Unionism, like all nationalisms, often looks to the past.

But there was a change last year. Alongside the flags celebrating historical battles, biblical organisations and semi-retired paramilitary forces, something modern emerged. Union Jack flags, murals and Orange banners, proclaiming ‘Thank you NHS’. 

My first emotion was positive. For the first time that I can remember, unionist and loyalist symbolism was being infused with genuinely modern meaning. The NHS is something that is much beloved by people across all spectrums of our society here. A far cry from white horses and black bibles. 

When the murals started to pop up, the pandemic had created a strange sense of social unity, with the NHS front and centre. My neighbours were out every Thursday for the clapping. Bashing baking trays with wooden spoons, like Protestant bin lids. As white collar workers tapped out emails at home, people knew that it was the low paid labour of nurses, cleaners and carers keeping the show on the road. ‘Thank you NHS’ was a daily and reverent incantation. 

I loved the spontaneous creative outpouring of the mural painters. Especially knowing that many of the people who walked past the murals were the very low paid workers who were putting their lives on the line. I appreciated the fact that the murals appeared in loyalist areas, amongst those who rely on the NHS more than some big house unionists with BUPA plans. 

It took a while for the deeper layers to hit. I’ve always lived in areas where the urban wallpaper is red, white and blue. You get used to it. A Catholic friend came home from England and rolled her eyes at the new flags. ‘Is it not better than UVF?’ a second friend asked. ‘I suppose so,’ she said, ‘but they still make me feel bad.’ 

Another friend wondered how the NHS would have been thanked if there had been a Sinn Féin minister of health instead of poor Robin. 

These questions are quite complicated, if you think on them. 

The NHS was a British project of life-altering importance. A legacy of British Labour Party and ordinary workers – including many Irish nurses – who are rightly and immensely proud of it. It is one of the best things about the UK. It brought most of us into the world, and has saved many of our loved ones’ lives. 

In contrast, the Republic of Ireland does not have universal, free at the point of access, healthcare. While over 30% of the Irish population have access to free healthcare via a medical card, 45% have private health insurance (compared to 18% in the north in 2017). The long awaited Irish NHS equivalent, Sláintecare, is a lovely thought which never quite seems to materialise. 

And yet, if I listen to Joe Duffy’s RTÉ radio phone in, or Willian Crawley’s on BBC Ulster, all that distinguishes the stories are the accents. Grannies are waiting years for cataract surgery in both Antrim and Cork. You won’t get your knee fixed in Donegal or Down until your hip has gone too. Unless of course you find a wad of cash down the back of the sofa and can go private. 

And this is possibly the saddest part of thanking the NHS. We’re effusively thanking them at their very moment of collapse. People in Northern Ireland are 3,000 times more likely to wait over a year for a hospital appointment than in England. 1/5 of Northern Ireland population were on a waiting list in 2019. 1/16 have been waiting for over a year. The waiting list I am on is 5 years. These are pre-COVID-19 figures. I can’t bear to think what they are now. It’s dystopian stuff. 

We’re also at a juncture in the UK where privatisation of the NHS more generally is an unkept secret. This has never been clearer than during the pandemic. ‘NHS’ test and trace in England was outsourced to private companies, with shambolic results. Procurement has been highly lucrative for private companies. There have been plenty of contracts and top jobs for Tory donors and friends. While nurses have to campaign for free hospital parking. And this, in turn, is potentially the saddest part for unionism. That the NHS – the greatest asset of the UK, a constitutional deal-breaker – seems like it is being deliberately unravelled. 

In contrast, the success of the UK’s vaccination programme – administered by the NHS itself rather than private companies – is marked. This has led some unionists to argue that the NHS remains one of their greatest opportunities. But we don’t yet know if ‘Thank you NHS’ is a past, present or future facing statement. 

‘Thank you NHS’ could be one of the most progressive slogans Northern Ireland has ever seen. It is a sentiment that has been, and can be, channelled into social solidarity. If we’re thanking Filipino carers, Polish nurses and Bangladeshi doctors, I’m all in. If it means the UUP’s Robin Swann taking science seriously, I am very grateful. If we can tackle border-hopping viruses in an all-island context, that would be better. If it means challenging healthcare for profit and creeping privatisation, I’ll take whatever colour scheme is on offer. 

But if ‘Thank you NHS’ is a cooption of British nostalgia, without a commitment to the mechanics of making future free and equal healthcare work, if it is Boris bravado without a commitment to the health of all the people on this island, if it means we are 3000 times more likely to wait for a hospital appointment, if it means local libertarians vetoing public health advice, then it genuinely isn’t worth the flag it is written on. 

This pandemic is not over. There will be pandemics to come. The financialisation and deregulation of healthcare is not a local issue. Our problems are global, and they cannot be solved by the solutions of nationalism, of any flavour. There is no political party that can afford to ignore this truth. 

There’s a little piece of graffiti on the way to the Newtownards dump (spotted by Jonny Currie). On a rainbow sign sporting ‘Thank you NHS,’ somebody had scrawled, ‘sorry about the PPE.’ And I don’t think it’s possible to put it better than this. A sad little poem to an institution we love, but which we may be powerless to protect from the ravages of late capitalism. It remains to be seen if any part of these islands can grasp the nettle of what needs to be done. Best not get sick in the meantime.