NHS at 75: 'We thought we could change the world' - Yorkshire doctors and patients share their stories as NHS turns 75

Among the team of Sheffield Community Contact Tracers are retired GPs Drs Tom Heller and Jack Czauderna.

Three years on, they’re still involved in the group, their focus now on research into Covid and Long Covid, and reminding people of the dangers that the disease can still present.

And it’s not the first time the pair have worked together. In the 1980s, Tom had taken over a GP practice in the Sheffield suburb of Darnall and Jack began working there as a trainee. The team adopted a revolutionary approach to the surgery’s organisation, operating as a collective that saw everyone who worked there get the same amount of pay per hour.

“I’m still proud of what we did, although it was completely off the wall, in a way,” Jack says, his words captured in a new book to mark the 75th anniversary of the NHS. “From receptionists to the doctors, we got paid the same hourly rates. We thought it was important in challenging the power relationships that health workers had between themselves, and also attempting to look at the way that we treated the relationships we had with patients as well.”

Tom and Jack’s recollections feature in a collection of stories telling the rich history of the NHS through the people who have experienced it. Our Stories: 75 Years of the NHS from the People who Built it, Lived it and Love it documents the voices of patients, staff and policymakers and was borne out of a project to create the first digital archive of NHS history.

The book’s editing author Dr Stephanie Snow, Professor of Health, History and Policy at the University of Manchester, has directed the NHS at 70: The Story of Our Lives project since 2017. Alongside Covid-19 testimonies, interviews from the project now form the Voices of Our National Health Service collection, one of the largest health-focused oral histories in the world, at the British Library.

The book was borne out of the project and captures the journey of the NHS from its inception in 1948, when it was launched to provide healthcare services that were free for all at the point of delivery, to its existence today.

“I think the book demonstrates that the NHS was built from below - and morale was built and all the innovations came from below,” Tom tells The Yorkshire Post. “Through each of the seven decades of the NHS, it’s been individual people who not only kept the service going but with real innovation, built the health service into wonderful shape…But the things Jack and I - and others in Sheffield - did wouldn’t be possible now. There’s money being spent in the health service but the control is totally top down rather than giving it to people who know what’s happening in their service.”

In the book, Jack and Tom reflect particularly on the 1980s, a time when primary care changed significantly, with the upgrading of old premises and the building of new health centres. GPs also began treating more patients suffering from mental health issues and became more involved in health promotion.

Tom had previously worked in Nepal after following in the footsteps of his father and brother and qualifying in medicine. On his return, he became focused on research looking at health problems in developing countries and then spent much of his career working as both a GP and an academic, creating health-related teaching material.

On his time in Darnall, he says in the book: “We decided to run as a collective. So people who came along, like the practice nurse who was a political friend, the cleaner, the doctor, we all got an hourly rate by seeing what the takings were over a year and dividing it by however many we were. We had big clinical meetings but also a practice meeting. Deciding what to do as a practice. Trying to be democratic. If there was money to spend, we would decide between us all how to spend it. Sheffield attracted doctors that wanted to work in this way. We called ourselves TCP – Towards Coordinated Practice.”

Jack had met his life partner while training in medicine in Bristol. In 1979 they decided to move north and Jack became a GP trainee in Tom’s practice.

“General practice in the 1980s still tended to be single-handed practitioners in their own buildings,” he says in the book. “We had a different model. We wanted to really overturn what was going on. I think we thought we could change the world.”

Jack and Tom say their practice in Sheffield was among the first in the country to have dedicated counsellors looking at people’s mental health. They talk also of adapting the surgery to look after people whose first language was not English and setting up a health visitor post focused entirely on the area’s traveller community.

Both men were also involved in what became the Sheffield occupational health project, going out into the community into the likes of working men’s clubs to talk to steelworkers, miners and other groups about the health issues that were affecting them.

“We were doing stuff that these days is often seen as normal,” says Jack, who stayed at the practice for 30 years.

In 1997, following a struggle to attract doctors, the surgery’s equal-pay model came to an end and it became a salaried practice. “Sadly, we couldn’t attract doctors [any longer] because of the pay. But [the model] lasted a long time…I’m proud to have been part of it.”

Our Stories: 75 Years of the NHS from the People who Built it, Lived it and Love it is out now, with royalties going to NHS Charities together.

‘It’s priceless’

Yvonne Ugarte has written a poem about what the NHS means to her. “Everything, it’s absolutely incredible,” she summarises, waxing lyrical about both how she has been supported with her own health and the care that her late son Emil received after he became ill with meningitis.

Leeds-born Yvonne was working as a health visitor assistant before Emil was born and had been distributing leaflets to parents as part of a meningitis awareness campaign.

In the book, she recounts how her “happy little chap” suddenly, at 15-months-old, became withdrawn, hot and was refusing his milk.

“We put him in a tepid bath,” she tells The Yorkshire Post, “and the water was warmer when we took him out.”

She took her boy to Leeds General Infirmary, where he was diagnosed with meningitis. “He was on intensive care and then one day he woke up and said ‘tubby toast’. He used to love the Teletubbies and I knew then he had turned a corner.”

Tragically, seven months after his recovery, Emil died. The pneumococcus was still in his brain and spine, but had remained undetected in tests.

Later, Yvonne underwent IVF in an attempt to get pregnant again. “I knew I was pregnant straight away,” she says. “I was laid in the IVF suite in the LGI and I could see a creche where the doctors and nurses’ children were. I could see this little boy climbing up the slide and he had a red jacket on and blonde hair - and Emil had a little red suit and blonde hair. And I thought that’s a sign.”

Daughter Amali was due on Emil’s birthday, but was born four days after the date.

“The NHS and the care we’ve had is priceless - it’s beyond measure,” Yvonne says. “So many people are appreciative of the amazing NHS. I just hope we can keep it as it is.”

Free for patients

When Raj Menon arrived at the YMCA in Chapel Allerton in Leeds, his bag was full of medical books - and very few clothes.

It was August 1974 and he’d applied for a clinical attachment at St James’ Hospital.

Raj had qualified in medicine in India, having been given a scholarship by the Indian Government.

Initially he had planned to return to his birth country of Singapore, where his Indian parents had emigrated - but the country’s government had de-recognised Indian medical degrees.

And so he borrowed money from his brother and headed to the UK.

Raj later went into General Practice, his first job at a rural surgery in Todmorden, West Yorkshire.

“Visiting patients in the middle of the night dressed in jeans and a turtleneck jumper wasn’t the done thing,” Raj says, “but I didn’t know that!”

Raj practiced in Halifax and Dewsbury before spending much of his career in Leeds.

“I developed smear clinics, antenatal clinics, baby clinics in the afternoon, which wasn’t existent in my practice when I took over,” Raj states in his extract in the book. “Monday afternoons, we had baby clinic, Tuesday afternoon, an antenatal clinic. All the afternoons were filled up as I went along, and by the time I retired, we had them every morning, afternoon and evening. The surgery was always full of people.”

By the time Raj retired, the practice cared for 6,500 patients and had four full-time partners.

“Where I come from in Singapore, my parents had to pay for any medical consultation,” Raj tells The Yorkshire Post. “Here, you can do your best for a patient and no money changes hands. That concept for the NHS excellent and I hope all governments of all colours preserve that.”

Covid-19 changes

When the Covid-19 pandemic began, Jonny Emms, pictured inset, was working as a GP down in London.

“It was really surreal because it was actually the quietest I remembered it in General Practice,” he tells The Yorkshire Post. “Nobody was going anywhere or doing anything. Usually we’d speak to 40 to 50 patients a day but we were speaking to 10 or 15 because no one was contacting the surgery - and the people who did have suspected Covid were being taken to hospital.”

For Jonny, the pandemic was a time of great change. As Covid-19 tore through society and halted life as we knew it, Jonny welcomed a son to the world and moved back to his hometown of Harrogate to be closer to his family.

A marked shift came in how surgeries operated too. “There was concern at the time that seeing patients face-to-face would spread Covid further,” Jonny says. A telephone appointment became the norm, with patients, in many cases, only seen if necessary.

Now, his day is split - half of his patients will be dealt with by phone, others he will see in person.

“The biggest challenge is there are not enough GPs and nurses and appointments for the demand currently there,” he says.

But, as he states in his extract in the book: “Big strengths of the NHS are the diversity of it, the public love for it, and the pride that the people that work within the NHS have for the service. The energy and intelligence and determination that goes about bringing our healthcare system together is miraculous, and everybody that’s a part of it can be proud of what they’ve been able to do.”

Jonny claims the government’s behaviour and messaging during the pandemic “made it harder for the NHS”.

“If the government had stuck to the rules that they were trying to implement, that would have made it easier for everybody to enforce,” his extract reads. “....They should also have listened to their health advisers a lot more. Listening to the press briefings, it was like you had to listen to two different stories. Chris Whitty and Patrick Vallance would be urging extreme caution and then the government saying, ‘Oh, things by Christmas will be a load better’ and so on. Those of us with any sort of medical background were well aware that this was absolute nonsense. I found it hard to stomach.”