The birthday gift our NHS needs
Dr Kailash Chand
This week the NHS is celebrating its 70th birthday. It remains Britain’s most cherished public service and one of the fairest systems of healthcare in the world. It started with the opening of the Park Hospital in Manchester on July 5 1948, by the then Labour Government headed by Prime Minister Clement Attlee, under the principle that treatment should be ‘free for all at the point of delivery’.
The idea of uniting all the country’s hospitals and doctors’ surgeries into one great state-run conglomerate had germinated during the Second World War, when the volume of casualties reduced the health service to near-bankruptcy. It has been described as one of the greatest social achievements of the 20th century, with its promise to care for the British people from cradle to grave.
In 1948, at the founding of the NHS, we still had the burden of the infectious diseases with very limited availability of antibiotics, hardly any anti-cancer drugs or cardiovascular disease treatments. This has all changed, thanks in part to research and innovations in the NHS, which has brought the world vaccination, penicillin, IVF, stem cell transplants, artificial hips and MRI scanners.
In more recent times, we have seen innovations like mechanical thrombectomy to improve stroke survival, bionic eyes to restore sight, and surgical breakthroughs such as hand transplants. When the NHS was founded in 1948, the life expectancy for men was 66, and for women, 71. Today those figures are 77 and 82. Ask what makes people proud to be British, and the NHS is always the top answer.
Our NHS needs a new model of healthcare, led by general practice
But all is not well on its 70th anniversary. There is a crisis in GP services, which is a barometer and gateway to all other services. Since 2011, the proportion of unfilled GP advertised posts has climbed more than fivefold. We’re are in the midst of a GP recruitment crisis. By 2020, there will be a 10,000 shortfall of GPs across the UK. The number of GP practices in England has fallen by 889 since 2010, a fall of 11%, as a result of closures or mergers. There are 4,425 fewer staff working at GP Practices today, compared with 2010. And if general practice falls, the NHS falls.
Growing up in India, I dreamed of moving to the UK and working for its health service, the envy of the world. Fulfilling that dream has been a huge privilege. Working at all levels of the NHS, I have learned that service will always need to change to match emerging science, changing demography, shifting disease profiles, and to meet increasing demand within a set budget. Our task now as a nation is to enable the NHS to properly adapt to medical advances and public expectations.
The NHS must move from a treatment model of care to one of prevention. Decisions made at the health service’s inception created the problems we see today. Social care was never integrated with the NHS, and domiciliary care has always been left to a mixture of private companies and local councils. Our NHS needs a new model of healthcare, led by general practice. It needs proper integration, transparency and accountability.
And if politicians are to remain involved at the heart of the NHS, they need to ensure it gets the funding it needs, not ready it for an insurance-based system.
After eight years of meagre 1% funding rises, the current prime minister marks the 70th birthday of NHS with a boost in funding, but this is not enough. This Government’s birthday present to the NHS is mere wrapping paper. Such half measures will signal an ending, not a new beginning.
Healthcare is a human right and everyone, regardless of ability to pay, gender, race, mental or physical ability or sexual orientation has a right to it. The pooling and sharing of risk on a national basis and public services free at the point of use, as NHS founder Nye Bevan said, liberate us from fear.
The NHS is a beacon of hope to millions of people around the world, demonstrating that universal, publicly funded healthcare is possible. The world would be a better, healthier place, if every country had a health care system like the NHS led by primary care.
Happy 70th birthday to the people’s NHS!
Dr Kailash Chand is a retired GP in Tameside