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Universal healthcare – does the promise stand post-pandemic?

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  • UserCharlotte Augst, Chief Executive, National Voices World_link
  • ClockThursday 18 November 2021, 12:30-13:30
  • HouseOnline panel format.

If you have a question about this talk, please contact Lucy Lloyd.

CCHSR Annual Lecture 2021: please save the date and registration will open in due course

The pandemic has confirmed the status of the NHS as national religion. An otherwise often hard-nosed political and civic culture in England gets misty eyed as it surveys the values underpinning the creation and running of the NHS . Its promise of universality is what connects it so clearly to the realm of equality, humanity and dignity. No matter your income levels or background, the NHS is there for you at a time of need.

During this event, we will unpack and evaluate this claim to universality. What does it mean? How does it withstand impact with reality? What should we make of it?

The concept merits analysis from a number of angles:

• Does the NHS in fact support people irrespective of ability to pay? Do people with different income levels, ethnic or racialised backgrounds, different levels of literacy or capabilities to self advocate in fact have the same access, experiences and outcomes? Since we know the answers to those questions, what does this mean for the concept of universality?

• Given the NHS is chronically short of resource, not least in the shape of workforce, how does the ability to universally access healthcare depend on the type of need you have? Emergency? Crisis? Acute? Long term condition? Need for rehab? Is the NHS becoming an emergency service only?

• Does the claim of universality have the possibly unintended consequence of making everything a problem the NHS should resolve? Does the medical model, which gives health professionals very effective hammers to use, make everything look like a nail?

• Does the air of universality place healthcare (unhelpfully) outside of the political realm? With all other ‘needs’ people have becoming contested (housing, benefits, higher education), does it trap healthcare in a vicious cycle of overpromising and underdelivering on its claim to create ‘health’?

• What does all this mean for this phase of recovery we are now (finally, hopefully) entering? What does the NHS need to do to realise a properly understood claim to universality and how does this enable a more progressive, inclusive and human shaped recovery?

Working through these questions, and any others the audience might have, will enable us to understand ‘universality’ as an idea that is more complex than is sometimes assumed and will help us to understand how we can realise more of the promise that is entailed in the NHS ’ founding principle.



Charlotte is the Chief Executive of National Voices. She came to London in 1997, after completing a law degree in Germany, to pursue postgraduate studies at the University of London.

She holds a PhD in law and medical ethics. Charlotte has held senior positions in health and research policy – in Parliament, for national regulators, and in the charitable sector.

Since starting at National Voices, Charlotte has led a strategic reorientation of the organisation towards a more visible role for its members – their insight, practice and innovations – and towards grounding National Voices’ influencing work more explicitly in the experience of people who live with ill health, disability or impairment.

National Voices is the leading coalition of health and social care charities in England. We work together to strengthen the voice of patients, service users, carers, their families and the voluntary organisations that work for them.

National Voices has more than 160 members covering a diverse range of health conditions and communities, connecting us with the experiences of millions of people.

This lecture is organised by the Cambridge Centre for Health Services Research (CCHSR), a partnership between RAND Europe and the University of Cambridge’s Primary Care Unit.

This talk is part of the Primary Care series.

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