From the cradle to the grave

The country waited with varying degrees of interest for the birth of the future King or Queen. Folk speculated on the gender, name, birth weight. Sweepstakes were run in workplaces. Around the country the picture is replicated for thousands of families, all awaiting their own special arrival, without the sweepstakes. The unusually fine weather will be uncomfortable for those mothers blooming in their final trimester, following their nesting instincts, but is warmly welcomed by most others. The newest Royal will have excellent medical care but is unlikely to need the frontline NHS. Nearly all others will. And it will be there - for delivery, neonatal and postnatal care, six-week checks, immunisations and every other eventuality in between. Sixty-five years in and we have come to depend on and expect those services, free at the point of contact.

For the elderly we medicate, monitor, respond to crises (with varying degrees of success) and palliate, until the grave. The elderly have been hardest hit by the heatwave, with 700+ deaths and counting. Trying to keep cool, in a country where air conditioning is rare and usually unnecessary, is particularly difficult for those who cannot strip off and jump into the nearest water feature. The elderly also find drinking sufficient fluids problematic (for many reasons) and dehydrate, constipate and become confused - also needing medical care.

Most living now will have little memory of having to find a shilling before the doctor would call. Of having to sit out whatever was ailing the family, because they couldn't afford the doctor's time or treatment. Nye Bevan had famously "stuffed our mouths with gold" making doctors commit to the NHS and leave exclusive, lucrative private practice. His decision to do so has impacted positively on more families than he might have imagined. But where are we heading?

As time passes, expectations of both the public and those who govern them, rise. We are vilified when it is politically expedient. Speciality is set against speciality. Hospitals are criticised and put in 'special measures' for high mortality rates and GPs are greedy and lazy. If the NHS has come to the end of its useful life, who will be strong enough to put it on the Liverpool Care Pathway? The NHS is like a favourite aunt, who was there for you whenever you needed her - nobody can bear the thought of being without her, let alone consenting to her being allowed to die.

Nye Bevan we need you now. We need a person of vision to see how healthcare in this country can develop in the next 100 years and they will also need the strength to deliver this particularly precious baby.

Sweepstake, anyone?

This month we have updated our guidance on Ulcerative colitis, Familial breast cancer and Falls in the elderly (following NICE guidance released in June). A new accompanying PIL on Preventing falls in the elderly was authored to accompany this, along with updates on several others - including Breast-feeding and Teething.