Comment: NHS is still going strong but we must protect it
Dr Mary McCarthy is a GP working in Shrewsbury and a member of the British Medical Association. Here are her views on the NHS at 70.
After 70 years, the NHS is still standing but we must protect it
In July 1948, as the effects of austerity were still strongly felt in a country recovering from the devastating effects of World War Two, Aneurin Bevan launched the National Health Service.
The first taxation-funded health care system in the world, it promised freedom from the financial penalties of ill-health, care for every person resident in the UK and a medical service that would be available at all times, in all places, for everyone.
The cornerstone of this new service was the family doctor, the general practitioner who knew your family, and your family’s circumstances; who cared for you from “cradle to grave” and who monitored your changing health.
When it started, on July 5 1948, people were not quite sure if it would work. One woman called for a doctor to come and see her at half past midnight and when he arrived at her door, told him “I’m not ill. I just wanted to see if you would come!”.
Aneurin Bevan thought that, although there would be an initial surge in demand as people finally were able to see a doctor without worrying about how to pay, the rush of patients would settle down as the public got used to the idea of health care that was free at the point of use.
General practitioners were to be used as a filter – sorting out the problems and only referring to hospital specialists those cases that needed hospital treatment. Every person in the country was to be given an NHS number and registered with a GP, or nowadays, with a GP practice. It is this registration with a practice or GP that makes the NHS work so well.
General practitioners realised early on how technology could help them and embraced computerisation more enthusiastically than other branches of medicine. GPs at Egton Medical Practice started one of the UK’s most successful medical computer systems and a GP (Dr James Read) worked out a coding method for disease classification which the government bought in 1992.
The NHS has of course changed over the years. When it started, the majority of GPs worked as single-handed practitioners, often from their own home, using two downstairs rooms, one as a consulting room and one as a waiting room. The GP’s wife acted as receptionist and secretary. The GP was on call day and night, seven days a week, though weekend calls were often shared with a neighbouring practice and many had a half-day during the week. They sometimes had a small dispensary attached to the surgery where they made up cough mixtures and burn cream.
When the NHS started female doctors were a rare sight; about 7-10 per cent of all doctors. Now, the majority (56 per cent) of medical students are female with women increasingly being seen as leaders in their field. In fact, last year there was a photo in the British Medical Journal showing 14 chairwomen of medical colleges.
I believe the NHS is the best idea that this country has ever had. It is not just that it has taken away financial pressures from the sick – those who are least able to bear them – it has altered the mindset of those working in the NHS.
It is because we have nothing to do with money that we concentrate on the patient themselves. It is because we are not worried about cost that we continue working above and beyond our stated and paid-for hours. It is because it is free at the point of use that so many working in the NHS give so freely of their time, their expertise, their skills and their care.
We must ensure that this remains the case. The chair of the BMA recently released a paper on a future vision for the NHS, one that was caring, collaborative and supportive. These are the principles that the NHS was founded upon but care and attention is needed to keep these enshrined in our health service.
I have witnessed many changes throughout my time, some for the better and some for the worse. Despite this, my dedication and commitment to the NHS remains the same today as it did on the first day I started as a GP in practice. I am however worried about the future of our dear NHS – battered and bruised but still surviving.
The NHS is still here owing to 70 years of hard work and dedication. We can rely on the commitment and support of staff and the public, but we need investment if the health service is to survive the next decade and many more to come.
