When asked whether he used private healthcare, British Prime Minister Rishi Sunak was widely criticised for his evasiveness. His response “I grew up in an NHS family” was deemed deflective and unsatisfactory, and after repeated calls this year from politicians and journalists to answer the “not relevant” question, he finally caved in.

Of course, it was hardly a surprise that the wealthiest prime minister in British history and his family opt to use private care. So why the secrecy? 

The NHS is deeply entrenched in Britain’s identity; one of its proudest achievements hailed worldwide as a shining example of healthcare done right. Admitting to the use of private care has historically brought with it a degree of taboo, social shame, and disappointment. But that may be changing.

Looking at the past, conservative prime ministers throughout history have gone out of their way to express their support for the institution.

When recent ex-prime minister Boris Johnson contracted Covid in April 2020, he openly credited the immigrant NHS health workers with saving his life. In 1994, John Major said of a 1967 car accident: “My leg was saved by treatment on the NHS. I have never forgotten that.” And when David Cameron was in charge he called the NHS ‘a fantastic and precious fact of British life’, regularly praising it for its quality care of his late disabled son.

The only notable exception may be the iron lady – Margaret Thatcher – who while campaigning for the 1987 election, proudly conceded that she used private medical insurance: “I, along with something like five million other people, insure to enable me to go into hospital on the day I want; at the time I want; and with a doctor I want. For me, that is absolutely vital… Like most people, I pay my dues to the NHS. I do not add to the queue… I exercise my right as a free citizen to spend my own money in my own way so that I can go in on the day, at the time, with the doctor I choose — and get out fast.”

So does Sunak’s admission harken back to the divisive, transformative era of 1980s Britain?

At the very least, Labour’s health spokesman Wes Streeting supports collaboration between the private sector and the NHS. This signals that attitudes are changing and that support for the NHS and private sector can co-exist.

Is it is just a case of ‘needs must when the devil drives’? Are the challenges we face so great and unprecedented that there is no choice other than to put aside social taboos and cultural shame?

If there’s one thing the two political parties can agree on, it is the need for a greater use of the private sector by the NHS. The rising use of private care suggests that on some level the public agrees too.