MARY Dunn remembers only too well what nursing was like in Scotland in the early days of the NHS: diphtheria and tuberculosis, long shifts and hours spent shining the floors.
That sharp contrast to today, as the NHS prepares to celebrate its 60th anniversary, shows just how far healthcare has come. Controversies rage daily about funding, cleanliness and quality of care in the modern service, but Dunn provides a use
ful historical context.
"I remember tuberculosis in the 1940s," she said. "You nursed the TB patients outside and it was cold, so you really had to have them wrapped up.
"We did longer shifts than today and we had one day off a week. You were totally responsible for your patients, keeping them comfortable, washed and bathed."
When the NHS was created on July 5, 1948, out of a long-held ideal that good healthcare should be available to all, regardless of wealth, no one could have predicted the milestones it would achieve.
It has funded countless new treatments, including vaccinations, organ transplants, the contraceptive pill, hip replacements, fertility treatment, CT and MRI scanning and keyhole surgery.
The challenge is how to take the service forward. In an interview with Scotland on Sunday to mark the 60th anniversary of the NHS, the politician at the helm of the service believes it comes down to four priorities.
Health Secretary Nicola Sturgeon said:
"Firstly, we need to be more preventative about healthcare.
Tackling health inequalities is a key priority, the gap between rich and poor. It's about investing much more in the early years. It's also about continuing to improve healthcare, with shorter waiting times, safer care and a better experience. And it's about democratising the health service. People want to be more involved in their own individual care."
Doctors are worried, however, about how these lofty ambitions will be funded. Dr Peter Terry, chairman of the British Medical Association in Scotland, said:
"The greatest achievement is the contribution it has made towards increasing life expectancy, which is due to access to universal healthcare. The biggest challenge will be to afford the best treatments."
Scottish Conservative health spokeswoman Mary Scanlon predicts advances such as genetic profiling will allow us to live longer, but warns individuals must take more responsibility. She said: "The NHS was set up to tackle disease and it has been successful in doing that.
"I don't think that anyone would have thought that 60 years later its biggest challenges would be alcohol, drugs and obesity. So the big message is that people are going to have to take individual responsibility."
Third-year nursing undergraduate Jessica Anderson is well aware of the hard work ahead of her. Unlike Dunn, perfect bed-making and floor-polishing are not on her mind as much as targets, new treatments and getting to grips with caring for patients on an intensive care ward.
The NHS, she concedes, will never meet everyone's needs because of the clash between cost and demand:
"There are always new illnesses being discovered, new treatments, new targets to meet and increasing demand."
But some things in the NHS at least, have not changed. Just as Dunn and her nursing colleagues attended to her charges 60 years ago, so Anderson does now. "In intensive care, many of the patients aren't well enough to speak," she said. "I didn't realise that I missed chatting to the patients and helping them do things.
It's nice to help somebody do things for themselves."
Decades of medical memories1960s: Robbie Robertson, GP
Robertson's first practice in Glasgow was in an old tenement. "The premises were decaying and had an outside toilet," says Robertson. "When that broke down, patients used one in a converted linen cupboard off the main consulting room. It was the era before appointments and we'd just see one patient after another, so we had to cease consulting whenever someone needed to use the toilet."
1970s: Lynne McCormack, nurse and NHS 24 Team Leader
"I was ordered through the screens to face my first corpse without warning. It was such a shock I shot back out, bumping into the ward sister who reprimanded me for my unprofessional manner and pushed me back to the bedside."
1980s: Rod Moore, paramedic
In the 1980s, Moore carried only oxygen and Extonox, a pain-relieving gas. His role was to get a patient to hospital as quickly as possible. The job began to change in 1986 with the introduction of defibrillators into ambulances.
"We resuscitated more patients successfully," he says.
1990s: Donald McNicol, dentist
McNicol says one of the biggest changes in the 1990s was progress in adhesive dentistry, mirrored by patients' attitudes. "People increasingly wanted to keep their teeth," says McNicol. "So now we don't take as many out."
The full article contains 804 words and appears in Scotland On Sunday newspaper.
