By Alethea Cope

I imagine I'm not the only one who greets today with ambivalence.

When I was a social policy student, I learnt about Bevan, Beveridge and the amazing plans for a free-at-the-point-of-access health service that began 70 years ago today. It is indeed a wonderful vision. But surely I'm not the only one who hesitates for a moment to pull out the party-poppers.

With two (shortly to be three) doctors in my family, it feels uncomfortable and even unpatriotic to admit that my feelings towards our NHS are mixed. Like many, I have struggled to deal with an NHS which was arguably not designed to support people with mental health difficulties. My story echoes that of many others across the country: I received a set number of therapy sessions. I felt pigeon-holed by clinical measures which indicated incremental progress but were unable to see someone struggling with daily life. When I sought further help, my referral was rejected – a slap in the face from a system that seemed unable to understand why I was not yet fixed.

Is our disappointment well-founded, or are we just expecting one service to solve a society-wide problem? Is my feeling of being let down by the NHS fair, or does the blame lie with other structures and systems? Do we need to separate our admiration and gratitude for the hardworking millions who sustain our NHS, from our frustration and distress when it doesn’t meet our needs?

When I sought further help, my referral was rejected – a slap in the face from a system that seemed unable to understand why I was not yet fixed

Some say that the NHS has simply been unable to meet the growing demands posed by modern-day society (although the evidence suggests that current rates of mental illness are actually similar to previous generations). What is less easy to dismiss is the side-lining of emotional wellbeing over the decades by a system devoted to the nation’s (physical) health. I don’t believe that the fault lies at the feet of nurses, psychiatrists, or anyone else working in the NHS. The inequalities which continue to unfold within mental health care are at best the result of an unwitting lack of understanding. At worst, they’re the result of a more sinister stigma which keeps mental illness silenced behind closed doors. Or maybe both.

Contrary to what you might be thinking, this post doesn’t simply serve as an opportunity to air grievances about an imperfect system. Rather, it aims to fuel the determination so many of us feel to keep fighting for a time when people are not refused the help they need. This does, at least in part, mean working out how a beloved institution already working under huge pressure can sustainably support people’s wellbeing without imploding. Part of that is most definitely, as Lisa McNally suggested, identifying how the structures around it – social care, local authorities, public health – can be supported to improve the nation’s wellbeing. And part of it is recognising that when people are at their most weak and vulnerable, it can be too difficult to fight for the help they desperately need.

What is less easy to dismiss is the side-lining of emotional wellbeing over the decades by a system devoted to the nation’s (physical) health

We owe it to future generations to do everything we can – raise awareness, change policy, learn what works, advocate on behalf of those struggling – and then put the full force of that knowledge and determination behind the NHS, to achieve a service that we can all be truly proud of.


This blog is part of our NHS 70 series. Take a look at other posts in the series.