5th July 2023 is the 75th anniversary of the NHS – and a good opportunity for all of us to think where we would be without it. It may be showing its age a bit and it’s certainly creaking at the seams – but our NHS is still the envy of much of the world.
It’s worth remembering just how extraordinary our NHS was when it launched – the first universal health system, free at the point of delivery, available to everyone in a nation, anywhere in the world.
In most countries with health insurance systems, you have to ring your insurer every time you’re referred for hospital treatment or submit forms afterwards for reimbursement. Many people can only afford the minimum cover and can incur huge bills through ‘Co-payment’ systems if they need medical help. Even getting a prescription made up can involve reams of paperwork.
My colleagues overseas tell me of patients with long-term conditions stuck for decades in minimum-wage jobs, because they don’t get health insurance until they’ve been in a new job for a year or more. And 27.5 million people in the US don’t have health insurance at all, meaning at least 1 in 5 adults missed out on care completely because of cost. In fact, 2/3 of Americans who file for bankruptcy cite medical issues as a key contributor.
Our NHS isn’t perfect – as the pandemic has shown, there are times when it struggles with the number of patients who need care. But part of that is that we’re doing so much more to keep people alive and well for longer.
When I became a GP-in-training 36 years ago, pretty much all the average GP’s work was taken up in looking after people who came in with symptoms. There were no targets for controlling blood pressure, reducing cholesterol or other important preventive work which has gone such a long way to increasing the life expectancy in the UK. In 1948, when the NHS came into being, the average life expectancy in the UK was 66 ½ years – today, it’s almost 82.
Today, about half the average GP’s time is taken up with preventing illness and complications – and national NHS vaccination and screening programmes, like treatment for illness, are free to people having them. Even most European countries don’t have a national screening programme to detect life-threatening eye problems in people with diabetes – in the UK, people with diabetes are invited every year.
Our breast, cervical and bowel cancer screening programmes save thousands of lives a year. They also pick up thousands more cancers at an earlier stage, meaning treatment can be less radical.
At the more cutting-edge end of the spectrum, the NHS has been responsible for:
- The world’s first CT scan was in 1971.
- The world’s first test tube baby was in 1978.
- The world’s first liver, heart and lung transplant in 1987.
- The world’s first national vaccination programme for deadly meningitis C was in 1999.
- The world’s first rapid whole genome sequencing service for seriously ill babies and children.
- Arguably the world’s best tracing programme for new COVID-19 variants.
Yes, waiting times are high, and no, that’s not acceptable. We need to do more to reduce waiting times. Part of that is to do with the recruitment and retention of highly skilled staff, who take many years to train.
But despite all the challenges, I have never regretted the decision I made 50 years ago, when I was still in primary school, that I wanted to be a GP. I’ve spent over 25 years training other GPs, and am proud to have helped ‘launch’ 27 fully qualified GPs into our NHS.
I’m also very proud to have been invited to a service at Westminster Abbey on 5th July as a representative of the millions of people who work in the NHS, to say thank you for all they do. After all, our NHS is amazing – but it would be nothing without its staff.