NHS: 60 and counting24th July 2008
On 5th July the NHS celebrated its 60th birthday amid a fanfare of events and news coverage. It seemed the number of people who were suddenly produced to tell their stories of how the NHS had changed their lives were never ending. Both the BBC and the revamped NHS Choices website contained a host of interesting profiles on the history of the NHS and both are worth a quick browse if you have a few moments. There are also localised versions on the BBC website. We really couldn't do it better - just follow the link to the right.
Even at 60 years old it appears the NHS isn't close to taking early retirement - but it may have to modernise (again). What a difference a decade makes. Ten years ago the NHS celebrated its golden jubilee and you can still find the BBC microsite dedicated to this event (just plug "NHS birthday" into the BBC search engine). Then, there were clearly mutterings about the problems with the service but the view of the future was quite optimistic and looked forward to an NHS influenced by a greater level of patient power. Quite prescient, in fact, because the last decade has certainly moved this agenda on in leaps and bounds, beginning with the Patient's Charter (remember that?) and subsequently followed by lots of policy documents with "Our" in the title, and the embryonic, problematic but ultimately here-to-stay Choose & Book system.
The next decade or two may not be so straightforward because the ethical foundation on which the NHS is based may be challenged by the blunt reality of economics. Past issues of Healthcare Today have identified various aspects of this in the form of doom and gloom scenarios for a range of conditions which are on the rise. The simple fact is, however, that we are becoming healthier, growing older and then succombing to a nasty range of chronic conditions that need to be treated by more and more complex interventions and expensive drug therapy. And if we do the maths then quite simply it doesn't add up; we can't pay for it all.
And that means we will almost certainly have to adjust the model. There's no talk about abandoning the NHS to the private sector and insurance companies yet but the dreaded phrase "a two-tier service" is starting to be banded about even more. This philosophy proposes that the NHS provides a universal standard service for all but with the option for individuals to "top up" their care to pay for expensive extras. Perhaps the dentistry service was the pilot for this; we'll have to wait and see.
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