In numbers terms, the article pointed

to something of a patchwork at the time, with ‘the State’ taking over more than 400 hospitals with 65,000 beds, with 80 percent of general practitioners to become ‘enrolled’, and the response of dentists and pharmacists, ‘not yet known’. Te hospitals were to be administered by five Regional Hospital Boards and ‘85 Boards of Manage- ment’. Fifty-five local health authorities – County Councils and the Town Councils of Burghs – will ‘continue to be responsible for such matters as the care of mothers and young children, and will provide a number of additional services, including domiciliary midwifery, home nursing, and vaccination and immunisation,’ the report added. And the cost of Bevan’s vision, for

Scotland at least? It was to be an estimated £25,000,000 per year, £4,000,000 of which would be provided for by the new ‘National Insurance Scheme’. During the 70th anniversary of the NHS,

it is of course right that we look back at its foundation and the campaigns and break- throughs which have marked its course in Scotland. Tere are too many achievements to mention, but the pioneering work of obstetrician Professor Ian Donald – along with engineer Tom Brown – which gave way to the first ultrasound scans in Glasgow in the late 1950s, Elsie Stephenson’s contribu- tion to nursing studies in Edinburgh in 1956, the UK’s first successful kidney transplant carried out by Sir Michael Woodruff at Edin- burgh Royal Infirmary in 1960, the world’s first MRI service launched in Aberdeen in 1980 and bioengineer David Gow’s ‘bionic hand’, in 2006, are among the standouts.

But fast forward to 2018 and the service is a very different beast to the one conceived in 1948. Te annual budget of the NHS in Scotland is now £12bn, with spending having risen as a proportion of gross domestic prod- uct (GDP) from just over 2% in the early years to 7% annually today, and supporting more than 300 hospitals, with 16,503 acute beds and 157,000 staff. With an A&E visit every 20 seconds and the proportion of over-75s estimated to grow by 25% in the next 10 years (this age group is more than 3.5 times likely to be admitted to hospital), thanks largely to the NHS’s own medical advances, the ‘free at the point of use’ concept is under greater threat than ever before. Dr Peter Bennie, a consultant psychiatrist from Paisley and Chairman of the British Medical Association (BMA) Scotland, did not mince his words recently when he said the service, which doctors themselves believe to be chronically under-staffed, is now “on the brink”. He says: “Te NHS was a child of its time;

my understanding is that there was a real fear and even an attempt to pre-educate the public that although treatment would be available if they needed it, it was really important that people effectively rationed themselves and didn’t all turn up on day

Nurses at Gartnavel Royal Hospital in Glasgow hoist a flag to mark the beginning of the NHS in Scotland on July 5, 1948

one demanding appointments and opera- tions. People were used to rationing in the war, where everyone pulls together and it’s tempting to think that mentality helped to get it off the ground. But there’s not too many people still around who were adults when the NHS came into being; we’re used to that being an expectation, most people think of it almost as a right within the UK. Of course, you don’t need to move too far from the UK to recognise it’s not so much recognised as a right, it’s been a very clearly made political decision.” Despite it being founded on “clearly

socialist principles”, unlike much of the rest of the country now, Dr Bennie says

This leaflet was distributed to every household in Scotland and a diagram explained how the new health service would function

NHS70 | SUMMER 2018 | 15

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