TOM BROWN: Sixty years of the NHS is reason for a good old knees up

There has never been a time when the health service was not in crisis

THE other day a surgeon offered me half a knee. Imagine that. Not enough to make me Robocop, but a snazzy super-strong titanium spare part that will last forever, unlike my creaky old bones.

Once again, I realised that the NHS has been one of the most beneficial factors in my own life and the nation's. Its 60th anniversary has been like having a friend in hospital – with a disappointing lack of visitors, flowers and drinks (both of the energy kind and the smuggled kind). There should have been celebrations in every town, hospital and doctor's surgery and yet the coverage has been muted.

I have already written about the effect July 5, 1948, the birth-date of the NHS, had on my hard-up family. Six decades later, the impact is so all-embracing that it is taken for granted. Covering dramatic cures and pioneering treatments as a health correspondent, I helped to make "medical miracle" a cliché – but it is the NHS itself that is the real miracle.

In fact, there has been a miraculous amount of miracles. The scourges of my childhood have virtually been exterminated: TB, scarlet fever, malnutrition, diphtheria, even ringworm – or, as we knew it, "scabby heid disease". A schoolboy pal had been a "blue baby", one of the few who survived congenital heart disease, although he was always smaller than the rest of us.

The 'fever' hospital, an isolation unit where those with the most highly contagious conditions were consigned, was right in the heart of our community. Home births were the norm, with a queue outside the door to see the new bairn just delivered by the doctor and midwife but sometimes dispersing silently when it went wrong.

Families contributed tanners and shillings to health insurance, only to be used in times of real crisis, and in our house the thick blue-bound Universal Home Doctor provided self-diagnosis and DIY treatment. Mistakes were frequent – as when my grandfather confused camphor oil and castor oil and damned near burned out my sister's intestines.

The NHS changed all that but then as now there were those who wrongly expected the service to be at their beck and call, even for the most trivial complaints. The "we are the masters now" mentality led to workers with cut fingers demanding a prescription for a piece of sticking-plaster, doctors summoned to homes miles away for children with runny noses.

There has never been a time when the NHS was not in crisis and I once wrote a week-long series asking Will The Patient Live? At the same time, there were far-reaching breakthroughs to report: the Pill, heart transplants, test-tube babies, cloning…

An allegedly ailing service continues to work wonders while its cripplingly expensive core commitment continues and has been newly reaffirmed by all four UK health ministers: a comprehensive service, available to all, with access based on clinical need, not an individual's ability to pay.

In the US, they scoff and cite France, Canada, Scandinavia and the UK as purveyors of near-Communistic care, although they happen to be among the best health services in the world. In America, 40 million – mainly the poor and old – out of 300 million have no health cover and turn up at overworked A&Es in an often forlorn hope of treatment.

Huge numbers of people in the world's highest-income country have no doctor or dentist. If you are poor and need a lung transplant, a heart op or cancer care, forget it. My own medicine cabinet is well-stocked with pills to lower my blood pressure, prevent cholesterol, keep my heart pumping and ease pain. In America, the cost of prescribed medicines has put them beyond the reach of many sufferers.

Sixty years ago, a Labour Government – and I refuse to let you forget that – made sure such things would not happen in this country. Can this medical miracle last another 60 years, or is it already coming to an end?

Symptoms are showing: the most common public concern now is that you may leave hospital sicker than when you went in because of superbug infections. Patients from overseas used to come to Britain for treatment, now Brits go abroad and have holidays-with-operations.

Despite making shorter waits a priority, waiting times are still a common cause for complaint. In Scotland, a guarantee of an inpatient or day case hospital admission within 18 weeks is all very well; but it is treatment that counts, and four-and-a-half months is still too long. And there should be no such thing as postcode care, better in some areas than others.

Pessimists argue that the traditional NHS is doomed because we cannot afford to go on funding an ever-growing array of new drugs and procedures. Some say a two-tier service is inevitable, with an open-to-all core package with a private top-up for "luxury" items.

Perhaps one answer is for us all to look after our own health rather better than we do. It was thought that with more people going to the doctor for free everyone's health would improve and it would eventually cost less. That has not happened, and if there has been a failure it is because the public has wilfully ignored health education.

And what about my half-knee? I don't need it after all – thanks to a newly acquired dog. My prescription: if you have creaky joints, get a lolloping Labrador to drag you across the countryside. But, just in case, I'm glad to have the NHS waiting in reserve.