Medical and technological innovations over the past 60 years have led to major advances in health care since the NHS was created. Health Correspondent Emma Brady asked staff and volunteers what changes have had the biggest impact.
Shaunagh Wand was a nurse at St Thomas’s Hospital in London between 1950 and 1960. She is now a League of Friends volunteer at Queen Elizabeth Hospital, Edgbaston.
“I was a Nightingale nurse when I qualified in 1950. The NHS was seen as a marvellous innovation and our training was superb, but tough.
We would be apprentices for a year, spending most of our time on the wards, fetching bed pans, washing patients and working under keen supervision of a ward sister or matron.
They would come round and run their fingers over everything doing regular dust checks.
Back then the patients were ‘gods’ so everything had to be done perfectly for them. Everybody appreciated that but I think the NHS has moved on from that belief now.
When I first started I was on a ward where they had started doing heart operations, and lots of them died, but the advances in medicine since then have been tremendous, and as a result people are getting more effective treatment and living longer.
As far as nursing goes, I think it’s good that nurses are getting university qualifications, but they’re becoming more academic than practical, there’s been a definite shift away from what we called ‘bedside nursing’.
Patients were in bed longer than they are today, and I’m sure nurses still do a good job, but all this MRSA and C.diff must mean something’s gone wrong. I think it’s the ward supervision that’s lacking.
I think free visiting was a great mistake. When I was nursing you could only have two visitors at a time, during restricted hours, and they couldn’t touch the bed, let alone sit on it. I think this is how many of these infections arrived on our wards.
My husband, Soloman Wand, was a GP in Balsall Heath and the practice where he worked has been named after him.
Before the NHS came into being he was helping patients to pay for treatment and he would see patients out of hours, and did surgeries on Saturday nights. He wouldn’t leave until he’d seen his last patient which could be as late as 9pm.
I agree you can’t work around the clock but I do feel the ‘family doctor’ no longer exists, in that you can go to a practice and see a doctor, but it could be a different one each time.
They don’t know you, your children or family history, and I think that’s very important, so the advent of polyclinics may improve access but won’t do anything to improve the doctor-patient relationship.”
Join the National Elf Service
Chris Ellis, director of clinical services for Heart of England NHS Foundation Trust, which runs Good Hope, Heartlands and Solihull hospitals. He began his career as a junior doctor at the Middlesex Hospital, in London, in 1971.
“Before I even qualified as a house physician and started work at the Middlesex, my first memory of the NHS was from a pantomime I went to when I was about seven years old.
There was a joke about the ‘National Elf Service’ which got a good response, not jeers or boos, so six years since its creation there was already great public affection for it.
I’m always amazed what was achieved 60 years ago, because we were only just figuring out how to use antibiotics and surgery techniques were very primitive compared to the procedures that are regarded as routine today.
Consultants more or less ran the show at the Middlesex. There were ‘lay managers’ but they tended to remain in the background dealing with the business side of running a hospital, they weren’t really involved in front-line patient care.
But now managers and MPs are getting more involved in care issues, and the deference to the medical profession – that “doctor knows best” – has gone. I do think the pendulum has swung too far in that way.
Incidents such as the Harold Shipman inquiry and the Alder Hay scandal are entirely exceptional, but politicians have been quick to seize on them as examples of what can happen if the NHS is left to run itself.
It is a disservice to the amazing advances that have been made in medicine to focus on such rare situations.
Antibiotics emerged after the Second World War – there was nothing else in 1948 when my father was a doctor.
Now the British National Formulae contains 600 pages of drugs and medication, of which 598 have been developed in the past 60 years.
As a neurosurgery house officer in the early 1970s, surgeons had no other option when treating an aneurism but to open the patient’s skull and clip the weakened blood vessel.
Recently Birmingham City boss Karren Brady was diagnosed with the same condition but instead of performing open surgery, her aneurism was successfully treated by passing a coil up through her body to the brain to clip that vessel.
However the technology is not the biggest change, it’s the most striking, but the fact that the population is living longer is testament to all that the NHS has achieved since 1948.
Looking after the bed pans
Frances Soocoormanee became an enrolled nurse in 1968 and, after working at various Midland hospitals, is now staff convenor at Heartlands Hospital in Birmingham.
“Enrolled nurses were ‘bedside nurses’ when I qualified, which basically meant our role was to see to the patients’ needs, whether it be a bed pan or pain relief.
The problem with that was you could end up being the only one on a ward at night, but there have been some excellent changes since then, especially in nurses’ training.
However I do think student nurses should be allowed to do more ward placements, so they get used to nursing practice in the real world and treating real patients. At present I don’t think they’re getting enough experience to back up their academic knowledge.
They need to go beyond the textbooks to be able to sense when something’s not quite right and share that information with the doctors.
Back then patients were used to being told what was wrong and what treatment they would get because ‘doctor knows best’ but now they’re more knowledgeable and more likely to ask for specific drugs or surgery as a result of surfing the internet.
After working at the Corbett in Stourbridge and Birmingham Accident Hospital, I went on to become an industrial nurse, working without much of that support you’d get on the wards, so that’s when a nurse’s instinct is vital.
I was working on construction sites, so I saw some pretty gruesome injuries, as well as a different side to nursing.
I also remember a major ’flu epidemic in the late 1960s which put real pressure on the wards. We used to be able to put emergency beds on the ward and any other space where we could fit one in, but you can’t do that now due to health and safety, and infection control rules.
We had our own cleaning staff on the ward those days, who would be managed by the ward sister, and they took real pride in their work and felt as if they were part of the team.
But now we’ve moved away from that and contractors are doing that job instead, and deep cleans aren’t done routinely like they were between the 1960s and 1980s, because demand for beds is so much higher. Back then there was time for beds to go “cold” before the next patient came in and visitors weren’t allowed to touch the bed let alone sit on it, but as we get more patients now we’ve got more visitors spending longer on the wards, which is how many bugs get into hospitals.”
How waiting times reduced
John George entered the NHS as a trainee lab technician in 1970 and now he’s preparing for the future – he will organise the Queen Elizabeth and Selly Oak’s move into the new University Hospital Birmingham, which starts in 2010.
“During my career there has been a big reduction in waiting times. For example it used to be one year for an MRI scan but that’s now just a few weeks, and cancer patients used to wait 14-plus weeks for radiotherapy, and that’s now just two weeks. This is partly down to the introduction of Government targets but it’s been coupled with huge investment in new equipment.
Millions have been spent on new equipment and diagnostic tools, which has had a big impact on patient outcomes as people are being diagnosed and getting the relevant treatment much more quickly.
One of my roles included responsibility for cancer care, which accounted for 25 per cent of hospital services at the Queen Elizabeth.
Cancer services existed in the 1970s but it was much more rudimentary with less sophisticated equipment.
Now with all these technological developments, the expectations on referrals from doctors and consultants is they expect patients to get tests or treatment that were either very difficult to get or unavailable in the 1970s and 1980s as a matter of routine.
Also until quite recently, until 2002/03, we had to send patients who needed a PET scan – a form of MRI – to the Royal Marsden in London because we didn’t have the equipment.
What is startling is that when I started out at the Accident Hospital, in Birmingham, as a student, there was a very obvious team ethic, with small multi-disciplinary teams with everybody working together, but those were ruined as the NHS became more mechanised and more management-orientated.
Technology and the use of IT are the biggest changes as we’ve moved quite quickly from passing pieces of paper round a room to being able to access records and results at the click of a mouse. Although the NHS has become a bit of a political football for MPs to kick about, I think people who work in the NHS remain dedicated to providing a good service, which continues to be free at the point of need.”