The National Health Service – NHS, celebrates its 70th Birthday today and it’s far from enjoying a quiet retirement!
The NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then minister of health, Aneurin Bevan, on July 5 1948, it was based on 3 core principles:
- that it meet the needs of everyone
- that it be free at the point of delivery
- that it be based on clinical need, not ability to pay
These 3 principles have guided the development of the NHS for the past 70 years and remain the core values of its staff.
Politics have played their part in disrupting the National Health Service with reforms that created internal markets, expensive Private Finance Initiatives for capital projects, and Clinical Commissioning Groups that have led to further fragmentation and an influx of private providers, often accused of cherry-picking profit making services.
In spite of this, the NHS remains committed to providing healthcare for everyone in the UK free at the point of care. The national programs for specialist centres for Heart Attack, Stroke and Major Trauma exemplify the power of a comprehensive service that can be coordinated nationally.
The Commonwealth Fund data show that the NHS is one of the most efficient and effective healthcare systems in the world, and that is in spite of spending restrictions for health and social care under the banner of austerity. In comparison with the healthcare systems of ten other countries (Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and USA) the NHS was found to be the most impressive overall by the Commonwealth Fund in 2017.
The NHS was rated as the best system in terms of safe care, affordability and equity. It was also ranked first in the ‘care process’ category, which encompassed preventive care, safe care, coordinated care and engagement and patient preferences.
In the category of health care outcomes, the NHS fared less well (10th). However the researchers did find that the UK achieved the greatest decline in mortality amenable to healthcare between 2004 and 2014 (37 per cent).
The NHS achieves this with lower spending that most other first world countries. Health expenditure in the UK was 9.75 per cent of GDP in 2016. This compares to 17.21 per cent in the USA, 11.27 per cent in Germany, 10.98 per cent in France, 10.50 per cent in the Netherlands, 10.37 per cent in Denmark, 10.34 per cent in Canada, 8.98 per cent in Spain and 8.94 per cent in Italy.
In terms of medical staffing the UK is low in the rankings with 2.8 physicians per 1,000 people in 2016, compared to 4.1 in Germany, 3.9 in Spain, 3.8 in Italy, 3.5 in Australia, 3.4 in France, 3.0 in New Zealand and 2.7 in Canada.
For a comprehensive national service the NHS has also had to reduce it’s bed base to reduce spending. The UK had 2.6 hospital beds per 1,000 people in 2015, compared to 8.1 in Germany, 6.1 in France, 3.2 in Italy, and 3.0 in Spain. The low bed numbers in the USA – 2.8 per 1000 – are likely to reflect the inequity of access to care, especially expensive inpatient care.
The NHS deals with over one million patients every 36 hours, and is built on the skill, training and dedication of its staff – that’s more than one million people committed to caring for people in the UK from cradle to grave.
We salute the NHS and its amazing staff, and in the words of its Founder, Aneurin Bevin:
The NHS will last as long as there are folk left with faith to fight for it!
Read more about how MedShr is working in collaboration with NHS bodies to support medical education.