Wishing the NHS an even longer life as it turns 70

Inequalities in health characterised by huge variations in life expectancy are unacceptable in this, the 70th anniversary of the NHS, which was created out of the ideal that good healthcare should be available to all, regardless of wealth.

Health inequality appears to have been increasing for much of the past 10 years, and indeed has done so at many points since 1948 when the NHS was formed. But it is not inevitable that this trend continues.

Excellent health and social care services must be available to the communities and people most in need. If healthcare makes a difference, but is not distributed according to need, the NHS itself widens inequalities in health.

Therefore one of the acid tests of the forthcoming long-term NHS Plan should be whether the poorest patients and communities benefit from the new investment promised.

We acknowledge the significance of the wider determinants of health, such as childcare, housing and education, as well as adopting practices within the NHS that promote wellness. So it must be that all parts of government and society put their shoulders to the wheel in the pursuit of health equality.

The prime minister called it a “burning injustice” that, “if you’re born poor, you will die on average nine years earlier than others”. We agree. Let us all work together to bring that injustice to an end.
Rachel Power Chief executive, Patients Association, Stephen Watkins Vice-president, UK Faculty of Public Health, Nitin Sodha Chair, National Pharmacy Association, Victor Adebowale Chief executive, Turning Point, Jim Minton Chief executive, Toynbee Hall, Merron Simpson Chief executive, New NHS Alliance, Paul Farmer Chief executive, Mind, Bridget Turner Director of policy and care improvement, Diabetes UK, Andrew Kaye Head of policy and influence, Macmillan Cancer Support, Dr Adam Todd Reader in pharmaceutical public health, Newcastle University, David Lock QC, Matina Loizou Co-chair, Prescription Charges Coalition, Dr James Noyes ResPublica

• As the NHS turns 70, we are right to celebrate it – and not only because it provides efficient and equitable healthcare here in the UK. The NHS is a beacon of hope to millions of people around the world, demonstrating that universal, publicly funded healthcare is possible. The world would be a better, healthier place if every country had an NHS.

But as things stand, the UK often undermines other countries’ attempts to build their own NHS. We undermine poor countries’ ability to build a decent tax base by supporting tax havens and enabling British companies to shift profits out of those countries. We promote and enforce privatisation through trade and investment agreements, threatening our NHS too. We promote private finance initiatives (PFI) for healthcare projects around the world, despite knowing that PFI has made our NHS more unsustainable. We fail to rein in big pharmaceutical companies that charge too much for drugs. And despite all this, we continue to blame the governments of poor countries for not investing enough in their healthcare systems (and indeed some that can should invest more) – ignoring our own significant role in diminishing their potential health budgets.

As the NHS turns 70, we must ensure not only that our NHS exists for another 70 years, but that we do everything in our power to promote affordable, public healthcare around the world, learning from what we have done right (and wrong), to ensure everyone, everywhere has access to an NHS.
Natalie Sharples Head of policy and campaigns, Health Poverty Action, Prof Allyson Pollock Professor of public health, Institute of Health and Society, Newcastle University, Iona Heath Former president of the Royal College of General Practitioners, Chiara Bodini and David Sanders Co-chairs, People’s Health Movement (PHM), Rob Yates Political health economist, Fanwell Kenala Bokosi Executive director, African Forum and Network on Debt and Development (Afrodad), Dr Youssef El-Gingihy GP and author of How to Dismantle the NHS in 10 Easy Steps, Dave Prentis General secretary, Unison, Dave McCoy Professor of Global Public Health, Dr Modi Mwatsama Director of policy and global health, UK Health Forum, Rosa Pavanelli General secretary, Public Services International, Bernard Anaba Policy analyst, The Integrated Social Development Centre (Isodec), Ghana, Amit Srivastava India Resource Center, Sophie Neuburg Executive director, Medact, Sarah-Jayne Clifton Director, Jubilee Debt Campaign, Nick Dearden Director, Global Justice Now, Asad Rehman Executive director, War on Want, Jane Lethbridge Director, Public Services International Research Unit (PSIRU), Elizabeth Rowley Director, T1International, Dr Joe Holly Co-director, Global Labour Institute, Bert Schouwenburg International officer, GMB, Steinar Westin GP and professor of social medicine, Trondheim, Norway, Jonny Currie GP and public health specialty registrar and People’s Health Movement UK, Diarmaid McDonald Lead organiser, Just Treatment, Wim De Ceukelaire Director, Third World Health Aid, Kiama Kaara Kenyan Debt Relief Network (Kendren), Ricardo Navarro Cesta At, El Salvador, Abdul Khaliq CADTM Pakistan, Deborah Burton Co-founder, Tipping Point North South, Sophie Strachan Co-chair, Sophia Forum

• Polly Toynbee is absolutely right to warn us that Theresa May’s birthday present to the NHS is mere wrapping paper (The NHS crisis will go on: this is a plan that no one believes in, 19 June). Here in Bristol, North Somerset and South Gloucestershire alone, the local NHS is expected by NHS England to reduce its expenditure by £305m by 2020. Similar, and in many cases much larger “savings targets” are in place across all 44 NHS regions in England. The national reduction in NHS expenditure required by 2020-21 amounts to a staggering £22bn. This is all happening under the guise of encouraging “sustainability and transformation” of the NHS.

This latest gift to the NHS seems a clear example of what used to be known as giving with one hand and taking away with the other.
Mavis Zutshi
Protect our NHS Bristol

• Four years ago, at the age of 50, I had an operation to replace a heart valve. The procedure was necessitated by a bacterial infection, endocarditis, which did not clear up following the usual antibiotic treatment. The infection caused an abscess on my heart valve which made emergency surgery the only option. I’d had no prior symptoms and hadn’t been ill.

The infection and subsequent operation resulted in me having an 11-week hospital stay, but four years on I’m perfectly well, with no after-effects and am no longer on any medication. The NHS saved my life and made me well again and I can’t thank the doctors and nurses enough for their care and professionalism. During my hospital stay I saw first hand the effects of the funding cuts our NHS has been subjected to and the heroism of the health professionals who treated me and others. Any government that does not fully fund the NHS and ensure that it remains a free service available to everyone when and where they need it does not deserve to be in office. Any government that seeks to introduce any element of private enterprise into the service is beneath contempt.

I and many others owe their lives to the NHS and its dedicated staff. It is a fantastic institution that must be defended. I will do all I can to ensure that it not only remains intact, but that it flourishes to save and protect the lives of my fellow citizens now and well into the future.

As the NHS is turning 70 on 5 July 2018, this seemed like an appropriate time for me to pen this message and to say a heartfelt thank you.

So thank you NHS. For everything.
Andy Walker
Ramsbottom, Greater Manchester

• If national insurance contributions were calculated by reference to all income (bank interest, dividends, capital gains, pensions etc), the problem of funding the NHS would be resolved. It would also be fairer sharing the burden more widely.
Michael Hall
Letchworth Garden City, Hertfordshire

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