Save our NHS : literature and the National Health Service

Save our NHS: Literature and the National Health Service corrects an absence in scholarly work on the cultural history of the NHS and argues for literary dissensus as offering a valuable corrective to deficiencies in the health service. This study contends that popular adulation of the National Health Service (NHS) obscures how the institution is entangled within the political creation of social inequalities. Drawing particularly on Michel Foucault's theorisation of healthcare and medicine as instances of a normative and regulatory biopolitics, this project shows how, throughout its history, the NHS has been defined by power relations that limit the potential field of actions open to patients. This thesis shows how the NHS has worked to maintain dominant paradigms in terms of class, gender, psychology, and sexuality. It has been a regular refrain in the medical humanities that literature offers an important means of challenging the unequal and undemocratic nature of healthcare, and so can improve the practice of medical professionals, as well as patient outcomes. I offer an elaboration of this perspective, although without therapeutic intentions, and argue that the instrumentalist nature of much medical humanities work has a limited understanding of literature's complexity and ambiguity. This study operates with an understanding of literature as offering resistance to the determinative biopolitics of healthcare through its democratic emphasis on social values and practices as a process that ought to be decided collectively. Raymond William's work is especially influential to this thesis's methodology due to his understanding of literature as engaged with responding to and attempting to shape emergent social practices. Twentieth-century British literary history is shown to attest to a regular dissensus against medical power, offering critical accounts of the stultifying and oppressive ways in which healthcare has functioned. At the same time, by closely reading a diverse array of literary texts, attention is given to the ambivalent and at times contradictory nature of these critiques. Literature offers evolving complications, not definitive answers. Consequently, this project argues that literary critiques of the NHS are a key component of ensuring that the institution furthers its egalitarian ambitions as they emphasise an ongoing process to define what health and care should mean and be.