The NHS afforded us freedom from fear that won't be given up without a serious fight - Joyce McMillan

Freedom is a noble thing, as the Scots poet John Barbour wrote more than 600 years ago; and we surely feel it, particularly when our most prized freedoms come under threat.

Yet freedom remains an elusive concept; and its complexities were brilliantly explored, at the end of the old year, in the 2022 series of Reith Lectures, inspired by Franklin D. Roosevelt’s famous 1941 speech on the “four freedoms”, delivered at the height of the Second World War.

Even within Roosevelt’s short list, there are subtle shifts; he first emphasises freedom of speech and freedom of worship, but then switches to two vital “negative” freedoms, freedom from want, and freedom from fear. And although all four Reith lectures were powerful and compelling - and, unusually, delivered by four different speakers - something about the times seemed to dictate that it was those final two lectures that most fully captured the attention.

Writer, rapper and anti-poverty campaigner Darren McGarvey’s lecture on freedom from want raised vital questions about how millions in Britain can now escape from the poverty trap in which they live, short of everything from decent well-paid jobs and opportunities to nourishing food. And the final lecture - by former White House security advisor Fiona Hill - focussed on how to resist fear, and not be paralysed by the apocalyptic threats, including the revived threat of nuclear war, that now seem to stalk the international scene.

The creation of the NHS afforded us freedom from fear but that fear is now being escalated by the acute problems in the UK’s health care system, writes Joyce McMillan. PIC: Michael Gillen.

All of which left me wrestling with many questions about the role of fear in our society, including fear of poverty itself; and of how fear is currently being escalated by the acute problems in the UK’s health care system, which is now experiencing severe difficulties across the country in responding rapidly and effectively to those needing emergency care. GP services are also under intense pressure; and these combined failures are now steadily removing the sense of a reliable NHS safety net that most British citizens have enjoyed since the service was founded in 1947.

That the British people have greatly valued this particular “freedom from fear” goes without saying. Much to the irritation of the private healthcare industry and the many British politicians with close links to it, the people of the UK remain passionately attached to the NHS and those who work in it, particularly after the events of the last three years. In taking on England’s NHS nurses, Rishi Sunak and his health secretary Steve Barclay have therefore picked a fight they cannot win; and they have done so because they belong to a party which, while often portraying itself as a friend of freedom, has at best an ambiguous attitude to those positive freedoms which help to empower ordinary citizens - including the right to vote, the right to protest, and the right to strike - and at worst a downright hostile one to the negative freedoms from want and fear highlighted in Roosevelt’s speech.

When the Beveridge Report proposing the founding of the British welfare state was published in 1942, after all, it too spoke of freeing the people from the fear of “five evils” - want, disease, ignorance, squalor, and unemployment. And it was precisely Margaret Thatcher’s willingness, after 1979, to revoke that commitment, and to use mass unemployment as a deliberate tool of economic policy, that sent shock-waves through the UK, as millions in Britain’s industrial heartlands saw the promise of care ripped from them, along with the sense of respect, security and worth that came with it.

And so far, Conservative governments of the last 40 years have got away with this erosion of the freedom from fear British people were promised in the postwar period; mainly because an ever-growing and sometimes booming economy, particularly in the property market, masked the mounting inequalities and tensions, at least for the more prosperous. Britain’s devolved governments in Scotland and Wales have also, by and large, remained loyal to those postwar values, seeking to mitigate the impact of Conservative policy in ways that help to sustain the idea that we live in a society which cares for our welfare, whatever the difficulties, and does not want us to be afraid.

Now, though, the engine of old-style economic growth is faltering, as the world chokes on its carbon fumes; and no amount of mitigation can conceal the consequences of 13 years of chronic under investment in a health service that was once Britain’s pride. And even if despair at the current state of our NHS soon helps sweep the Conservative Party from office, that shift towards a new period of Labour government will still leave the UK - and all of its four nations - facing profound underlying questions about whether we want to live in a society and economy based on fear, and ugly notions of social Darwinism, or in once based on love, and the assumption that we are a community of equal human beings, each entitled to the same care and respect.

In that sense, the NHS is a living embodiment of the idea enshrined in all our great statements of human rights, that each of us is born with the same intrinsic right to live, to thrive, to make choices, and to be free of the evils that make those rights impossible to exercise; and our willingness to fund it, is a measure of our continuing effort to be the kind of society that delivers on those freedoms. Freedom, in other words, is not only a noble thing, but a thing with many faces, some to do with a clear absence of social pressures, others to do with the presence of social structures that enable and empower us; and it seems that the freedom from fear brought to us by the founding of the NHS, 76 years ago, is one that even the notoriously passive British public will not give up, without a serious political fight.