The most striking findings are, perhaps, that many nurses fear the future of the service is uncertain and the majority think that even now the NHS no longer fulfils its original aims.
Only 38% of the 1,426 survey respondents felt the NHS had achieved Nye Bevan’s aim in 1948 – ‘to provide you with all medical, dental and nursing care. Everyone, rich or poor, can use it.’
Many nurses cited dental care as a major area in which the NHS had failed. Other areas too are cause for concern.
‘The NHS does a great job but dentistry appears to be for those with money only, drugs are a postcode lottery and poverty equals health inequalities,’ said one respondent.
RCN policy adviser Tim Curry said: ‘I think people are also concerned about nursing care for older people and care in hard-to-reach places, such as the very poorest estates in central London.’
Indeed, 31% of respondents said the health of vulnerable groups – such as those with learning disabilities or the elderly – had not improved since the inception of the NHS, despite 60 years of free healthcare.
Anna Delehunty, who was training to become a district nurse in 1948 in London, agreed. ‘I think the care of the elderly is not as good as it was – I don’t think the respect for the elderly people is how it should be,’ she said.
But Margaret Reading, a community nurse in London in 1948, said the NHS had lived up to its vision and it was public expectations that had changed.
‘People’s expectations are so different today...there is a lot more questioning of everything,’ she said.
Just 11% of respondents said they thought the service would still be free at the point of demand in another 60 years.
‘The NHS will self-destruct by 2068 if not before,’ stated one survey respondent. ‘It will be a tragedy. People’s heath will suffer because of financial reasons and medical unaffordability.’
Almost two-thirds of nurses responding to the survey thought that patients should have to pay for some services such as IVF.
Mr Curry said this issue was currently a ‘hot potato’. But he pointed out that the public had been paying for certain kinds of care for many years. ‘I don’t think the NHS is free at the point of demand any more and it probably only was for the first five years,’ he said. ‘As soon as charges for opticians, dental and prescriptions came in, it ceased to be completely free.’
Perhaps surprisingly, it is not finance that nurses believe is most hampering the NHS. When asked what was the greatest problem facing the service, the most common response was ‘too much bureaucracy’ followed by ‘frequent reorganisations’.
Additionally, 94% of respondents thought the service would be better run by health professionals than politicians. Nurses also raised concerns about the impact of the private sector on the NHS with more than six in ten nurses saying its use undermined the values of
But, while many respondents were quite negative about the future of the health service, 40% still believed the NHS to be the ‘envy of the world’.
‘I think it is most certainly the envy of the world,’ said Mr Curry. ‘There are millions of people treated every year with a high degree of success and that is something to be very proud of.’
Cheryll Adams, acting lead professional officer for Unite/CPHVA, added: ‘When you look at the American system you realise how incredibly fortunate we are. The NHS has achieved an immense amount of good.’