70 years in pictures ➜

Scotland’s NHS the NHS “clearly has the backing of the

public and has done throughout much of its lifetime”. As to whether the NHS’s core principle of

being freely available will continue forever, Dr Bennie, concludes: “It’s so hard to know, and that’s writ large through medicine. What we can be reasonably certain about is that there will be substantial advances in various differ- ent fields of medicine over the next 30 years, which is a good number to pick because it takes us up to the centenary. But what we don’t know is where those advances will be, when they will be and what they will be.” Dr Bennie says a good way of looking at the

future is to look to the past, and mentions his own city of Glasgow which is surrounded by “at least half a dozen hospitals” which, when they were built, were purely for the treatment of respiratory diseases, primarily TB, when the disease “killed” or “crippled” its sufferers. “All of those hospitals have of course now closed down, having gone through six or seven stages of doing different things. We haven’t needed specific TB hospitals with hundreds of beds for many, many years, because a treatment was developed.” He says: “Te hope and expectation is that

with various conditions which currently cause great stress to individuals and their families, and cause a huge burden to society, that we will be able to treat them, but we don’t know when. And it’s so hard to plan for that kind of thing.”

One thing the government and local authorities are all planning for, though, and which has been described as this genera- tion’s single biggest reform, is the integra- tion of health and social care. Dr Bennie believes it is the right course of action but fears that unlike in the 1980s and 90s, when there was sufficient ‘bridging funding’ to allow the transition of services from hospital to community care, that there isn’t enough slack in the current system. It is, he says, a “real, real challenge”. “Te key issue is people will often think

if we can reduce the number of beds in a ward and therefore reduce the staffing a little that frees up significant amounts of money that we can then place in community care,” he says. “But actually the economies of scale are such that you don’t really make significant financial savings unless you’re at a position where it’s genuinely safe to close down whole units or whole hospitals. And two problems flow from that. One is that it’s a much bigger undertaking in the first place, so you’ve got to have the community facilities up and running and doing the job, and the other one is the local politics of shutting a local hospital. People will always see the closure of a hospital as a bad thing, but often it’s the appropriate thing to do, both in order to improve the quality of care in a hospital and in the community. But it’s almost impossible to manage that in a way that satisfies everybody.” n

16 | NHS70 | SUMMER 2018

Trailblazing women who changed the status of their professions

Elsie Stephenson and Maggie Myles leave a legacy that has shaped nursing and midwifery in Scotland and the world over



he idea of nursing as a subject fit for study at university level was first suggested in 1900 by Mrs Bedford Fenwick, a British nurse who campaigned for the profes-

sion’s first national certificate. It would take another 56 years for the subject to be

officially recognised as worthy of higher education attainment, when Elsie Stephen- son – who reportedly wanted to become a nurse aged three after her father died in the 1919 influenza epidemic – became the first director of the Nursing Studies Unit at Edinburgh University. A trailblazer who pre- vailed against stuffy attitudes among some academics because she was ‘not a gradu- ate’, Stephenson is one of the lesser-known figures within the NHS’s history in Scotland over the last 70 years, but whose contribu- tion to education in the field helped set the standard for generations to come. Maggie Myles, an Aberdonian midwife, is

another whose work in her her own disci- pline has become synonymous with setting the standards worldwide. First published in 1953, Myles’ ‘Textbook for Midwives’ remains the world’s most popular midwifery manual. It still sells in more than 75 countries and is

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