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NHS HIGHLAND: Our relationship with the NHS needs to be different

By Dr Tim Allison

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Lifestyles change so our health needs change.
Lifestyles change so our health needs change.

We have recently been celebrating the 75th anniversary of the founding of the NHS. The achievements over these years have been huge.

From the start of the NHS people no longer had to worry about paying bills for medical treatment and access to effective care and treatment was available for everyone who needed it. We should also remember locally the Highland and Islands Medical Service which started 35 years earlier and which was a forerunner and model for the NHS.

During the time that the NHS has been in place there have been massive changes in treatment and care for people. Conditions such as tuberculosis that were often fatal or needed long and severe treatment are now much rarer and more easily treated. Many cancers can now be effectively treated or cured and treatment for heart disease has been completely transformed.

Our lives have changed radically too. There is less manual work than 75 years ago and more women are in the workforce. Education has expanded and we spend more time with leisure activities. We are better connected with each other and with the world both through travel and through communication. In terms of health, we are on average living longer, although many people have illnesses as they grow older. More people now have mental health, musculoskeletal or other conditions that last for years.

It may seem a bit odd to say that we have moved away from frequent infectious diseases when we have recently had the biggest pandemic for a century. We do have a continued risk from Covid and similar infections, but vaccination and treatment have had a great impact on the diseases. Compared with 1948, many diseases such as measles, whooping cough or smallpox have become extremely rare or disappeared.

The biggest burdens of disease now are longer-term conditions and cancers. The impact of Covid too is being shown in long-term illness among some people who have been infected. Since the pattern of illness is now different, our relationship with the NHS needs to be different from the past. We are looking less at a health service that fixes injuries and treats infections and more at a health and social service that supports people and prevents illness. This can only be done effectively in partnership with everyone.

We are right to continue praising the dedicated staff who work in the NHS, as well as those in social care and across our communities. We should also consider how we can support our own health and the health of friends and family. This includes things like smoking, alcohol and physical activity and it also includes understanding long-term illnesses that we may have and recognising when there are signs of early serious illness.

The NHS can help us with taking up a healthier lifestyle and with managing our health. If we are to celebrate the centenary of the NHS in another 25 years, we all need to work together.

Dr Tim Allison is NHS Highland’s director of public health and policy.

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