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Let’s also celebrate the other health heroes who have made the NHS a great success

Let’s also celebrate the other health heroes who have made the NHS a great success

by Nora Smith, Chief Executive, CO3


The NHS has become so central to all our lives that it is hard to imagine what health care was like before its creation.

Today there is a funding crisis and everyone now accepts that fundamental reform is necessary to ensure that it is as successful in the 21st Century as it was in the last.

And it has been a great success. Just take the most telling statistic of all. In 1948 life expectancy for men was 66 and for women 71. Today it is 79 and 83 respectively.

Much has and will continue to be written about this. But it must not be forgotten just how much the voluntary sector has contributed to the health service we have today.

In fact before the National Health Service came into being, charities provided around a third of all beds and accounted for all the major teaching hospitals of the day.  Some of these dated back to the 18th Century.

The arrival of the NHS meant that those charities had to re-evaluate their roles. One of the most striking examples of that process is the King’s Fund, established in 1897 to raise funds for poor people to be treated in hospital and ultimately, providing emergency beds. After 1948 it put its money into promoting good practice, and then taking on a research function. Today it is one of the UK’s most important think tanks, helping to guide policy makers into improving health and social care.

Many other charities have superb research capabilities that have and are helping to revolutionise care. Since 1956 the MS Society has invested £218 million into research. This work is critically important because medical science is edging tantalisingly close to a cure.

The British Heart Foundation is the biggest independent funder of heart research in the UK. In Northern Ireland alone it funded the great Frank Pantridge’s pioneering work in developing the defibrillator, and is currently financing research at Queens which hopefully will lead to a breakthrough in the prevention or treatment of Heart Failure.

These projects matter, not just in helping to improve treatments, but also help save money from health budgets as well.

Cancer Research is another charity which is making a significant contribution to the advancement of medical science. This is another exciting area for research as scientists work to prevent cancers occurring, spot them earlier and improve treatments. The organisation has helped to ensure that cancer survival rates have doubled in the past 40 years. It recently co-funded the Francis Crick Institute, one of the world’s leading research centres which is the size of 17.5 football pitches.

In 1911 Douglas Macmillan invested his £10 inheritance from his father who died of cancer to set up an organisation dedicated to prevent and relieve cancer.

Over the next century the charity blossomed into Macmillan Cancer support. Today it has many thousands of health professionals, including the much-loved Macmillan nurses helping millions through their cancer journey. It has a research function, it provides training and information and it supports people with cancer every step of the way.

Aside from the research that charities carry out they are also prominent in providing social care – the bedrock on which the National Health Service sits. Many are also powerful advocates for client groups, helping to guide policy and giving vulnerable people a voice.

Age NI is just one example. Its tireless advocacy led to the setting up off the Commissioner for Older People in Northern Ireland, which in turn has proved to be a formidable defender of the rights of older people directly influencing health and social policy to the public good.

Many charities have helped to raise the profile of mental health conditions, breaking down stigma and promoting understanding of a vital area which has not enjoyed the funding and investment it deserves.

Others like Contact NI have not just provided counselling services for people in crisis they have also introduced global best practice in dealing with suicidation and self-harm into Northern Ireland.

The health and social care system in Northern Ireland is in a process of transformation which will put people at the centre of their own care. It will see a shift from treatment in acute settings to a new regime where more and more people with chronic conditions are helped to live independent, dignified lives in their own homes.

This will not be possible without the involvement of community and voluntary organisations providing specialist support and expertise in partnership with the authorities.

Just one example of this in practice is the Clare Project which started in the Mount Vernon area of north Belfast. It is a profoundly simple and extremely effective project which simultaneously enriches the lives of older, vulnerable and often isolated people and saves the health service money.

The way that it works is that volunteers from the organisation meet with older people and identify what they need to be able to live independently at home. These are often simple things like shopping, visiting the bank, or in some cases just providing a little company.

The end result reduces isolation and loneliness, helps people to stay in their own homes for as long as possible and  strengthens the community.

The project has received international attention and this kind of community-based care will be an important adjunct to health services in the future.

There has been considerable research in recent years which points to the devastating health impacts of loneliness. The starkest statistic is that it increases the likelihood of mortality by 26%. It also has been estimated as being equivalent to smoking 15 cigarettes a day. Lonely people are also more prone to develop dementia and to become depressed.

Long before these findings emerged community groups have been at the forefront of reducing isolation within their neighbourhoods. Their work may not have been recognised in the past. It should be now, and further funding is necessary in order to help stimulate even more work to combat loneliness. 

If we really are to help people live longer, healthier lives then everyone agrees that there needs to be a shift from a system dedicated to treatment, to one that also promotes prevention, helping people to avoid lifestyles and diets that put them at risk.

In Northern Ireland the Public Heath Agency does sterling work in this area. But its work is supplemented by an array of campaigning charities who have done so much to build and promote this agenda.

The promotion of healthy exercise, campaigns over air quality and environmental damage, combatting alcohol and drug abuse, the campaigns around sugary food, the prevention of stroke, the long attritional war on the tobacco industry. These are just a few of the vital issues championed by our charities. This work will continue and will be critical to achieving health objectives. The fact that charities are independent of the system and enjoy high levels of trust make them ideal partners in health promotion.

So as we reflect on the 70th anniversary of the greatest health institution ever created we should also reflect on the contribution that charities and great philanthropists have made to it. After all they valiantly did their best to shoulder the burden before its creation and their work has informed, guided and supported it throughout its history. And as we look forward to the reforms to come, we must remember that a properly funded, supported and recognised voluntary sector will be crucial to its full implementation to the benefit of all. Here’s to the next 70 years!

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