Covid made visible that people’s health is directly linked to their wealth (Marmot et al, 2020), and that the NHS is providing unequal healthcare, an issue previously identified in the Kings Fund’s evidence to the Joseph Rowntree Foundation (Buck and Jabbal, 2014).
The NHS Constitution requires the NHS to provide comprehensive healthcare for all based on need. It starts with the words ‘The NHS belongs to the people.’ In fact, it is becoming apparent that it belongs to some people more than others. Charlotte Augst from National Voices (August 2021) reminded us that the pandemic has shown that the NHS is not providing universal healthcare, due to the rationing of NHS services.
We know from the Marmot Review (2020) that poverty has had and is having a disgraceful impact on health. But poverty alone cannot be blamed for the lack of universality of healthcare.
The Universal Healthcare Network proposes that the NHS has also been complicit in three ways:
- Medicalising poverty and providing ‘sticking plaster’ approaches that, with the best intentions, make the problem of poverty invisible.
- Providing services that are not accessible to all.
- Not being frank and open about the reality of the rationing of services. The latter is depicted in one of the National Voices ‘I’ statements – I am not forgotten. (National Voices 2020).
