Today the NHS is 65 years old! Happy birthday! A celebration?
Or should we just acknowledge the date with a fond nod to the brilliant birth of an ideal? The original vision and principle was fantastic and brave and gave security to those without the means to pay for care if they became ill or injured. What was not to like about it?
But has the NHS lived up to the ambitious vision? 1948 was a very different world.
What defines ‘health’ now has changed from that of 65 years ago. We live in a different culture. People were grateful for the care they received but today many expect or demand healthcare for their contributions. Life expectancy was lower and we have achieved more added years but not necessarily a better ‘life’. Scientific and technological healthcare advances have changed how we view the world but we face considerably more moral and ethical dilemmas as a society.
Nurses and doctors were well respected, trustworthy and advocates for their patients but recent surveys suggest we would not trust some hospitals with the care of our family or friends. The NHS is now big media bait open to criticism: advocating it as a ‘national’ service - not an ‘international’ service that should care for the sick not the lifestyle habits of the well.
Today evidence indicates that poor health can often be attributed to poor lifestyle choices – should, or can, the NHS continue to pick up the tab? We need to balance the NHS books better and make some uncomfortable decisions. NHS funding is not enough to provide the quantity and quality of healthcare the politicians have promised. Should GPs charge a consulting fee to discourage the huge number of DNAs and the frequent abusers of a primary HEALTH service? Can or should we separate social or health needs – what is poor housing, substance abuse or domestic violence? Are continence, hygiene and nutrition social needs that impact on the health of the individual? There are suggestions we should contribute additionally and directly to our consultations, investigations, medicines and hospital meals and laundry – would we be more caring of ourselves if we had to?
On its 65th birthday, the NHS is unwell and the signs and symptoms are considered endlessly by the great and the good, hoping to establish a diagnosis. It has been worked too hard, with inadequate resources and politically bruised and publically abused. It is physically suffering, mentally tired and socially tarnished. Yes, it is venerated but needs to change with the times to survive. With a worldwide reputation for excellence and accessibility threatened, it needs treatment – and fast.
As a tax payer and a user, what is your solution?
A full version of this article will be available in your next issue of Nursing in Practice, through your doors in the next three weeks. To apply for a free subscription to Nursing in Practice, click here.
BA(Hons) PGCE RN RM RHV FWT NP
Nurse Adviser and Independent Trainer
As well as working on the Nursing in Practice advisory board, Marilyn is also Lead Nurse for a teaching PCT, supporting nurse-led services and the development of practice nurses and healthcare assistants. She enjoys being a respiratory trainer and a nurse opinion leader and is passionate about expanding and blurring nursing boundaries in primary care.
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