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.

Reuters/New Statesman composite.
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When it comes to social media, we all have a responsibility to avoid sharing upsetting images

If Twitter is the new journalism, we are all editors – and responsible for treating our fellow humans with dignity.

“I wish I hadn’t seen that”, my colleague says from across the desk. It’s been an hour since the first reports came in of a shooting outside Parliament, and the news agency Reuters has started posting photographs of injured people, knocked down by the terrorist as he drove across Westminster Bridge.

In one, a brunette woman leans over a victim whose blood is beginning to stain the wet pavement. Lying on her back, she is framed by scattered postcards sold for tourists which have been knocked to the floor. She is clutching the arm of the woman helping her, but her eyes are staring dead into the photographer’s lens.

Another photograph – the one that my colleague is referring to – disturbs me even more: a man who has fallen (or been pushed?) off the bridge onto a stairwell. He is face down in a pool of blood, his left leg at an unnatural angle. It is impossible to tell if he is alive or not.

Briefly, before I scroll past, I wonder if someone, somewhere is seeing the same picture and experiencing a shock of recognition as they recognise their friend’s clothes.

And then there is one picture which I now cannot find on Twitter, but which, lying in bed last night, I could not stop thinking of: a woman’s legs extended from under the wheel of a bus, her skirt hiked up to show her underwear, her shoes missing.

We are a desk of journalists covering an attack on the Houses of Parliament, so I keep scrolling. It is only later, in an article by the Telegraph, that I learn a junior doctor has declared the woman dead.

Of course, the shock of seeing images like these is nothing compared to what war reporters, doctors or police go through on a regular basis. But a 2015 study at the University of Toronto found that extended exposure to violent or disturbing material can have a severe effect on journalists’ mental health.

The impact can be particularly confusing when one does not anticipate seeing violence.On social media, we increasingly encounter images this way: without warning and without a chance to steel ourselves. This is particularly a problem when it comes to members of the public, whose jobs don’t require them to look at shocking material but who can nevertheless be exposed to it just by virtue of using a social media network.

It is for this reason that, shortly after Reuters published their photographs of the Westminster victims, prominent journalists began posting asking their colleagues not to retweet them. Some protested the fact that Reuters had published them at all.

In today’s media landscape, news moves fast and social media faster. Where a picture editor would have previously had until their print deadline to decide which images to run, now photographers are able to send their work back to the office almost instantaneously, and editors must make a snap decision about what to release.

Deciding what images to use can be a difficult call – especially under pressure. On the one hand, there is the urge to not turn away, to bear witness to the full magnitude of what has happened, even if it is shocking and upsetting. On the other, there is the need to treat fellow human beings with dignity, and particularly to avoid, where possible, showing images of victims whose families have not yet been informed.

Social media makes this process even more difficult. Once released online, photographs of the Westminster attack were quickly saved and re-posted by private individuals, stripped of context or warning. One can choose not to follow the Reuters Pictures account, but one cannot necessarily avoid seeing an image once it is being retweeted, reposted and recycled by private accounts.

As the line between traditional news and social media blurs and we increasingly become participants in the news, as well as consumers of it, our sense of responsibility also shifts. On Twitter, we are our own editors, each charged with making sure we extend dignity to our fellow humans, even – especially – when the news is dramatic and fast-moving.

I was glad, this morning, to encounter fewer and fewer photographs – to not see the girl lying under the bus again. But at 3am last night, I thought about her, and about her family; about them knowing that journalists on desks across Britain had seen up their loved one’s skirt during the last moments of her life. It was, without putting too fine a point on it, no way to encounter a fellow human being.

Over the next few days, we will find out more about who the victims were. The media will release images of them in happier times, tell us about their jobs and careers and children – as is already happening with Keith Palmer, the policeman who we now know died on the Parliamentary Estate.

It is those images which I hope will be shared: not just as a way to resist fear, but as a way of acknowledging them as more than victims – of forging a different connection, based not in horror and voyeurism, but in a small moment of shared humanity.

There is no shame in being affected by graphic images, however removed one “ought” to feel. If you would like someone to talk to, Mind can provide details of local services.

The BBC also provides advice for those upset by the news.

Find out how to turn off Twitter image previews here.

Stephanie Boland is digital assistant at the New Statesman. She tweets at @stephanieboland