An Irishman in London: Britain’s once-brilliant health system is now on its knees

Using private clinics been would have been unthinkable when I first moved here. Now, it feels almost irresponsible not to use one if you can afford to do so

Peter Flanagan: 'When I tell people in London about life back home, I feel like an oddity from another dimension, telling tall tales about my bewildering home planet.' Photograph: Karla Gowlett
Peter Flanagan: 'When I tell people in London about life back home, I feel like an oddity from another dimension, telling tall tales about my bewildering home planet.' Photograph: Karla Gowlett

“You pay to see a GP?” my flatmate asks.

She assumes I’m joking at first. Ireland is a modern European nation, after all.

“I’m being serious,” I say. “When I lived in Kildare, I wouldn’t go to see the doctor until I had at least two or three things wrong with me. That way, I got my money’s worth.”

When I tell people in London about life back home, I feel like an oddity from another dimension, telling tall tales about my bewildering home planet.

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“Garth Brooks is our favourite musician, dogs aren’t allowed in pubs, and almost 50 per cent of the population have private health-insurance.”

My flatmate’s mouth hangs open as I tell her this. Her idea of us as simple, sexy innocents is usurped by the grisly reality – we are a nation of dog-hating, anarcho-capitalists, racing around dodgy rural roads while listening to country and western music.

Incredulity gives way to sympathy. “Ireland has always been a bit mad,” I can her inner monologue say. “At least that could never happen here.”

She’s wrong – about the healthcare bit at least.

Private providers are doing record business in the UK. The percentage of the population using private clinics (roughly 10 per cent) is still drastically lower than Ireland, but the direction of travel is clear.

This would have been unthinkable when I first moved here. The care provided by the public system was so good that paying exorbitant prices to see a doctor just didn’t make any sense.

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My mother was incredulous. Born in the west of Ireland in the 1960s, her expectations from public services are witheringly thin. Her generation are a bit hardier, I suppose. If the council can fill the potholes in the road, what more can one reasonably expect from Government? She imagines public hospitals to be the domain of machete-wielding wild men making critical medical decisions based on guidance from a Ouija board.

My healthcare experiences in England were mostly brilliant. Problems that I would have put off dealing with until they were chronic in Ireland were dealt with quickly and for free. My physical and mental health improved. It’s something I feel genuinely grateful to the UK for.

My faith is getting a little shaky recently. I’m not alone – polling from last year revealed that two in three people in the UK believe that its services are “bad”. Though it still offers world-class care, the NHS cannot offer it quickly enough to meet the needs of an increasingly sick country.

More than a decade of underinvestment from the Conservatives has left both staff and patients in desperate situations. Long waiting lists and cancelled appointments at short notice are now the norm. Telephone appointments are offered as standard – I personally have not seen a GP in person since September 2021.

The misery of being left to languish is driving people into the embrace of private hospitals. This widening gap between patient’s needs and the services they’re receiving is being exploited with marketing campaigns offering “30 per cent off breast cancer screening”, “MRI scans from as little as £250″, and “up to 40 per cent cashback from Waitrose”.

Perhaps we should be grateful that the NHS has lasted as long as it has.

Started in 1948 after the second World War, the Labour government of the day believed humanity was due some sort of dividend. Its promise to provide medical treatment to absolutely everyone based on their need, and not on their income, was completely radical.

It’s something that the country has been highly protective of ever since, even as the other cornerstones of Britain’s post-war social consensus have been chiselled into nothing.

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Perhaps we should think of it as a minor miracle that the country’s hospitals have remained in public hands for as long as they have. The Tories have sold off almost everything else. From the railways to public housing, they flogged the nation’s assets like thistle-chewing grifters at the Athy market.

Despite Labour’s commitment to resuscitate the NHS, they are unlikely to curb the longer-term trend. The system is on its knees. If some people can afford to pay for their own treatment and free up space for those who can’t, then no government is going to discourage them from doing so.

I do not believe that Britain is on the road to an American style of healthcare as some fear. But an Irish-style, two-tier cop-out is already a reality.

Far from being the taboo that it was when I first moved here, it feels almost irresponsible not to use a private clinic if you can afford to do so.

Already there is a sense that something special has been lost for good.

  • Peter Flanagan lives in Hackney, London, and works as a comedian.
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