Our health service is the envy of the world, so let's cherish it

As the NHS celebrates its 60th anniversary, Dr Peter Terry says we should be proud of the service it continues to deliver, particularly in Scotland.

I WAS born in 1952, four years after the NHS was established. The health service has therefore been integral to my whole life. For me, an interest in science and the attraction of a useful and rewarding career was what led me into medicine. I trained in the NHS and have been proud to work in it ever since.

It is hard to imagine what life would be like without a health service that is free at the point of delivery.

Imagine every time you go to see your GP, visit A&E, get your child immunised or encourage your parents or grandparents to get their flu vaccine – having to pay individually for all those dealings with the NHS.

The NHS is truly something to be proud of – good quality healthcare available to everyone, from the cradle to the grave.

There is often a lot of criticism of the service, but it's worth taking a step back and realising that we have something that we should cherish and fight for.

Since devolution, the NHS has undergone many significant changes. Some would say that we no longer have a single national NHS but four – different ones in each country within the UK.

Nowhere is this more apparent than in the divergence of healthcare policy between England and Scotland.

In April this year, health ministers from the devolved nations of Wales, Northern Ireland and Scotland met to discuss health policy and issued a joint statement which made a commitment to a publicly funded and publicly delivered NHS.

This is very different to health policy south of the Border, where there is an increasing role for private healthcare providers in both the primary and secondary care sectors.

The British Medical Association is proud that the NHS in Scotland has kept to its founding principles and its commitment to partnership and collaboration, rather than competition and fragmentation. The medical profession's disappointment with the direction of health policy in England will become even more apparent during the BMA's annual conference, which takes place in Edinburgh this week.

Doctors will debate motions on English Government policy that "deplore the waste of public money and resources" due to the costs of using private companies who are making profits for shareholders.

Other motions condemn Government policy which, it is claimed, has undermined and fragmented core NHS services and diverted increasing levels of funding out of the public sector.

Looking to the future, I believe that there will be even greater divergence of health policy that will have consequences on UK-wide health policy, such as the training of junior doctors and the regulation of the profession.

In my view, the greatest achievement of the NHS is the contribution it has made towards increasing life expectancy which is due, to some extent, to access to universal healthcare. However, a great many challenges remain to tackle the growing health inequalities that exist in Scotland. In 2002, men living in the most disadvantaged areas had a life expectancy almost nine years less than men living in affluent areas. For women, the gap in life expectancy was five years.

Securing good health for all members of society requires co-ordination across all areas of Government policy, since our health is affected by a whole range of social and environmental factors. We have a great many public health challenges to tackle.

In Scotland, more than 13,000 people die every year from tobacco use – the equivalent of 35 a day.

Alcohol misuse costs the NHS in Scotland an estimated £110 million each year, and accounts for around one in 30 of all deaths in Scotland.

Almost two-thirds of men and half of women are either obese or overweight, while one inthree children is overweight by the age of 12.

Physical inactivity is one of the contributors to coronary heart disease, a condition which affects half a million Scots each year.

If we can tackle these public health challenges, we will become a healthier nation. The NHS is no longer a service that just treats the sick. There is an increasing role for doctors in managing long-term conditions and preventing hospital admissions.

A survey published by the BMA this week found that although the public supports the principles of the NHS and wishes to preserve a tax-funded system, it is clearly worried about the future funding of the service.

The public may also fear that, with rising drug and treatment costs, advances in technology and increasing demand for services, the NHS will no longer be able to afford a universal system of care.

While there may well be the need to debate what the NHS can afford within limited financial resources, it would be a travesty if charges were introduced. It would destroy the ethos of a healthcare system valued by patients and admired right across the world.

The Government must take steps to reassure the public that it intends to maintain a tax-funded NHS, not just in the next ten years but for the foreseeable future.

• Dr Peter Terry is a consultant in obstetrics and gynaecology working in Aberdeen and is chairman of the BMA in Scotland

THE FACTS

• Every week, the NHS delivers more than 10,000 babies, and carries out 1200 hip and 3000 heart operations

• Only the Chinese People's Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more than the 1.5 million people who work for the NHS

• Life expectancy in the UK was 69 when the NHS was founded on 6 July, 1948. Today, it is 77 and rising by a year every four years

• When the NHS was launched it had a budget of £437m (roughly £9bn at today's value). It now receives well over ten times that amount – £105bn, with the budget having almost trebled in the last ten years alone