‘Pint of your best mild please kind landlord. It’s been a busy day.’
‘Certainly Dr Woodcock. Busy then? That will be one and three please[i].
‘I’ll be glad when the whole world settles down a bit. It’s a time of great change Mr Landlord, great change. Have you seen Mr Barmforth recently?’
‘The records man from the hospital across the road? No not seen him or Alf Gubbins for ages’
‘No Alf passed on. He never really got over his injures did he – poor fellar. No - I was goin’ to ask Mr Barmforth about how he is coping with all these recent changes in his hospital. Has it settled down now four years on?’
‘To be honest Doc, it still looks the same to me. Not changed much since it were a workhouse. Just painted up a bit.’
‘Oh I see him now crossing the road. ‘Watch your fine hat doesn’t get blown off Barmey’ as the door opens, allowing some fresh air to flutter through the gloom.
‘Oh hello there Dr Woodcock. And quite balmy it is too. What on earth brings you down my neck of the woods? I would have thought you would be in your practice this time of day.’
‘Well, I just needed a pint to be honest -whet my whistle after work. But I also wanted to talk to somebody about something more than just bad backs and runny noses.’
‘Funny you should mention backs ….’
‘Enough! I tell you I am sick of them. We’re a few years in now with this NHS but I reckon there are still more trials and tribulations to come?’
‘Yes, perhaps youre right - but isn’t it a good thing? It seems to be settling down a bit now – although I must admit, expectations are that we will cure everything at a stroke. Do you remember what was it like on your first NHS day in 1948? ‘Cos I do.’
‘Yes, I remember it well. As a GP, we were previously paid for each visitation but this new fangled NHS caused quite a stir amongst my ‘flock’ I tell you. When I arrived at my surgery on day one, I was greeted by a queue half way down Westbourne Street. I remember it well. It was the day DFS didn’t have a sale on so it was a quite memorable day!
‘Sorry – never mind. To be honest I think they only came to see how they could get their medicine for free! Especially the woman and children who hadn’t been covered previously by any work insurance schemes.’
Mr Balmforth added ‘Yes I remember. They often subscribed to dubious and often downright dangerous old wives cures. I remember one particularly dodgy ‘cure’ of putting butter on a burn!’
‘As much use as an ashtray on a motorbike I’d say’ said Dr Woodcock in an unusual display of comedy. ‘Right – yes – so that was me, but how did your hospitals work before 1948 then?’
‘Well, they too charged up front for their services, which could then be claimed back by the poorer people. But they often didn’t have enough money to pay up front. It was a mess. And to be honest, hospitals really only were involved wirth ‘serious’ conditions and you’d be in hospital for weeks and weeks! Oh and local authoriteis looked after elderly care and mentally ill patients.’
‘Well I guess change was long overdue, that’s for sure’ said Dr Woodcock. ‘Do you remember the torturous process it went through – a difficult and protracted birth what?’
‘Yes after thirty years of Reports and White Papers and consultations eventually the Cabinet endorsed the White Paper which was published in 1944.[[ii] This White Paper includes the founding principles of the NHS: it was to be funded out of general taxation and not through national insurance, and services would be provided by the same doctors and the same hospitals.’
Dr Woodcock picked up the baton of history: ‘Yes the other principles being:
- Services were provided free at the point of use;
- Services were financed from central taxation;
- Everyone was eligible for care (even people temporarily resident or visiting the country).’
‘Not an easy birth either by all accounts, with your lot almost putting a block on it all together!’
‘Yes, Bevan encountered considerable debate and resistance from my very own BMA I seem to remember, who voted in May 1948 not to join the new service, but Bevan brought them on board by the time the new arrangements launched on 5 July 1948.
‘I suppose though we are looking at a reducing need aren’t we Dr Woodcock?’
‘In what way Mr Barmforth?’
‘Well – if we get rid of the sickness first then concentrate on preventing sickness, surely we won’t need to be spending a lot on the NHS in the future. It stands to reason.’
At that moment, through the grey blue throat tickling fog of the pub, came a shimmering bright light. Bright. Brief. Then it returned to being dark and gloomy again.Two giggling young people walked in - the young girl in a very flowery gay coloured dress, brushing off what looked like brightly coloured little paper pieces. They fluttered to the sawdusted boards. Him in some sort of camouflage trousers with tan jumper with a hood. Very strange apparel for an Army personage.
‘No not in here George. I just can’t breath. It’s so foggy. I thought they’d banned smoking in pubs!’
‘You’re right. This just won’t do Katie,’ replied George. ‘Shame, it looked so quaint from the outside. Let’s just find another one down the road’.
As he turned to leave, a rolled up newspaper fell from his back pocket onto the floor as the shaft of light from the opening door showed up the swirly smokey grey and black atmosphere that was the Volunteer Arms[iii]. The door shut.
Standing up, Dr Woodcock quickly picked up the paper and smoothed down the front page. ‘What a strange publication this is – and all in colour too.’
‘I dont believe it. I just don’t believe it! Our very own PM at the time of the founding of the NHS - Clement Atlees’ great granddaughter has just married the grandson of the first ever NHS patient at Trafford General[iv]. Now if that’s not completing the circle of life I don’t know what is!’
‘I don’t believe it either!’ this time Mr Barmforth.
‘The year is 2018 and they still using paper!’
The landlord pushes between them and points to an advert on the bottom of the page with his mucky looking glass drying cloth.
‘And whats this then? A pint of beer is £3.45p and it’s made from a badgers crushed paw. Wow – what DOES the future have in store for us eh?’
Indeed dear reader, (whoever and wherever you are), what does the future have in store for us?
2018 is 70 years since the NHS was created and no coincidence; it is 70 years since IHRIM (formerly AMRO) was founded. Since the very dawn of the NHS, good record keeping and its safe management was seen as a fundamental requirement to deliver an efficient and effective health service. In 2018 we are looking at reducing reliance on paper but simply shoving a computer in the loop does not deliver good records. These records will still have to be managed effectively, have good sensible structure and created with agreed national standards. YOU will continue to be a part of that process. Be ready.
[i] 1952 Pint of beer 1/3 (old pence) = 6p new money.
[iii] Re-named EPR Arms in the year 2000