The NHS in England at 70

To celebrate 70 years of the NHS, St George’s Library takes a look over its history

As the NHS marks its 70th year, a look over its history can help to draw into focus the achievements of its time so far, along with the changes that have taken place both within the service itself and in the society which it serves. Created on the basis that good quality healthcare should be available to all, the NHS rested upon three core principles: that it meet the needs of everyone; that it be free at the point of delivery; and that it be based on clinical need, not the ability to pay. These principles retain their importance 70 years on.

At its inauguration in 1948 the NHS was a three part system, with hospitals, general practice and local health authorities being run separately, though by the 1960s this model was increasingly seen to be ineffective. Numerous reports during the 1960s set out recommendations for the future development and structure of the service, but it was 1974 before the NHS was reorganised into regional authorities covering all three parts of the system. In the intervening period, authority for NHS services has continued to change, from 1991 when the first NHS Trusts were established, to 2002 with the introduction of Primary Care Trusts, and the current situation which gives authority and responsibility to Clinical Commisioning Groups (CCGs) and NHS Foundation Trusts, amongst others.

Amidst the 70 year history of the NHS, sit a number of innovations in treatment. The first kidney transplant was carried out in 1960, the first IVF baby was born in 1978, and the first successful gene therapy took place in 2002. In addition, changes to the approach to treatment have taken place, such as the Mental Health Act 1983, which introduced the issue of consent to treatment; under the prior Act of 1959, there was no requirement for patient consent.

Underpinning developments in healthcare services and practice all the while, has been the accessibility and use of relevant information and knowledge. As outlined by a blog post on The King’s Fund website, that organisation (when named King Edward’s Hospital Fund for London) provided an information service for hospitals and other organisations interested in hospital work even before the advent of the NHS. In November 1948 the service was formalised as the Division of Hospital Facilities, which included an Information Bureau and a Reference Library.

Today, Health Education England continues that commitment to enable NHS staff to access the information that can help shape good quality healthcare, and the library at St George’s is one of 215 NHS library services that supports NHS staff access and use of information resources for study, research and clinical practice. St George’s Library existed before the advent of the NHS as it supported St George’s Hospital and Medical School going back to the 1700s. Fortunately, developments in the provision of library services have also taken place over the years, meaning that current members no longer have to observe the following regulation:

11. A Member wishing to read a Book in the Reading Room must write the title of the Book, and his name on a piece of paper, and hand it to the Librarian, who alone is to take books from the shelves and replace them.

(Historic Regulations for the Library and Reading Room of St George’s Medical School)

The NHS70 website provides more on the history and the future of the National Health Service, as well as up to date news on celebrations of this milestone. The NHS England website also provides a decade by decade timeline of the service outlining more of the significant medical developments and innovations to have taken place in the NHS, alongside the key pieces of legislation and structural changes affecting the delivery of services by NHS staff throughout the past 70 years.

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