No money for birthday gifts as NHS turns 75 – BBC News

The BBC Scotland office in Edinburgh has been very grateful to the NHS in recent weeks.

My colleague, political editor Glenn Campbell, recently disappeared in action – spending a week in the hospital after an incident with a serious hole in his bicycle.

It involved paramedics, A&E and the trauma team, but luckily he’s on the mend.

At about the same time, our wellness producer, Claire McAllister, found herself very dependent on the rather complicated end of her pregnancy.

Again the staff were amazing and provided adorable bundles of preemie joy – and mum and baby were fine.

It got me thinking, what was that experience like 75 years ago when the NHS was born?

And I wonder what the future NHS will be like, for babies born in 2023.

Clearly the health service is still doing a tremendous job in increasingly difficult circumstances.

But Covid and its aftermath really tested a system that had struggled for years – and the warnings from experts about the future are bleak.

The two biggest challenges are how to pay for the soaring bills, and how to find enough people with the right skills to meet demand?

Earlier this year, BBC Scotland conducted a poll to find out your views on healthcare. Most of the people who answered said they hoped the NHS would remain free in times of need in 10 years’ time and believed the highest earners should be the ones paying for it.

In Scotland, this year’s health and social care budget is £19 billion. That’s far more than is spent on education, the justice system and transport combined – but it’s still not enough.

Already, taxpayers making more than £43,662 are paying an extra penny in pounds, with the money going directly to the NHS, raising £129m in Scotland.

But to put it into context, the cost of this year’s raise given to nurses, paramedics and other health workers is more than £500 million.

Major advances in medicine and technology in the last 75 years have meant that many people can be cured of disease or live comfortably with quite complex medical conditions.

It’s cause for celebration but at the same time, board health budgets can’t always be expanded to offer the most expensive drugs or invest in new buildings or equipment.

NHS demand is much greater now than when the service was built.

Despite some of the world’s leading public health policies, Scotland remains a deeply unhealthy country.

A third of adults are now obese, and a quarter are drinking at dangerous or dangerous levels.

About one fifth of the population lives in poverty.

More and more of these people will need help with a combination of complex illnesses, including heart disease or cancer, in the years to come.

Labor is the second fundamental problem facing the NHS in Scotland.

Scotland’s retired population is expected to increase by 35% by 2043, but over the same time period the working age population is expected to decline by 3% and the number of children decreased by 22%.

There are already significant levels of NHS vacancies and a critical shortage of social carers.

I was shown a presentation slide the other day suggesting three out of every 20 primary school children in Scotland should choose a career in the NHS, just to keep up with the current demand.

Attracting NHS workers from overseas is one option – but at the same time many local doctors are seeking more rewarding opportunities abroad as the health service struggles to retain existing staff.

Meanwhile, thousands languish on record waiting lists, wondering if the NHS is really providing the safety net it promises, from cradle to grave.

It’s really hard to see how policy makers can sustain the kind of service we’re used to.

And while the majority of people in our BBC poll wanted the NHS to remain free when used, 43% said they would likely pay for private care if they had to wait a long time.

In the past year nearly 10% have done so.

But First Minister Humza Yousaf has made it clear he does not want two-tier healthcare and must stick to his basic principles.

This is a problem facing the whole of England, but many professional bodies and unions have criticized the Scottish government for promising more than it can realistically achieve.

And the spending watchdog says the government needs to be honest with the public about what its priorities are, and what the NHS can afford.

So there are a lot of difficult and potentially unpopular decisions to make.

Do you increase taxes, cut other public spending, or even charge people for an element of maintenance?

If not, the reality is reducing some of the services the NHS provides.

It’s a big birthday for the NHS but celebrations are likely to be muted – while the hard work continues.