This Christmas the country came together to celebrate the NHS with the song Bridge Over You by The Lewisham and Greenwich NHS choir reaching number 1 in the charts .
The NHS frequently comes top in lists of things people are proud of about Britain. Nigel Lawson [a former Minister for Health] once famously said that ‘the NHS is the nearest thing that the British have to a national religion.’
The core principle of the NHS is that good healthcare should be available to all, regardless of wealth. The NHS is ‘free at the point of use’1 (free to see a doctor, you pay in other ways-through taxes, national insurance) for around 65 million people (2010). Only certain prescriptions and certain optical and dental services are chargeable – [These are free in Wales and Scotland.]
‘Since its launch in 1948, the NHS has grown to become the world’s largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive.’-nhs.uk
The NHS is this country’s biggest employer. World wide it is the fourth largest. Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people. It receives a budget of in excess of £100billion.
Medical applicants need to know about the NHS. This is why there is a whole chapter on the NHS, its origins, principles, structure and how it runs in my book [chapter 3] Medical School Interviews, All You Need To Know. The Knowledge. The NHS funds the training of medical students for their clinical years [the expensive last two years] and it trains all junior doctors.As a potential medical student you should know about how it was founded, its core principles and how it runs. Its principles and ethics should become part of you.
We have a lot to be proud of. Our medical schools and Royal Colleges and training are highly rated. Those of you who will become doctors in this country have the satisfaction of knowing that your medical degree is accepted and welcomed worldwide. The UK invented among other things MRI scans, CT scans, and IVF and we have won 34 Nobel prizes for medicine – more than any other country apart from the USA. The NHS model of primary care is highly regarded. The skills and the ‘gate keeper’ role of GPs are important in keeping costs down [see p 56 of my book Medical School Interviews All You Need To Know The Knowledge]. The National Institute of Clinical Excellence [NICE] is well regarded as a leader in evidence based medicine [p 69-72]
All countries face enormous challenges with regard to health care. All developed countries have rapidly rising health care costs because of an ageing population, obesity and increasing technology. Enoch Powell, a former Health Secretary declared spending on health ‘a bottomless pit’ and indeed it can be. Britain however spends less of its GDP on health than any other developed country yet it does well in its performance with good survival and treatment rates for chronic conditions and mid ranking rates for cancer survival compared with other developed countries. The USA which has almost non existent primary care, spends twice as much of its GDP as Britain on health care yet has the worst health care statistics of all the developed nations. In August 2011 The WHO [World Health Organisation] showed that the UK saved more lives for each pound spent than any other developed country [apart from Ireland] over 25 years.
It does have problems and faces major challenges and we should all strive to improve it. However like virtually all doctors, I am profoundly grateful and proud to work for the NHS and truly appreciate the fact that I never have to add to a patient’s distress by demanding payment!