TODAY, I will be attending a choral concert at York Minster to mark the 70th anniversary of the creation of the NHS. I can think of no other public institution that would warrant such a tribute.
As Health Secretary during the 60th anniversary celebrations, I had the privilege of meeting many people with personal experience of what the NHS replaced.
There were huge disparities in provision through a patchwork of voluntary and municipal hospitals. Lady Almoners controlled means-tested access to the ‘voluntaries’ whilst the ‘municipals’ carried the stigma of being former workhouses and Poor Law establishments.
The great social historian, Arthur Marwick, records that “medical provision before the war depended upon a primitively unstable mixture of class prejudice, commercial self-interest, professional altruism, vested interest and demarcation disputes”. With only 43 per cent of the population covered by the rudimentary insurance scheme introduced by Lloyd George in 1911, the cost of calling out the doctor was too high for most working class families.
Not only was infant mortality high, the number of mothers who died in pregnancy was one in every 1,500 births. Today it’s one in 25,000.
Nye Bevan, the founding father of the NHS, summed up what its introduction meant to the vast majority of the population in one word – serenity.
A comprehensive service, funded by taxation, available to all free at the time of need removed at a stroke the biggest single cause of anxiety from people’s lives.
It was replaced by a bond of social solidarity which to this day helps to bring the nation together when so much else drives us apart.
It is absolutely right that, as well as celebrating NHS 70, we face up to the challenge of ensuring the service remains effective in a society that is vastly different to the one it was born into.
An ageing population (itself a cause for celebration), together with medical advances, means that the major concern of the NHS today is the 15 million people living with chronic conditions such as heart disease, asthma and diabetes.
Therefore the crucial challenge is how to combine health, social care and early intervention to keep us healthy for longer.
The day after the event at York Minster, I will be at the opening of the £10m Jean Bishop Integrated Care Centre in Hull which will bring together teams from the NHS, Hull City Council, Humberside Fire and Rescue, voluntary and community groups to focus on proactive assessment and care planning for 3,000 of Hull’s most frail, elderly residents.
Rather than placing its users on a conveyor belt towards hospitalisation, the centre is devoted to helping them to live active and independent lives (following the example of Jean Bishop, Hull’s famous Bee Lady who, at 95 years of age, continues to raise money for charity).
The fire service in Hull already relieves pressure on the NHS by dealing with falls, still one of the major reasons why the elderly are hospitalised. A brand new fire station is co-located at the Jean Bishop site.
I am involved with this project as the Independent Chair of Citycare which has partnered Hull Clinical Commissioning Group (recently voted CCG of the Year) and Hull City Council in providing this facility. It is this kind of integrated working that is needed as well as proper social care funding.
In the past decade, around 950 care homes have closed with around 30,000 places lost. Despite rising demand, social care spending has actually declined by nine per cent per person. For hospitals this has meant more patients who cannot be discharged safely. The NHS spends £3bn a year providing beds for elderly patients who no longer need one.
In the end, I’m afraid most of these problems do come down to finances. The recent announcement of more money for the NHS is welcome, but it will only help to meet the rising demand in healthcare and does nothing to resolve the crisis in adult social care.
For the National Health Service to succeed into the future, it needs innovation and proper funding. There now appears to be a political consensus around the need to preserve the founding principles of the NHS.
Hopefully the 70th anniversary of what Bevan called “the most civilised step a country can take” will inspire our politicians to ensure that the serenity it provides is safeguarded for future generations.
Alan Johnson is the former MP for Hull West and Hessle. He was Health Secretary from 2007 to 2009.