Where there is love there is life
- Mahatma Gandhi
“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”
- Aneurin Bevan
As I enjoyed the privilege of attending the recent NHS 70th anniversary event in Westminster Abbey it seemed an appropriate time to reflect on 48 years of working in and around the NHS. The tenor was uplifting and positive, symbolising the remarkable institution we know as our NHS. It was refreshing. We are, after all, a nation which loves to bemoan our shortcomings at the expense of celebrating the best. While that may give us a relentless drive to improve, to succeed, even to excel, I wonder what damage it does to the psyche. Economists, studying the benefits of happiness, conclude that national prosperity follows a happy populace, and could we not do with a touch of extra productivity at the moment?
Cynicism and politics were temporarily suspended throughout the moving service which heard from victims of horrific events, staff who remember 1948, senior NHS leaders, as well as politicians. The event served to reinforce that justifiable deep pride in the NHS which so many of us share. I am hugely proud of its ethos, what it achieves against any odds and the unique and irreplaceable ‘free at the point of delivery’.
I am clearly not alone in my feelings about the NHS, nor alone in being able to construct a logical argument for my unashamed passion, but truth is, I would argue my views are more visceral – it is in my DNA. But how far does that unquestioning passion extend in our society, in over one million healthcare workers, and does it matter?
In the splendour of the Abbey, I considered where my strong feelings come from. Is it that my parents (both of whom worked in the NHS in its earliest years) passed on their experiences of life before 1948 – well encapsulated by Aneurin Bevan’s In place of fear – or is it the product of a long and rewarding career? Is it the people who make it happen: from the more humble in unseen but vital roles, to those who deliver compassion at times of great need; from those who design or deliver sophisticated and complex treatments to those who constantly push back the frontiers of science, masters in the art of what was hitherto thought impossible? Or is it the ill-appreciated leaders and managers; or the politicians who make the funding decisions knowing that whatever they provide will never be deemed to be enough? Or is it all of the above, seasoned by international experiences of less inclusive systems?
These thoughts have been brewing for some time. What if the current or subsequent generations, unfettered by pre-1948 history, do not have the same faith in the model that is the UK NHS? I realise I have been massively privileged in never really having to consider costs in patient interactions, but will subsequent generations think the same? Or will the daily diet of ‘the NHS is unaffordable’ hold sway when those of us with the visceral connection die out? After all, you only need to venture across the Atlantic to find millions of intelligent people who do not understand the NHS and even deride the fundamental principles which we hold so dear. I have worried for some time that the quickest end for the NHS as we know it would be for its staff to stop believing in it. What after-shocks could the current, seemingly relentless pressure be creating?
I said earlier that the NHS is in my DNA, but perceptive molecular biologists will know that it is not! Therefore, that passion for the NHS will not automatically pass to subsequent generations. What is our responsibility to engage later generations in intelligent debate about the NHS’s future? Indeed, to become more involved in deciding its future than previous generations have been. Are we helping them to gain the necessary political savvy, strong leadership, resilience and determination? How do we engage students in this complex subject and how do we harness the energies of our junior colleagues, do we even see it as necessary?
Remember the Native American Proverb: We do not inherit the earth [insert NHS] from our ancestors, we borrow it from our children.
So many times we have faced inevitable challenge by expressing loud forebodings rather than by planning ahead. Initiatives come and go to be replaced by other initiatives – not so the NHS – once that goes it will not return. At a recent debate on NHS70, Ben Page, CEO at Ipsos MORI, said: “The NHS is one of the most loved things in the UK – a focus for patriotism.” So, it’s time to act, the NHS is too precious not to, and now we are assured of a 5-year funding plan our actions may be better-planned than in the past. Long live the NHS!