Collage by Exposure with background image of the sea by Pexels from Pixabay
Angela Mascolo examines how governments, past and present, can be driven to respond to crises
The National Health Service (NHS) has become more prominent in everyday life since the outbreak of Covid-19. July 5th, 2021 marks the NHS’s 73rd anniversary.
Whilst walking outside during the height of the pandemic you may have seen the numerous ‘Thank You NHS’ posters on windows. You may also have read articles and social media posts highlighting concerns with Personal Protective Equipment and the pandemic’s impact on NHS staff.
With the NHS at the forefront of public discourse, its introduction in the UK in 1948, following the Second World War (WW2), has been compared to the possibility of introducing Universal Basic Income (UBI) in the aftermath of the Covid-19 crisis. In theory, UBI would ensure everyone had financial stability if a situation like this were to happen again.
As a History graduate, I’m passionate about showing how history continues to be relevant today. My course involved learning about how and why the NHS was founded and, over the past few months, it has been interesting to see similar arguments for why UBI should be brought in.
UBI could be seen as an improvement to the current Universal Credit (UC) system. UC was legislated in 2011 as a benefit payment for people in and out of work. It replaces other benefits and credits such as Housing Benefit, Child Tax Credit and Income Support, and is paid once a month.
This system has proved particularly inadequate since lockdown began. Those who have been self-employed for less than a year and workers who have been made redundant are two groups who have not been able to benefit from the government’s furlough (paid temporary absence) scheme and instead have had to turn to UC.
Food banks have reported that demand for charity food goes up significantly when Universal Credit is introduced into a local area
Some of the downfalls of UC include payments being reduced if you have savings of up to £16,000, or not receiving any UC at all if your savings are over £16,000. UC offers only £94.25 a week and there is usually a five-week wait for payments to start.
What’s more, poorer claimants are at higher risk of hunger, debt and homelessness. Food banks have reported that demand for charity food goes up significantly when UC is introduced into a local area. Since the outbreak of Covid-19, the numbers of applicants for UC nationally is ten times higher than usual.
The need for UBI at a time when UC is insufficient can be compared to the need for the NHS when WW2 broke out. Prior to the NHS, healthcare in the UK was founded on insurance-based schemes as most people could not afford to pay for medical costs.
People with jobs were the only ones entitled to free treatment. Healthcare was not covered by a single entity, but rather by a combination of charities, Poor Law and an unregulated private sector.
The outbreak of WW2 in 1939 really spurred the government to implement free healthcare for everybody. Treating large numbers of civilian casualties from air raids gave people access to unprecedented medical treatment. The Emergency Hospital Service was set up to care for the wounded. It provided more hospital beds and supplies, first-aid posts, medical personnel and inter-hospital transport.
Labour’s manifesto, which included the creation of a welfare state, played a key role in the party’s election success in 1945
This was a driving force behind the publication of the Beveridge Report in 1942, written by government economist Sir William Beveridge. The report set out plans for the future of post-war Britain, which included the creation of a welfare state.
Three years later, as WW2 was coming to end, the Labour party (led by Clement Attlee) came into power in a shock election victory. Labour’s manifesto, which drew directly from the Beveridge Report, played a key role in the party’s election success. It promised a National Health Service which would make healthcare available for everybody, regardless of their means, financed out of general taxation. This meant that the rich contributed more than the poor.
The Minister of Health, Aneurin Bevan was tasked with launching the NHS. His background as a Welsh miner and trade unionist fuelled his passion to turn the NHS into a reality. In 1946, the National Health Service Act was passed and two years later, the NHS was finally launched.
It was the first time in the world that free healthcare was made available on the basis of citizenship, and brought hospitals, doctors, nurses and dentists together under one service. Even migrants living temporarily in Britain were eligible for treatment. The poor had access to treatment which would have been unimaginable prior to the NHS.
Aneurin Bevan on the first day of the NHS at Park Hospital, Davyhulme, near Manchester (image: University of Liverpool Faculty of Health & Life Sciences)
Just as the NHS was established to provide free care to civilians, UBI could be introduced to address the shortcomings of UC. Problems with UC have been highlighted since at least 2017, and it seems to have taken a pandemic to get people seriously lobbying for a shift to UBI.
At least conceptually, UBI would allow people to receive regular and unconditional sums of money from the government to cover basic living costs such as food and heating, as well as additional payments to cover housing costs for those in rented accommodation and for disabled people.
With UBI people are not caught in a benefits trap and can do part-time or low-paid work to supplement their income. For example, someone who receives Housing Benefit may no longer be eligible for it once they get a job, yet the job may only pay enough to cover their housing costs. This can disincentivise people on benefits from working.
A two-year pilot in Finland has shown that paying people UBI improves their mental wellbeing and has a small but positive effect on whether they take up jobs.
It is a great privilege to be afforded free healthcare when we need it most
A petition was started asking the UK government to implement UBI. However, the government responded by saying that they didn’t think UBI was the best method to tackle the problems brought on by Covid-19 because “it does not target help to those who need it most.” They claim that UBI would end up in the bank accounts of those who don’t need it.
There was similar opposition to the NHS when it first launched; charities, churches and local authorities didn’t want the government taking control of hospitals. Doctors disliked the idea of becoming employees of the state, and Conservatives feared that the poor would take advantage of the free health services.
Despite the challenges and opposition faced by the NHS, both past and present, it is a great privilege to be afforded free healthcare when we need it most. The Labour government’s unprecedented response to WW2, with free healthcare 72 years ago, could be taken as a good omen to risk implementing UBI.
It would be a great way to ensure nobody is left behind in times of crisis. Only time can tell if UBI would offer similar longstanding benefits as the NHS has done.
As Mark Twain is reported to have once said (it’s apocryphal but a great quote in and of itself), “History does not repeat itself, but it often rhymes.”
To see how the NHS has changed and what it has achieved since 1948, check out this article.
To learn more about the NHS today, I recommend ‘Your Life In My Hands: A Junior Doctor’s Story’ by Rachel Clarke.
Collage by Angela Mascolo with original images from Pikrepo