Over the past 70 years the NHS has become the darling of the British public. Born in 1948 to a post-war Britain and a skeptical medical profession, the NHS has had its ups and downs over the years. However, its role and importance as a symbol of our Britishness and intense pride in being able to provide universal care, free at the    point of delivery, has remained throughout.

Care, at that time, was based on the doctor/patient relationship with all others working to support this. The nurse acted as ‘handmaiden’ to the doctor, physiotherapists could not provide treatment unless it was prescribed by a doctor and prescribing drugs was the domain of medical staff only. How things have changed! The care of patients has been enhanced enormously by the education, training and development of the workforce.

Improvements in social conditions and public health, together with new medical devices, surgical procedures, drugs and interventions have effected changes survival and increased life-expectancy.

No longer do we only perform single episode acute or elective treatments while administering to the sick and comforting the dying. Methods of patient management and ways of delivering care have evolved to lengthen life. This can only be a good thing, but with patients living longer we must accept further challenges in patient management and ways of delivering care. Challenges which are not easy to overcome today and look set to get harder in future.

To help celebrate the NHS at 70 the Academy asked our members – representing all medical specialties – what they thought was the single greatest development in their area of medicine in the last 70 years.

True to form, our members took a range of approaches, one even went as far as to organise a ballot of their members! The results were fascinating and highlighted just how far we have all come in medicine since the start of the NHS – and how things we take for granted now were, once upon a time, new breakthroughs.

The Royal College of Paediatrics and Child Health indicated that for them it was the simple inhaler for children with asthma. The faculty of sexual and reproductive health, not surprisingly, said it was the contraceptive pill. The Royal College of Anaesthetists suggested the laryngeal mask airway.  The cardiologists from the Royal College of Physicians of Edinburgh plumped for the first implantable pacemaker. The Royal College of Physicians of London took a different approach and argued that banning smoking in public places has – and will continue to have – the greatest impact on health in the future.

Looking into the future many suggested genomics and personalised medicine will improve the quality of care in the next ten years.  We will watch and we will see!

This wonderful insight is available on the Academy’s website as part of the celebrations this year.


Professor Carrie MacEwen, Chair, Academy of Medical Royal Colleges

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