This week marks the 75th anniversary of the NHS.

Members of the Beacon team reflect on personal experiences, the concept of a public healthcare system, and the people who work tirelessly within this unique institution.

Dan Harbour, Managing Director:

“The NHS care my family received when going through two pregnancies and deliveries was fantastic, timely and caring. Likewise any treatment / investigations my immediate family has needed have been timely, professional and high quality. The clinical expertise and advice provided to my mum’s care home by the community palliative team made that whole situation much more bearable for my family, and comfortable for her. The dedication of those NHS staff who put themselves on the front line, providing an exhausting level of work at great risk to themselves during the Covid-19 pandemic is, in my opinion, remarkable.

Continuing Healthcare bucks the trend for many people who go through the system. I have met some fantastically gifted strategists who have genuinely tried to improve the system and some highly motivated and caring nurse assessors and CHC managers who have battled pressure from above – often driven by fears over spiralling costs – to make sure people are assessed correctly, looked after along the arduous CHC journey and given the care that they are entitled to.

But sadly the system is far too subjective and prone to both economic pressures and massive individual performance variability with poor attitude, cynicism and burn-out often at the heart of that variability. The poor practice, lack of consistent training, uncompliant local policies and individual competency issues individuals can experience by a stretched, demoralised and underfunded workforce can have a devastating impact on those in our society who are at their most vulnerable.

But I want to acknowledge the amazing work done by so many doctors, nurses and support staff across the country over the past 75 years, the positive impact the NHS has had on so many millions of lives and the fact that we don’t have to get our credit cards out to call an ambulance. Here’s also to those who are working tirelessly and skilfully within the CHC system with the right intentions and the right attitude, to do the best for their patients and communities in such an incredibly challenging system.

Happy birthday NHS!”

Rob Walsh, Casework Service Manager:

“The NHS is guided by a number of key principles, including that it is a comprehensive service available to all, free at the point of delivery and based on clinical need not on an individual’s ability to pay. To paraphrase Aneurin Bevan, illness is neither an indulgence for which people should have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community – and arguably no society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means.

There are of course those who advocate for a private / insurance-based system instead, however it is worth noting that by comparison the USA’s system (the only developed nation without a system of universal healthcare) spends far more on healthcare – including per capita – than any other nation yet has significantly worse healthcare outcomes compared to peer nations. It has led to a significant proportion of its population having no ability at all to access adequate medical care, with this disproportionately affecting minorities and those on lower incomes, and with medical debt contributing to nearly 50% of all personal bankruptcies. The only people who benefit from such a system are the private companies making money from it – to be able to charge for healthcare is incredibly lucrative for businesses, with people having no choice but to either pay arbitrary costs or go without healthcare – and not the citizens.

Whilst the reality of delivering the NHS is complex and challenging – in 2010 the NHS was ranked the best healthcare system in the world, but since then it is has significantly declined – to my mind it is crucial to remember that the NHS belongs to, and is for, the people. It does not exist so that organisations or individuals can make money from it, but to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. Whilst it is of course legitimate to criticise its failings on a practical level, it is important not to allow these to obscure its purpose and principles. When the NHS is struggling – including if this is by design – then to my mind fixing it must always ensure these principles remain intact, fully protected and central to decision-making. It is something we must protect and help improve, holding governments to account for its failings rather than turning against its founding principles and allowing these to be chipped away at.”

Amy Sumner, Marketing & Communications Executive:

“Like many others I was profoundly moved during the Covid-19 pandemic by the selflessness, dedication and commitment of NHS workers and healthcare professionals who seemingly unquestioningly kept calm and carried on, delivering frontline services in an environment we were very much learning about as it developed. It made me reflect on just how fortunate England is to have an institution as readily available and readily willing to step up – truly altruistic, truly operating for the sake of ‘the greater good’. The seemingly tireless actions of these individuals caused me to reflect on my own altruism – what was I giving back to the society I was part of? It effected real personal change for me, I’m sure like thousands of others around me.

Writing this in July 2023 against a backdrop of further planned strike action (NHSE says that to date more than 600,000 appointments have been cancelled as a result of strikes) and ongoing staffing shortages (one in every 10 posts are currently unfilled) makes this feat even more remarkable.

Like any large organisation, within the NHS there are areas which require real reform and improvement, and our field of Continuing Healthcare is undoubtedly one of these areas. Complex legislation, chronic understaffing and a lack of dedicated CHC training go some way to explaining the difficulties this field faces. But as evidenced by the ongoing industrial action, this is an entire institution that is currently being failed by underfunding and understaffing in a very real way.

It’s telling how often reflecting actually involves looking ahead.

At its launch on 5 July 1948 one of the core principles at the heart of the National Health Service was that it meet the needs of everyone. So congratulations to the NHS on 75 years of tireless national service, and here’s to looking ahead to further reform, progress and change from outside and within, to ensure that this institution meets the needs of both those who require its care and support at their most vulnerable, and those of the people enacting front line delivery.”