Well last week was fun, and in
the main I enjoyed the #NHS70 celebrations. There were some wonderful stories
to read, of cleaners, porters, doctors, occupational therapists, nurses and all
those who each day help provide safe care for others. There were stories from
early NHS patients, of babies born, and of the changes made in how illness and
trauma is now treated. Stories of new technologies, new professions and the
changes that had been achieved in the scope of practice for many professions. I
wanted to add to those stories in this blog, but my friend, colleague and
wonderful blogger, June got there before me. Her story is eloquent and told
well – read it here.
There were many photos of the past, particularly what folk
looked like when the qualified. Here is my picture taken at my nurse
‘graduation’ now some 40 years ago – the mental health cohort I was in had just
14 students, but as can be seen from the picture, there wasn’t great numbers of
students in those days. During my time as Dean of a large school of nursing and
other health and care professionals we regularly took just under a 1,000 nurses
and midwives in each year to start their education and training to become a
health care professional.
Whilst last week’s celebrations
were most welcome, it was also a chance to reflect on some of the lows as well
as the highs of the last 70 years. For me I guess one of the most memorable
lows was the Thalidomide Babies era. Thalidomide was first prescribed as a
sedative and given to pregnant women to help combat morning sickness. The drug
damaged the foetus, and stunted the development of arms and legs. It wasn’t just
a UK issue however. Worldwide it’s reported that some 20,000 Thalidomide babies
were born before the drug was withdrawn in the early 1960s. More recent studies
have put the figure as 100,000, if miscarriages and issues for the families concerned
are included. The UK reports 2,000 babies were affected.
Sadly, Brazil re-licenced
Thalidomide in 1965 as a treatment for skin lesions associated with the disease
leprosy. I didn’t know that in Brazil leprosy is more prevalent than in any
other country except India. More than 30,000 new cases are diagnosed each year,
and millions of Thalidomide prescriptions are made each year. By 2013, more
than 100 Brazilian children had been born with arms and legs defects typical of
the original Thalidomide babies.
More recently in the NHS’s
history were the dreadful, and avoidable deaths that occurred at the Mid
Staffordshire NHS Foundation Trust. Whilst there has been many arguments over
the number of deaths (400 -1,200) that could have been avoided had better care
been provided, it is totally unacceptable that in 2008 so many people suffered as
a result of what were economically driven decisions which ignored the impact on
the quality and safety of the care provided. I felt that nurses were
scapegoated in many of the reports investigating the deaths. There are many good
research studies that have shown that the number of nurses holding a bachelor’s
degree is associated with much lower mortality levels, anything from 7% - 10% lower
than in areas where there is not a good ratio of graduate nurses to patients.
I think amidst all the celebrations
and reflections, many folk would have missed the announcement of the death of
the pioneering GP Julian Tudor Hart. He was 91 years old. I remember being
enthralled at hearing about his work in primary care when I was undertaking my
own nurse education. Maybe it was because I studied in Wales, which is where Dr
Tudor Hart practiced. He introduced the concept of what we now know as the ‘inverse
care law’. This law notes that the availability of good health or care services
tend to vary inversely with the needs of the population being served. He was
way before his time in terms of such thinking and what might be done to counter
such inequalities.
He was very interested in the way
in which folk’s life style choices (or often the limited options open to them) impacted
upon their health and wellbeing. In 1961, Dr Tudor Hart moved to a coal mining
community in South Wales. He stayed in primary care, practising as a GP for
some 30 years. He is the first GP to routinely measure every patient’s blood pressure,
and his practice was recognised to be the first research-based practice in the UK.
Interestingly, he was a lifelong supporter of the Communist Party in the UK.
This was a group that openly supported Stalin. Stalin became famous for
enforcing an ideology that inspired the murder of millions of innocent people. A
strange counterpoint to some who has been universally described as the father
of primary care.
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