Why Britain's Conservatives Support a Socialist Health Care System

Prologue: Britain's National Health Service (NHS) has encountered difficult times under the government of Prime Minister Margaret Thatcher. A conservative who shares many of the philosophical tenets that guide President Reagan, Thatcher has sought to force the NHS to make tougher choices. She also has told the electorate bluntly that the health service does not represent a free lunch. Thatcher declared herself pointedly in this regard during the Conservative Party's annual conference in October 1983. “Let us never forget this fundamental truth: the state has no source of money other than the money that people earn themselves…. Let me take the subject on which there has been so much debate —the health service. People talk about a free service. It isn't free. You have to pay for it. ” Nevertheless, Thatcher and her party colleagues, not unlike all successful politicians in the United Kingdom, seem duty-bound not to be seen as attacking the NHS. After her support of it became an issue in 1982, Thatcher declared at the party's annual conference that year that the service is “safe in our hands”—a comment that helped her win reelection by a landslide. In 1982, the NHS consumed 6. 3 percent of Britain's gross national product, compared with 10. 6 percent for personal health services in the United States in the same year. On a per capita basis, medical care expenditures in the United Kingdom were 390 versus 1, 265 in the United States. Rudolf Klein, a professor of social policy at the University of Bath, explains in this essay why so socialistic an instrument as the NHS enjoys the support of the Conservative Party. Klein, a former journalist, has written widely on the NHS and is regarded as a leading British commentator on the health service. His recent book, The Politics of the National Health Service, is a primer on the evolution and status of Britain s most popular social program.