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Looking to the future of the NHS

I have just returned from a short break in the beautiful Derbyshire Peak District. We were lucky enough to be able to stay with friends who have a weekend retreat there where they spend as much time as possible away from the hustle and bustle of city life and work in Manchester.

So it was really special to be shown a part of the country to which I have never been to before, by people who know it well. It is all very different in East Sussex where I live; the long narrow fields are bordered by dry stone walls not hedges and are filled with sheep. (I learned to my amazement there are 41 different breeds of sheep and I thought a sheep was a sheep was a sheep!) There are very many narrow valleys that have steep sides rising craggily to high ridges and are scattered with grey limestone outcrops. In other places there are hay meadows dotted with wild flowers where cows munched contentedly. The weather was equally varied so although we did manage one day of walking another was spent visiting several of the impressive caves around Castleton.

As I was just a passenger on the way back to Brighton I had plenty of time to reflect on all we had seen and done, and it suddenly struck me that although the geography of the White Peaks is very different to that of the South Downs, their underlying structure/geology is not. The Peaks are composed of limestone and the Downs chalk so the flora and fauna they support are very very similar.

In a strange way this is not unlike the NHS. It can hardly escaped anyone's notice that at the beginning of July we celebrated its 60th Birthday, and as a result there have been numerous articles in newspapers and journals, programmes on the television and radio reminding us of the "then and now".

In many ways there are huge differences. In my own field there is the explosion of drugs available to cure and alleviate conditions and diseases that previously could only be treated by the caring and good nursing practice of those that looked after them. Technology and surgery have made possible procedures that were only dreamed of all that time ago and an understanding of the complex processes that take place in the body at the molecular level enable interventions to be made that can dramatically improve outcomes once a diagnosis has been made.

However, what has remained unchanged is the original aim to provide medical care that is accessible and available to all, free at the point of use at the time of need. Lord Darzi's review placed patients firmly at the centre and this seems to me to take this one step further. The recent policy papers and draft NHS charter outline the future direction of travel making it a "health and wellbeing". I read somewhere that making changes to the NHS is like trying to turn round the Queen Mary, so I do wonder where we will be after another 60 years.

However I have no doubt that the other unchanging feature of our National Health Service, the hard work and dedication of all frontline staff that has kept it going through economic cutbacks, structural changes and staff shortages will once again enable it to meet all these new challenges and remain the envy of the developed world.

What do you think the NHS will look like in 60 years time? Your comments: (Terms and conditions apply)

"Sadly in many ways we have not moved forward at all as nursing care has not improved. Yes we can carry out operations we could not 20 years ago. Yes patients are in and out of hospital much quicker. We have developed so many new drugs and treatments for diseases what we do need to develop is good practice that works and stop continually making change for the sake of it. The NHS has come a long way but at what cost!!" - Name and address supplied