The NHS at 70


The NHS is seventy years old. It was on the 5th July 1948 that Aneurin Bevan opened Park Hospital in Manchester (today known as Trafford General Hospital) and officially launched the new service (royal assent had been given to The National Health Service Act in November 1946). After years of planning, medical treatment for all, from ‘cradle to grave’, free at the point of delivery was made available.

It was a remarkable achievement, and the NHS remains one of the country’s most loved institutions albeit with serious questions raised daily about what needs to change to help it survive and sustain its service to the country.

We asked our stakeholder panel what we should be celebrating this week and what, as ‘critical friends’ we think needs to change.

Here’s what they told us.

 

Professor Mike Bewick, healthcare consultant and former Deputy Medical Director, NHS England

To be born impoverished pre-1948 was a probable death sentence. Free universal healthcare a dream. My profession resisted this universality with suspicion and self-interest. After 70 years, despite its inefficiencies and inconsistency the NHS survives as a beacon of goodness. 70 years isn’t a seminal number but striking a time when societies norms adapt to a socially networked population requires a step change for the NHS. It will have to still serve us from cradle to grave but our involvement needs to be more. Indeed, without it the NHS will succumb. This is the greatest opportunity in my lifetime and requires significant change in professional attitudes and response. AI and its derivatives will replace decision making. The human face and touch of medicine are irreplaceable, but only in the new paradigm that serves the wider consumer audience.

 

Sir Nick Young, former Chief Executive, Macmillan and Red Cross

“It’s high time we developed a cross-party nationwide long-term vision for the NHS, with a politics-proof development plan. The last thirty years have seen countless changes of mind about what the NHS should look like – which have been damaging to the service, confusing to patients and their families, and deeply demoralising for staff. Rightly regarded as a national treasure, the NHS has for far too long been a political football, inhibiting its capacity to adapt strategically to shifts in demand, and developing technologies. In spite of all that, you cannot beat the NHS and its dedicated staff when you are seriously ill – how do they do it?”

 

Professor Brian Dolan, Director, Health Service 360, Honorary Professor of Leadership in Healthcare, University of Salford, Visiting Professor of Nursing, Oxford Institute of Nursing, Midwifery & Allied Health Research, founder of Last 1000 Days and EndPJParalysis campaigns.

The values that bring somebody into the NHS are the same today as they were in 1948. That sense of service to a greater cause transcends the generations and has survived all the political tumult, the funding crises, staffing crises, facilities crises that the NHS has had to weather and continues to face. It doesn’t matter if you are talking about a nursing, therapy or medical student, a manager, a cleaner, or a porter; if you strip away all the day to day problems you find that sense of enduring pride in this institution. The other thing that hasn’t changed is the importance and value of patients’ time. We each only have a limited time in our lifespan, and the NHS is there to serve, to protect and treasure that, and not steal it away from people through waste and inefficiency. It is easy to get distracted and think about money, but as we switch to understanding that time is the real connecting currency, we are on our way to rethinking the way the NHS works because while our time is busy and important, our patients’ time is sacred and is the most important currency in health and social care.

 

Len Gooblar, former Head of Government Affairs, pharmaceutical industry

When the NHS was established the average lifespan was just over 68 years, so as we approach its 70th birthday we need to establish if it’s still fit for purpose. The NHS is excellent at managing acute illness but since its inception, chronic disease has rocketed and a major challenge has to be managing the capacity to meet the needs of today by improving this critical component of care. Great strides in this direction have been made in the last few years, however, focus on what is really needed as opposed to what is nice to have or indeed what should be conducted under the NHS is key here. In addition, it is imperative that NHS clinicians are trained in communication skills which are still sadly lacking, and that the organisation as a whole improves at speaking in a language that the recipients understand.

 

Dr Simon Gabe, Consultant Gastroenterologist and President of BAPEN

The NHS is world class. The amount it achieves with the funding it receives is quite remarkable. The people who have delivered care over the years should be praised as many go over what is expected in an act of selflessness to help others. However, there are problems, and not least in clinical nutrition. At BAPEN we want nutrition care to be developed across the board to the benefit of patients. Clinical nutrition touches on all patients in every setting, from screening for malnutrition to nutrition advice and artificial nutrition support, so by focusing on this we can help all patients in all settings. I look forward to further funding for our NHS to continue to provide a world class service.

 

Graham Phillips, Superintendent Pharmacist, Manor Pharmacy Group, Fellow of the Royal Pharmaceutical Society

100 years ago, the primary killer were infections. Today, most people die of so-called non-communicable diseases (hypertension, diabetes, heart disease, cancer and dementia) which are mainly lifestyle diseases and therefore preventable.  But the NHS is still overwhelmingly focused on treating (rather than preventing) illness. We also know that the NHS is desperately short of doctors (especially GPs) and nurses.  The network of community pharmacies is a highly accessible public health network. We have offered to do the same in England as our colleagues in Scotland already do: i.e. to take pressure of GPs and hospitals. There is plenty of evidence that we can do so safely and effectively.  I read recently that NHS health checks are failing to attract sufficient people to have these vital, potentially life-saving tests. This is yet another area where community pharmacy could help. Despite all of this, the Govt is intent on closing 3000 local pharmacies, not in any planned way, but at random. So my birthday with for the NHS is to allow community pharmacy to do more, much more!

 

Damian Hebron, Director, London Arts in Health Forum

This anniversary is an opportunity to think about what we want from the NHS. Is it simply about extending life and treating illness or is it about promoting health and wellbeing? If the latter, then we need to think beyond traditional medical interventions and really invest in community and social approaches to health – including arts and culture. Pleasure and meaning in life is proven to be key to our health and we need to do more to prevent illness and promote wellbeing, offering everyone the chance to participate actively in society.

 

Mandy Wardle-McLeish, Chief Executive of the Community Health and Learning Foundation, Fellow of the Faculty of Public Health

I am pleased and proud to have the opportunity to wish the NHS a happy 70th birthday. But I also believe it is an important time to reaffirm the importance of one of its key aims; to reduce health inequalities. At the Community Health and Learning Foundation we are proud to be working with NHS colleagues and partners to reduce health inequalities by supporting the NHS’s work on the development and use of health literate resources, services and training. Research shows that 43-61% of people lack the skills to enable them to access, understand, appraise and use information and services to protect and improve their health and wellbeing and therefore we believe health literacy should continue to be top of the agenda in the years to come.

 

Katherine Murphy, healthcare consultant and former Chief Executive, Patients Association

From the NHS’s inception we had the opportunity of creating holistic patient centric care.  This would have embraced the treatment of the whole person; not promulgate the silos of body and mind. Prevention would have been prioritised, reducing the impact of chronic disease, safety and experience would have a greater dimension and the quality of our health (and social care) a greater outcome.  But all is not lost. The NHS has done amazing things; it has relegated the individual’s need to pay, it has enhanced access to the majority and it has innovated. Now it needs to push even more on quality, to enable patient leadership and to receive the resources it deserves. We now need to provide integrated care to improve the patient experience and outcome, and we need to work with patients and design services in the communities so we take the pressure off our hospitals.  We need to address the crisis facing the health and care workforce and invest in people so that safe, dignified care is provided to patients with compassion and empathy by staff with the right skills and expertise.

 

 

Watch this space for more of our stakeholder panel thoughts, and NHS70 birthday wishes.