Our NHS: A History of Britain's Best Loved Institution

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Among Yale’s titles in British history, Deborah Cohen’s Household Gods: The British and Their Possessions (2006) , Edmond Smith’s Merchants: The Community That Shaped England’s Trade and Empire (2021), and Sasha Handley’s, Sleep in Early Modern England (2016) all provided examples of how to achieve such a balance. One of the things that kept me motivated to finish writing the book lay in how the service’s history allowed me to talk about lots of different things, from shifting meanings of class and gender, to Britain’s experience of Commonwealth immigration, to architectural aesthetics or debates in medical economics.

In this blogpost, part of the 50 Years in 50 Books series for our 50th Anniversary, Andrew Seaton gives us an insight into how he went about writing a history of one of Britain’s best-loved institutions. In Our NHS, Andrew Seaton explores how the National Health Service, a great achievement for Aneurin Bevan and the left, became a national institution commanding widespread support. The two authors are aligned in their analysis, covering much of the same material and identifying many of the same recurrent patterns: the constant pressure for innovation provoking fear of core NHS principles being abandoned; tension between a consumer culture that increasingly expects customised choice and a system that functions by pooling resources on a principle of collective solidarity; the challenge of imposing minimum standards without the perverse, unintended consequences that rigid targets generate; the simple fact that there is never enough money, but also that more cash is not always the answer and Treasury pockets are not infinitely deep.Yet its success was hardly guaranteed, as Andrew Seaton makes clear in this elegantly written, highly original history of an institution that survived numerous crises to become a model for the democratic welfare state and the very antithesis of the health inequities we face today as Americans. It is explicit in his conclusion – that the tenacity of the NHS in fending off marketisation might serve as a model for the resurgence of egalitarian, social democratic politics in Britain. The Gospel of Wealth and the National Health: The Rockefeller Foundation and Social Medicine in Britain's NHS, 1945-60', Bulletin of the History of Medicine 94, no. He is a historian of modern Britain, with particular interests in political history, social history, and the history of medicine and the environment.

Seaton emphasizes the resilience of the NHS—perpetually “in crisis” and yet perennially enduring—as well as the political values it embodies and the work of those who have tirelessly kept it afloat. Britain’s National Health Service remains a cultural icon—a symbol of excellent, egalitarian care since its founding more than seven decades ago. As a first-generation university student from a low-income background, Andrew is an advocate of widening access to education, and has volunteered with programming to encourage students from underrepresented backgrounds to pursue higher education. Both books describe party political wrangling without overt partisanship, although Seaton’s leftward tilt becomes increasingly clear in later chapters.Our NHSwas published in the summer of 2023, during a period of serious concern for the health service. For most people in the middle it is just there, an immovable feature of the landscape, like a mighty river or majestic forest. Our NHS has received positive coverage in The Financial Times, The Guardian, The New York Times, The Times Literary Supplement, The Lancet, and The Literary Review. Seaton] is insightful on the ways that American conservatism, and its grotesque distortions of what state-funded medicine involves, have fed a British defensiveness that insulates the NHS from some of the more aggressive privatising impulses in the Tory party.

Our NHSinsists that neither the institution’s acclaim nor its survival were automatic or pre-ordained.Seaton’s study is an important corrective to overarching accounts of the triumph of neoliberalism in Britain, a testament to the power of unintended consequences in policy-making, and a must-read about the strange survival of social democracy and everyday communalism into the twenty-first century.