Public health ‘revolution’ at heart of NHS success at 70

As the National Health Service marks its 70th birthday, the Public Health Agency (PHA) is celebrating the dramatic improvement in the health of our population over the past seven decades, from an era where polio and TB blighted society to one where we enjoy free comprehensive vaccination and screening programmes to help prevent and detect illness. 

However, the PHA is also highlighting the challenges ahead for our health service given the ageing population here and increasing prevalence of overweight and obesity. 

Dr Adrian Mairs, acting Director of Public Health at the PHA, said: “The 70th birthday of the NHS is the perfect time to take stock of how far we’ve come as a society in tackling some of the biggest public health challenges that have faced us. Thanks to the hard work and dedication of health service staff, innovation in the prevention, screening, and treatment of illness, improvements in the environmental conditions in which people work and live, and societal shifts in areas such as smoking, we are now able to tackle many of the health threats which faced people in their everyday lives seventy years ago. Life expectancy has gone up by over a decade since the time the NHS was founded. 

“Vaccination is a particular success story. The virtual eradication of many deadly illnesses here is thanks to the fact that we are fortunate to have a free, comprehensive vaccination programme in place for our population, from new born babies right up to those over 70 year olds. 

“Polio, for example, will be remembered with fear by people born in the thirties and forties. During the early 1950s there were polio epidemics, with as many as 8,000 annual notifications of paralytic polio in the UK. However, in 1956 a routine immunisation was introduced and by the 1960s cases had dropped dramatically. 

“Polio, along with other ‘diseases of the past’ such as diphtheria and tetanus, remain part of the childhood programme today, and thankfully the incidence of these three infections has fallen dramatically, with no cases in Northern Ireland in recent times. 

“The measles, mumps and rubella (MMR) vaccine is another hallmark of the success of our health service. In 1948, the year when the NHS was founded, 22 people in Northern Ireland died of measles; in 2016 there were no deaths from the illness.” 

“Our screening programmes are also a fantastic example of how the NHS is enabling the early detection and treatment of a range of illnesses. We now have free screening programmes for a range of conditions such as breast cancer, bowel cancer, diabetic retinopathy and abdominal aortic aneurism, all provided free by the health service to improve and save lives here. 

“In other areas of health, we have seen great strides forward in terms of prevention and treatment of illness. For example, we are now much more aware of mental health issues, and people are increasingly feeling more able to talk openly about how they are feeling, with NHS-funded support such as the Lifeline helpline in place to help those in distress or despair. In terms of physical health, since the 1960s, cardiovascular disease death rates in Northern Ireland have fallen by three quarters. However, as a health service, we face new challenges which we need to address as a society if we are to continue delivering effective free healthcare. 

“Research by the Department of Health has revealed that 36% of adults here are overweight and 27% are obese, which brings with it illnesses such as type 2 diabetes. Smoking prevalence dropped from around two-thirds when the NHS was in its early years to approximately one third of adults by the mid-1980s, but the fact remains that roughly one in five of us still uses tobacco, resulting in a terrible cost to wellbeing such as lung disease, with half of smokers dying as a result of their habit. And while, in general, we are reaping the success of seeing people living longer lives, an ageing population presents its own challenges, with people requiring care for longer and for more complex conditions. All of this is bound up in the wider challenge of tackling health inequalities, which see people who live in more deprived areas living shorter and less healthy lives than those in more affluent neighbourhoods. 

“This is why it is so important that each of us takes steps to live well and look after ourselves, and the health service is geared up to help with this. 

“If you smoke but want to quit, the Public Health Agency funds more than 650 free stop smoking services on the NHS across Northern Ireland, in places such as pharmacies, GP surgeries and healthy living centres. More information is available at www.want2stop.info” 

“If you want to achieve a healthy weight, check out the PHA’s website www.choosetolivebetter.com which provides advice on physical activity and healthy eating. Taking control of your diet is the key to managing a healthy weight. Being overweight or obese can increase your risk of developing heart disease, some cancers and type 2 diabetes. Making small changes every day, like eating healthier meals, can have a positive long-term impact on your health and wellbeing.” 

Dr Mairs concluded: “Our NHS is something which people across the world admire. For 70 years it has been providing free healthcare across our population from birth to old-age, and its success can be measured in people here living longer, healthier lives. 

“However, we cannot take our health service for granted – as demands on it reach an all-time high, it is the responsibility of all of us to play our part in taking preventative steps now to maintain and improve the health of ourselves and our families. This can include continuing to get our kids vaccinated, participating in screening programmes, increasing our physical activity, and addressing habits which can have a major impact on our health such as smoking and drinking. By doing so, we can help protect the NHS so it can continue to deliver and innovate for future generations.”