Opinion & Features

Mary Kenny: A religion in need of reform

The public are mostly sympathetic to the junior doctors’ strike – but is it ethical? (AP Photo/Frank Augstein)

It is said that the British regard the National Health Service as the nearest thing to a state religion – though those who make such a claim might be informed that the United Kingdom already has a state religion, i.e the Church of England. Of which the monarch, Elizabeth II, is the supreme governor. But if the NHS is a kind of state religion, perhaps like all forms of faith it needs to remain both true to its principles and, at the same time, relevant to its followers. I think it was Pope Paul VI who said “we must never refuse progress”.

It seems, however, that most members of the public are sympathetic to the ongoing junior doctors’ strike – they are taking industrial action on a rota of dates, the next being Friday, March 11 – and against the policies of Health Secretary Jeremy Hunt. The argument concerns the doctors’ contracts, and the main problem seems to be focused on Saturday working, promised by the Government, but insufficiently remunerative to the staff.

The medics themselves voted overwhelmingly for industrial action, so it is a democratically supported decision. Some older doctors, however, question whether it is ethical, ever, for a physician to go on strike. This is a discussion which also should be conducted within the medical profession. And there is a bigger discussion to be had about the administration of this “state religion” of the NHS. Can it go on doing what it does ad infinitum? Health provision is a bottomless pit.

When Nye Bevan first introduced the health service, he believed that curing TB and providing everyone with free prescription spectacles would make everyone happy. It’s a different picture today, with demands for everything from heart bypasses to transgender re-assignment on the state. “I love the NHS, but it’s a mess,” a Catholic doctor told me recently. “We spend half our time chasing people up for their care. “People don’t take enough responsibility for their own health. They have high expectations, and yet passive attitudes.” Whatever the rights and wrongs of the current dispute, the NHS clearly needs reform: as all institutions eventually do.

We live, thankfully, in a golden age of television drama. There are three absolutely corkers currently showing on British TV. One is the Icelandic thriller Trapped every Saturday night on BBC Four. It’s hugely absorbing, and maximum play is given to the ferocious weather and brutal terrain of an Icelandic winter. Yet it’s very like one of their ancient Norse sagas come to life. Another is John le Carré’s The Night Manager on Sunday night on BBC One. This is sinister, ambiguous, violent, a kind of upmarket James Bond, starring Hugh Laurie as the smooth-talking villain.

But best of all is Tuesday night’s Happy Valley, with Sarah Lancashire as the Yorkshire policewoman with a blunt exterior but a deeply human heart. This is written by Sally Wainwright who is, in my view, one of the best scriptwriters alive. Her drama is superior to anything I have seen of contemporary writing on the London stage. As in most great drama, there is a moral centre to Wainwright’s values. Lancashire’s police sergeant is cussed – but she wants to do the right thing. We are also blessed with the invention of the iPlayer, which allows catch-up on missed episodes. You just go on to your laptop, Google the name of the programme, and it all appears. How fortunate we are to have such windows of intelligent entertainment available to us.

Japan’s population has declined by almost a million over the past five years: the country now has the world’s oldest population and one of the least fertile. They have now appointed a minister whose task is to increase the birth rate and persuade more women to become mothers. Some analysts say that Japan’s deep prejudice against births outside of wedlock is to blame – only two per cent of the Japanese people are born outside of marriage – in conjunction with an equally strong prejudice against young immigrants, who tend to be more fertile.

Population decline is usually multi-factorial, but the widespread use of abortion as a contraceptive is inevitably a major factor in Japan.