The NHS at 70
The UK’s National Health Service (NHS) is celebrating the 70th anniversary of its foundation begun in 1948. Designed to provide care, free of charge, on demand and at the point of delivery, the original aims of the service were to improve the health of the nation, provide universal care and to ease the end of life with dignity.
The British (English, Scots, Welsh and Northern Irish; from a healthcare perspective now four different systems) are justifiably proud of this ‘first of its kind’ health service and say it has proved a massive success in addressing many of the ongoing conditions of the 1940’s and, to a large extent, in keeping up to date with ongoing healthcare developments.
It is almost implied in commentary in the national press that these achievements are somehow peculiar to the UK and have not been mirrored in most western countries and that somehow the NHS is superior to all other health systems. Anyone who has traveled and studied alternate solutions can see through that claim but it goes some way to explain why countries without a nationalized system are seen as inferior if not barbaric, free healthcare being seen as a human right in the UK.
I have been traveling in the UK for the past few weeks and whilst it is usual to see news and comment on healthcare on a daily basis this period has been one of saturation coverage with nightly TV programs, celebrities and politicians; all contributing to the birthday celebrations.
With 1.4 to 1.5m employees, powerful trades unions and political futures bound up with the successes and failures of the system, plus (some may say) little else to celebrate by way of recent achievements, it is no real surprise at the celebrations now under way.
The 70th anniversary is also proving an ideal focus on a service that has suffered from massive mission creep since its inception and is also now dealing with all of the problems facing healthcare throughout the developed world.
These probably do not need to be restated but include an ageing population and the attendant costs of care; male deaths in 1948 averaged 67 years of age, today 87. Today more treatments, drugs and devices, are demanded across all age groups. In the UK, an additional issue is that the NHS is, and has always been, used as a stick to beat the party in power and politicians divide on party lines making real progress and sensible discussion near impossible.
Despite the promotion of the NHS as a ‘free’ service, and many patients and caregivers seemingly oblivious to cost, healthcare does, of course, cost a huge amount and is paid for out of taxation. An announcement was recently made of more funding for health; to general applause, followed two days later by claims by the doctors that ‘more was needed’ (the default response) and then widespread consternation that taxes would of course be raised to pay for it. There is even talk of a hypothecated tax.
Out of all this some very good thinking is clearly being applied about the future of the service in a very different era and with general statements that it is no longer fit for purpose in some regards. We will reflect on some of these in the coming days as they seek to address the western world’s common healthcare ills.
Look out for NHS @70 (2)