The NHS at 70
There are many publications, tweets, media reports and so on around celebrating the National Health Service’s 70th birthday on 5th July this year. There is less focus on social care although it is also the anniversary of the founding of the social care system. Health and social care are inextricably linked so it may feel as if we celebrate the birthday of one twin but not the other. The impact on colleagues who work in social care is likely to be negative. The celebration of the NHS at 70 may also feel negative to those who are working in difficult situations – poor environments, lack of support, insecure employment and reducing wages.
The NHS is an amazing achievement and it is something of which we should be proud. A healthcare system paid for by general taxation that is free at the point of delivery is important. A healthcare system that provides care to all based on clinical need is important. These principles give us the foundation for a fairer society where gaps in health should not dictate life opportunities. However, health is not wholly determined by healthcare. There is much evidence of the social determinants of health including effects of poverty on health and mental health (limits cognitive capacity). Social determinants of health include housing, education and employment and these also have an impact on life span.
Psychological approaches and interventions cut across all these boundaries. The psychological professional workforce has expanded greatly in the past 20 years with counsellors, cognitive behaviour therapists, psychological wellbeing practitioners and others working in health (and to some extent social care). Psychological professionals contribute to practically all areas of healthcare but not comprehensively nor consistently. Psychological professionals work with patients, service users, carers, and staff as well as with teams, systems and organisations. We are not wholly part of mental health nor physical health care. Yet we work across all these areas and also into social care.
Mental health and social care have been described as Cinderella services in terms of funding and development. It can feel that psychological professions are the missing glass slipper as we are often unrecognised and underfunded. Even knowing how many psychological professionals there are seems impossible to find out, as the job codes are not used consistently whether within psychological professions or across healthcare. Job adverts are often erroneously categorised. These mask the true picture of workforce and it is difficult to get change.
So on the birthday of the NHS, what should we make it of this? As a citizen, I feel proud that I can access healthcare free at the point of delivery and according to need. As a citizen, I feel despondent that what is available can be patchy (postcode lottery), fragmented and of variable quality. As a psychological professional, I feel proud to have contributed to the wellbeing of those service users/patients with whom I have worked. I feel proud to have contributed to the wellbeing of staff with whom I have worked. I feel proud to have contributed to the development of our Psychological Professions Network. As a psychological professional, I feel despondent that our professions are not available to all when they need them. I feel despondent that our different approaches are not available to all when they would most benefit from a particular approach. I feel despondent we continue to have to explain the value of what we do when this is not levelled at other groups. Despite this, I feel some optimism that we can continue to navigate our way through these difficult times. We have the skills to identify these issues and work with others in overcoming them. We have the skills to help people change. We have the skills to support each other.
So, on the birthday of the NHS, my glass may be filled halfway and I’ll raise a toast and hope that half-full can become a more generous measure. Happy 70th Birthday NHS.