Saturday, 5 July 2008

Hope represents kidney care at NHS celebrations

Congratulations: 60 years ago the NHS was born, in Manchester at Park Hospital, Trafford. Aneurin Bevan’s vision of a national service, universally available to all, irrespective of their ability to pay, served as the inspiration for the modern NHS we see in action today across the country. Since that time, the NHS has served our communities well and we are rightly proud of its achievements.
In 2006, The Commonwealth Fund ranked the NHS the highest performing service in a study of many of the world’s industrialised nations, higher than the USA, Germany, Sweden, New Zealand and Australia.
I was privileged to be invited to the ceremony at Westminster Abbey on 2 July 2008 to celebrate this achievement but unfortunately was called to another event. Jonathan Hope (kidney transplant recipient from Guys & St Thomas’s Hospital) attended in my stead and, from his feedback (and in his own words) “the highlights of the ceremony included Bevin's inspirational broadcast signalling the establishing the NHS where he talked about revealing and treating the nation's `silent suffering. This was supported by a patient describing in uplifting detail how the NHS healed his tongue cancer with a couple of months, giving him back his voice and a padre who gave the main sermon advocating that the future of the NHS hinges on the ability of clinicians to shift to a whole person approach! Inspirational and uplifting stuff!”.
A little known fact is that, in the famous photograph of Aneurin Bevan at Park Hospital, the young lady in the bed is suffering from post streptochoccal glomerulornephritis – a condition that is now vanishingly rare in the UK probably because of a combination of public health measures and shift in the antigenicty of the bug.
The burden of chronic kidney disease of course continues to grow. Latest estimates suggest that around 10% of the overall adult population have some degree of CKD and we know from the Renal Registry and our own practice that advanced kidney disease grows year on year. With an aging population it is likely that the requirements for dialysis will continue to grow year on year for at least the next 15 years however good we get at increasing organ donation and transplanting our patients.
The greatest asset (by a long, long way), of the NHS is its staff. Despite the image of hospital services in the papers when I speak to patients they are nearly all pleased with the quality of care that they have received. They comment on people going out of their way to make appointments work for the individual, the care and compassion of nurses, the importance of other key specialist members of the team – dietitians, social workers, technicians, physiotherapists, speech therapists – the list is long.
Individuals respect and believe their doctors more than nearly any other group in society – certainly more than politicians and senior managers. This anniversary is therefore a good time to reflect on what we want for our service over the next decade to meet the aspirations of the public and the challenge of increasing demand. We need to go beyond reform to transform. We need to recognise the importance of patients’ experiences as much as outcomes. Nationally, we now spend over £100 billion a year on the NHS. We have some of the best staff in the world. Our services are not yet world class – but they can be, each and every one of us has a role to play in achieving that.