UK: The NHS At 70 – Time To Celebrate Our Own Independence Day

Last Updated: 13 July 2018
Article by Karen Taylor

As almost everyone knows, the Fourth of July is American Independence day. My premise for this blog is that the 5th July 1948, which marked the birth of the NHS, was in fact the day that people across the UK were liberated from worry and distress over their own health care. Consequently, a fitting tribute to the NHS on its 70th birthday would be to declare 5 July as our own 'independence day', and fight with all our might to retain the principles and values of the NHS.

The NHS's creation was an explicit rejection of the unfair rationing of health care where people who could not afford it would go without or rely on charity to afford treatment. Today, as the NHS celebrates its 70th birthday, it continues to enjoy huge support, with the majority of the public continuing to see the NHS as a 'national treasure' that defines the way we value health at both an individual and a societal level. The NHS also has a set of values designed to ensure we deal fairly with the risk and uncertainty of ill health. It also provides assurance to all on how the state will protect its citizens.

Today, the NHS provides a variety of care much more efficiently and to more people than in the past. Care is also more evidence-based, less paternalistic, and more efficient and effective. It is also much more cost-effective than many other comparable health care systems. Technological developments such as safer anaesthesia and laparoscopic surgery, modern maternity, obstetric and end-of-life care, and significant advances in life-extending and precision therapies are improving health outcomes. Many people who experience a stroke, coronary heart attack or cancer are alive today who would not have survived 10 years ago. The majority of people who have had a child with a life threatening or life limiting illness will attest to a health service that goes above and beyond all expectations, providing care to the child and support to the family in equal measures.

According to the OECD's latest country profiles in its State of Health in the EU, life expectancy at birth in the UK was 81 years in 2015, up from 78 years in 2000 and above the EU average. Spending per head is above the EU average, and the share of GDP spent on health (9.9 per cent) matches the EU average in 2015. Public funding provides 80 per cent of total health expenditure, and out-of-pocket payments, as a share of household consumption, ranks third lowest in the EU. Overall, amenable mortality in the UK is better than the EU average and, importantly, unmet needs for medical care are low, and coverage is highly equitable, with very narrow differences in access to care between high and low income groups.1

Nevertheless, performance statistics show that the last few years have been increasingly tough with little sign of a let up. In the face of unrelenting demand, the waiting times and other performance targets introduced during the 2000s have proved too challenging for most NHS trusts, with only five major A&E departments meeting the four-hour A&E target in 2017-18. An increasing number of people waited longer than four hours on trolleys for admission to hospital, and overall performance against the four-hour target dropped to the lowest levels seen in 15 years. Nevertheless, the NHS continues to work heroically to stay afloat, taking drastic steps to manage demand for urgent care, such as deferring planned elective treatment and increasing its focus on demand management, referral protocols and improving the management of delayed discharges.

While we should indeed celebrate the NHS, we also need to spare a thought for social care and that in the same year that the NHS Act was passed so was the National Assistance Act 1948 (13 May 1948). This latter Act established the National Assistance scheme to provide support to elderly people who required supplementary benefits for living. It also obliged local authorities to provide suitable accommodation for those who through infirmity, age, or other reasons were in need of care and attention not otherwise available. Those who could afford it, could be charged to cover the costs of their accommodation or the care services provided, unless they could satisfy the local authority that they had insufficient means to pay.2

Today, the plight of social care has become a national crisis, with most local authorities raising the bar on eligibility criteria, requiring families and millions of unpaid carers to fill the gap left by the lack of local government funding. Indeed, over 900,000 people who used to benefit from social care no longer do so since local authorities raised the eligibility bar.

Deloitte's public sector survey for our State of the State in 2017 report showed most people were unclear what social care is and even less clear on how it is funded.3 This also provides part of the explanation as to why the public have not been more vocal about the parlous state of social care. Let's hope the increased emphasis on integrated care, the emergence of new models of care and the expectations of the new white paper will provide a belated birthday present for social care.4 This is just as important to the NHS, as numerous studies have shown that the absence of effective social care is inexorably linked to the increase in demand for health care.

So back to the NHS and the celebration of the 70th birthday. While the NHS is far from perfect, our 2016 report, Vital Signs, found there isn't a healthcare system in Europe or anywhere else in the world that is.5 Those contemplating alternatives should be careful what they wish for, as despite eight years of flat-line funding, the NHS is out performing the UK economy. It continues to treat millions of people successfully day in and day out and regularly performs miracles without causing the people who need it unwarranted financial hardship. Moreover, no other country is as transparent in measuring and reporting the quality of performance.

It has been 10 years since we celebrated the NHS's 60th birthday – when funding was more plentiful and most commentators on the NHS were extremely positive about its future. Few were aware of the economic downturn that was just around the corner or the unprecedented challenges that the NHS would face. Despite the challenges, the NHS has survived and in many cases has thrived and something we should be extremely proud of. It is also something I've seen first-hand over the past seven and a half years as a non-executive director of an NHS trust where, despite the challenges, patient outcomes and feedback from staff and patients alike remains extremely positive. So, as I intimated at the beginning, we should indeed celebrate the NHS as it turns 70 and remember how it has provided us and our families with an independence from worry and financial despair.

Happy 70th Birthday dear NHS, happy birthday to you - and many more!

Footnotes

1 https://ec.europa.eu/health/sites/health/files/state/docs/chp_uk_english.pdf
2 https://navigator.health.org.uk/content/national-assistance-act-1948-received-royal-assent-13-may-1948
3 https://www2.deloitte.com/uk/en/pages/public-sector/articles/state-of-the-state.html
4 https://www2.deloitte.com/uk/en/pages/public-sector/articles/state-of-the-state.html
5 https://www2.deloitte.com/uk/en/pages/life-sciences-and-healthcare/articles/vital-signs.html

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Authors
 
In association with
Related Topics
 
Related Articles
 
Up-coming Events Search
Tools
Print
Font Size:
Translation
Channels
Mondaq on Twitter
 
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
 
Email Address
Company Name
Password
Confirm Password
Position
Mondaq Topics -- Select your Interests
 Accounting
 Anti-trust
 Commercial
 Compliance
 Consumer
 Criminal
 Employment
 Energy
 Environment
 Family
 Finance
 Government
 Healthcare
 Immigration
 Insolvency
 Insurance
 International
 IP
 Law Performance
 Law Practice
 Litigation
 Media & IT
 Privacy
 Real Estate
 Strategy
 Tax
 Technology
 Transport
 Wealth Mgt
Regions
Africa
Asia
Asia Pacific
Australasia
Canada
Caribbean
Europe
European Union
Latin America
Middle East
U.K.
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.

Disclaimer

The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.

General

Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions