On the NHS 75th anniversary it’s time to reflect on its past, present and future Everyone has their own stories about our NHS. For me, it’s saving the life of my baby and wife to be and helping my dad when he was dying. I’ve spent 22 years working as an A&E doctor and I’m proud of my service. But I’m also tired and although optimistic for the future I’m worried about what will happen. At the moment its suffering and the care provided Is not as good as we would like. But that doesn’t mean the concept is wrong; free at the point of need, where resources are used for what’s right for patients and not profits. But its under threat. And it’s at risk like never before. Waiting lists for operations at their highest levels ever, longer and longer waits for beds after being seen in A&E and for the first time since the NHS was formed, life expectancy is starting to fall. But it can and it must survive and that’s why what you do is so so important to fight for its survival. In July 1948, every household received a letter to explain the creation of the NHS: It stated: It will provide you with all medical, dental and nursing care. Everyone – rich or poor, man, women or child can use any part of it……There are no insurance qualifications. But it is not a charity. You are all paying for it, mainly as tax payers and it will relieve your money worries in times of illness. The nation rejoiced as the realisation hit and it became apparent that no longer should people ever again die because of their lack of wealth. On 5 July 1948, the keys to Park Hospital, in Trafford Manchester were symbolically handed over to Nye Bevan who tool them on behalf of the country. There was a public round of applause and a guard of honour as the nurses and doctors walked into work on their first day as NHS employees. The first patient through the doors was a 13-year-old girl named Sylvia Beckingham, who was admitted for a serious liver condition. She came from a working-class background and her family could not afford the care she needed. Without the NHS she would have died. With it, she survived and went on to live a fulfilling and wonderful life. She epitomises the NHS’s long and great history In the last 75 years, Infant mortality has fallen from 36 per 1,000 births to less than four. Life expectancy had grown for men from 65 to 80 and for women from 70 to 84. But worrying the last two years it has started to fall But the way we deliver care has changed. When the NHS was set up there were 480,000 beds, now 120,00. The NHS is there to treat illness. In the past it was “fast things” which killed us and which the NHS was there for – trauma and infection. But now its slower less obvious causes such as neurodegenerative disease, cancer, cardiovascular and metabolic such as type two diabetes. Much more care, rightly, is done in the community, with GPs and care of the elderly doctors leading the way and preventative medicine and encouragement of public health initiatives rightly becoming more important So as illness change, so does the way in which the NHS works must change Although things have been far from perfect in the NHS, it has always been resilient to the pressures thrown upon it. It. Now needs that more than ever But one thing which is no different is the dedication and devotion of the staff who work in the NHS. The NHS is not its buildings, its drugs or its machines. It’s its staff They work for an institution whose ethos puts patients above all else. An institution which leads the world in research, cutting edge care but most importantly humanity. But it’s not a given that the NHS is here to stay. it does not have the universal support it had 13 years ago and its not cheap But its money well spent. Its ethos of doing what’s right for patients rather than profits means test are done where they will change management rather than where they allow profits to be maximised. This means it’s the most efficient health system in the world – even though it doesn’t feel like that at times. But that efficiency is being damaged by current political direction – you only have to look at what happened when the private sector got involved in PPE and track and trace Yes it needs reform, but in a way which encapsulates all it stands for. But it also needs support and love. We need to support it as a best friend would do – with honest and reflective love and not unfettered adulation. Because only then can it reform and grow in the way our nation truly needs it to. But its at risk like never before. The NHS staff are demoralised and struggling. Claps on a Thursday and lights shining on buildings today, can’t stop the brain drain of expertise we are seeing I manage major trauma in my day job. Giving blood is often needed to keep the patient alive. But to save a life you need to stop the bleeding. NHS Workforce management is the same as trauma management. There is a real risk that the actual beneficiaries of the new NHS England workforce plan and investment will be the Australian health service. The NHS is nothing without its staff. I know so many doctors, nurses and others who are burnt out and do not think working in the NHS is worth it anymore. The long term damage to patient care from this is enormous. The NHS is a brilliant concept which is being mismanaged by our politicians. Those of us who work and use and need the NHS are being let down by our political leaders. We need new ideas, policies and funding to save the NHS before it’s too late. Our NHS which was formed by heroes of WW2, may not be there for our children. As Nye Bevan said, the NHS will survive as long as there are the folk with the faith to fight. We have to be the folk, We have to have the faith And we must fight it. Otherwise, our children will never forgive us