have been at school.

That’s not to suggest that our experiences in the capital – or mine at least – haven’t made us a thousand, million times better. 

I’ve met people who’ve lived lives I would never have known and I’m a profoundly better person for having the chance to meet people who aren’t just like me. But to take that view back home is increasingly like translating a message to someone from an entirely different world.

“You know, it’s only because you live in a country like this that a woman like you is allowed to even say things like that,” assured one of my dad’s friends down at the British Legion after we’d had a beer, and an argument or two.

Too right, pal. We live in what we all like to think is an open and tolerant and progressive society. And you’re now saying I shouldn’t use that right to call you out for your ignorance?

We’re both Warringtonians, English, British and European but I can increasingly find more agreement with a woman from Senegal who’s working in tech than I can with you.

It’s absolutely no secret that London has drained brains from the rest of the country, and even the rest of the world, to power its knowledge economy.

It’s a special place, but we have to see that there are many people clamouring for jobs they are far too qualified for, with no hope of saving for a home of their own, at the expense of the places they call home.

It’s been suggested in the past that London becomes its own city-state, now Londoners are petitioning to leave the UK.

But isn’t it time for people like me, who’ve had privileges and experiences not open to everyone, to start heading back to our local communities, rather than reinforcing London’s suffocating dominance?

We can expect local governments to do more with less, but when will we accept we need people power back in places like Warrington if we want to change the story to one of hope?

If this sounds like a patronising plan to parachute the north London intelligentsia into northern communities to ensure they don’t make the same mistake twice... Get fucked, as they say in Warrington.

It was Warrington that raised me. It’s time I gave something back.

Kirsty Styles is editor of the New Statesman's B2B tech site, NS Tech.