Speech Delivered by David Alton – Lord Alton of Liverpool – at the NHS Anniversary Celebration Liverpool Metropolitan Cathedral May 2nd 2018
Choral Evening Prayer – 70th Anniversary of the NHS
It is a great privilege to have been asked by Peter Davies to join you for this Choral Service celebrating the 70th Anniversary of the NHS.
What a wonderful wayto mark the achievements of one of the nation’s most respected institutions; to reflect on the vital role the Service plays in our lives; and to honour and thank the extraordinary, dedicated, 1.5 million NHS staff, from all over the world, making it the country’s biggest employer: always there when we need them – caring for us and supporting us and day in, day out.
In the aftermath of the Windrush scandal this is a good moment to pay special tribute to those Commonwealth nations and others from overseas – some 150,000 I believe – who have contributed so richly to the NHS.
I am especially pleased to be here with one of my sons – an A and E doctor in a Liverpool hospital – and it is with regret that I learnt that Dame Lorna Muirhead is unwell and unable to be with us as she was one of the midwives who helped my children into the world.
One of those children later had orthopaedic surgery opeated on by wonderful staff at Alder Hey; my wife worked for the Service as a speech and language therapist with children and adults with learning difficulties; and, beyond my family, as a one-time City Councillor and Liverpool Member of Parliament, I have seen countless examples of the life-saving, and life-changing, phenomenal work undertaken by the NHS.
Over these past 70 years the NHS has transformed the health and well-being of the nation – and its founding principle, of providing care for all, regardless of means, is one I have supported throughout my life.
Thanks to the NHS; to improvements in public health; and to extraordinary medical breakthroughs – in everything from bionic eyes to hand transplants – our life expectancies have become greater while diseases like polio and diphtheria are all but eliminated.
Yet, we also know that the advances also mean that the challenges facing any 70-year-old have to be carefully considered too.
Following the Beveridge Report, it was Aneurin Bevan,as Minister of Health, who spearheaded the establishment of the National Health Service. he once remarked that“politics is the religion of priorities”.
In shaping priorities, we must never lose sight of our values – chief of which must be a profound respect for the dignity of the whole person.
Bevan also said: “the victories won by preventative medicine are much the most important for mankind”perhaps that was a foreshadowing of our increasing contemporary understanding that prevention is better than cure.
Prevention combined with early diagnosis followed by rapid intervention must be the gold standard for twenty first century health care.
In this context, consder for a moment mental health for a moment.
I was particularly struck by the findings in the recent Green Paper Transforming Children and Young People’s Mental Health Provision, that:
“Children who are exposed to persistent and unresolved parental conflict are at a greater risk of early emotional and behavioural problems, anti-social behaviour as an adolescent and later mental health problems as they transition into adulthood”.
Prevention will require a paradigm shift in the emphasise we place on family support and parenting.
Yet, resources, commensurate with the challenges, will always be needed too.
According toThe Independent, 50% of clinical commissioning groups say that they are planning to spend less of their total funding on mental health during the current year.
Paradigms and priorities do not shift without commitment and, often, without a fight.
InIn Place of Fear published by Bevan in 1952, he wrote that:“No society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means”and that “The NHS will last as long as there are folk left with faith to fight for it.”
Those with the faith to fight for it – and who see the NHS as a hallmark of our civilised values – need to recognise that the priorities and challenges vary from generation to generation but that the good will always be eclipsed when we take it for granted and fail to fight for it.
And, new times create new challenges and new fights.
For one thing, there are more of us using the Service.
Britain in 2018 has 17 million more citizens than when it was founded seven decades ago.
And as we live longer, with 18% of the population now aged 65 and over and 2.4% aged 85 and over – the pressures on the Service and the needs of its users have significantly changed.
The Institute for Public Policy Research has predicted that the NHS will need an extra £50 billion by 2030.
As things stand, the Health Foundation, the Nuffield Trust and the King’s Fund suggests a shortfall of £3.5 billion in social care alone by 2020.
But, interestingly, in a recent poll no less than 66% of the public said:“I would be willing to pay more taxes in order to maintain the … spending needed”,
The public support NHS expenditure – but, of course, they want it spent judiciously and effectively.
Small adjustments can enable resources to be redeployed.
For instance, my colleague, Baroness Finlay, with her enormous experience in palliative and end of life care, argues that better integration of hospices and the NHS would result in an up to 40% decrease in the use of hospital beds, with significant savings of more than £1,000 per patient.
But it’s not just about money. Making a change that reflects our values and, in particular, the upholding of human dignity, this can significantly improve care at the end of life and enable people to remain independent in their own homes for as long as possible.
As we look forward to the next 70 years, throw into the mix the need to create parity of esteem between mental and physical health.
Throw into the mix the new and often complex ethical challenges that challenge NHS staff on a day by day basis – highlighted by the cases of Ashya King, Charlie Gard and Alfie Evans.
Throw into the mix the challenge of reducing variations in care and outcomes related to inequality and deprivation which were highlighted in a recent House of Lords Report.
And throw into the mix the opportunities offered by the digital revolution.
Dr Murray Ellender, writing in the Times last week, outlined some of the opportunities presented by modern digital triage tools but observed that“if we use social media as a benchmark, digital consulting is still at the Friends Reunited … stage”,
These complex challenges cannot be ducked and nor must the NHS be a points-scoring political football.
A consensus needs to be established on how a future NHS should be funded and how it, and a care system, should be delivered.
Along with others, I have argued for the creation of an all-party commission to consider the long-term sustainability of the NHS.
Bevan was right, the NHS and the values on which it was built, helps us to understand what makes for a civilised society.
And, whether we are secular or religious, this is something that should unite us. For the Abrahamic religions – but others too – the command to heal the sick and to affirm life itself is foundational. It is there inJesus’ Golden Rule about love of neighbour.
Which brings me to the two Readings we have heard this evening.
The first was taken from the Book of Deuteronomy, composed in Jerusalem in the 7th century BC. Chapters 1–30 of the book consist of three sermons or speeches delivered to the Israelites by Moses on the plains of Moab, shortly before they enter the Promised Land.
Addressed to the children of Israel, we hear the words:“Behold, I set before you this day curse and blessing, life and death, therefore choose life that you and your descendants may live.”
But you don’t have to be a Christian, Jew or Muslim to hold fast to this life affirming belief.
At least two hundred years after the death of Moses, between the third and fifth centuries BC, the Greek father of medicine, Hippocrates, drew up an oath that required a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The Hippocratic Oath is the earliest expression of medical ethics: “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing.”
Hippocrates abjures the harming of a patient and like Moses he insists that in our words and deeds we must always choose life.
Yet we know that some doctors like Harold Shipman – or those in Holland who recently killed patients with Dementia – have not always held fast to that injunction.
Only a few days ago, we learnt that the Austrian paediatrician,Hans Asperger, after whom the Syndrome is named, was directly linked to the Nazi programme that sent children with disabilities to their deaths. More than 200,000 disabled children and adults were murdered during the T-4 and child euthanasia programmes.
Consider for a moment some of those who are said to have experienced Asperger’s Syndrome – including Abraham Lincoln and Albert Einstein – and you get a glimpse of how much poorer humanity would have been if they had been eliminated.
In our over-zealous pursuit of medical knowledge, our prioritisation of patients, and our practice of medicine we must never lose sight of the call to the children of Israel or the oath of Hippocrates.
In the second Reading, we were reminded of the high calling of the healer – as Jesus, the Great Physician, heals ten men with leprosy. Each of us is made in God’s own image and, regardless of the disease, disability, or social standing of the patient, must be worthy of the attention of the healer.
We are also reminded not to expect the thanks of those we serve. Jesus, heals all ten lepers but it is only the foreigner who returns to thank Him. So often we can fail to offer thanks for what T.S.Eliot describes as“the sharp compassion of the healer’s art”:Christ is“The wounded surgeon,” who “plies the steel; That questions the distempered part“And “Beneath the bleeding hands we feel The sharp compassion of the healer’s art Resolving the enigma of the fever chart”
The sharp compassion of the healer’s art is all around us in the National Health Service but it has its origins in the first century after Christ, when Clement recorded how the Christian community in Rome was alleviating suffering.
Later, St Basil of Caesarea founded a 300-bed hospital and it was followed by hospices and leprosy houses.
Benedictines established monastic hospitals and committed themselves to care for the seriously ill: to “help them as would Christ”.
In the eighteenth century, inspired by John Wesley the Christian hospital movement was founded and Christian philanthropists challenged by the desperate needs of those living in grinding poverty, worked for creation of hospitals like the London Fever Hospital and for advancing public health.
Demonstrating that good ethics, good science, and good practice can march hand in hand, people of Faith have been at the cutting edge of crucial discoveries, including William Harvey’s work on circulation; Jan Swammerdam’s work on lymph vessels and red cells; and Niels Stensen’s work on fibrils in muscle contraction.
Think of Lister, a Quaker, and how his discoveries were applied to surgery; Davy and Faraday, who discovered and pioneered the use of anaesthesia in surgery; and the obstetrician, James Simpson, the first to use ether and chloroform in midwifery; while William Keen, a Baptist, was the first to successfully operate on a brain tumour.
Edward Jenner, was the Christian responsible for the beginnings of immunology and in ending the scourge of smallpox.
Think of the role of Florence Nightingale in transforming nursing or the foundation by the Sisters of Charity in 1905, of St Joseph’s Hospice in Hackney, and the pioneering work of the Anglican, Dame Cicely Saunders at St Christopher’s Hospice in providing for those with terminal illness, while offering an environment of Christian love and support.
Or, think of Louis Pasteur, the French Catholic scientist whose discovery of germs was a turning point in the understanding of infection.
To end, let me leave you with a story that illustrates that faith and works, prayer and deeds can, and should, go hand in hand. They are not enemies.
This story is about a young medical student who boarded a train in a small university town in France. He had recently qualified and was rather proud, perhaps too proud, of his academic achievements.
As the train left for Paris, the young man took his seat facing an elderly gentleman who appeared to be dozing.
Suddenly, the train lurched and s string of rosary beads fell from the elderly gentleman’s hands. The young man reached down and handed the beads back to the elderly gentleman with the words: “I presume you are praying sir?”
“You are right” I was praying, came the reply.
“I am surprised,” said the young doctor “that in this day and age there is still someone so benighted and so superstitious. Our professors at the university do not believe in such things.”
He proceeded to “enlighten” the elderly passenger – who expressed surprise and amazement.
“Yes” insisted the young man “the enlightened do not believe in such nonsense.”
“You don’t say!”
“Yes, sir, if you wish I will send you some excellent books to illuminate and educate you further.”
“Thank you” came the reply. “You may send them to this address.” And he handed the young man a card, which read: Louis Pasteur, Director of the Institute of Scientific Research, Paris
The moral of the story is never to assume that faith and reason, prayer and action, cannot go hand in hand. In an increasingly intolerant age we need to be more respectful of one another and better informed about the values that animate countless men and women. Nowhere more so than in the NHS,
So, in celebrating the sharp compassion of the healer’s art; in praising those who uphold a high sense of their calling; in celebrating those who put God’s gifts at the service of others; we have every reason to be like the leper who returned to Jesus, to raise our voices, and to give heartfelt thanks for 70 years of dedicated service.
15 See, I have set before you today life and prosperity, death and adversity. 16 If you obey the commandments of the Lord your God[a] that I am commanding you today, by loving the Lord your God, walking in his ways, and observing his commandments, decrees, and ordinances, then you shall live and become numerous, and the Lord your God will bless you in the land that you are entering to possess. 17 But if your heart turns away and you do not hear, but are led astray to bow down to other gods and serve them, 18 I declare to you today that you shall perish; you shall not live long in the land that you are crossing the Jordan to enter and possess. 19 I call heaven and earth to witness against you today that I have set before you life and death, blessings and curses. Choose life so that you and your descendants may live, 20 loving the Lord your God, obeying him, and holding fast to him; for that means life to you and length of days, so that you may live in the land that the Lord swore to give to your ancestors, to Abraham, to Isaac, and to Jacob.
Jesus Heals Ten Men With Leprosy
11 Now on his way to Jerusalem, Jesus traveled along the border between Samaria and Galilee. 12 As he was going into a village, ten men who had leprosy[a] met him. They stood at a distance 13 and called out in a loud voice, “Jesus, Master, have pity on us!”
14 When he saw them, he said, “Go, show yourselves to the priests.” And as they went, they were cleansed.
15 One of them, when he saw he was healed, came back, praising God in a loud voice. 16 He threw himself at Jesus’ feet and thanked him—and he was a Samaritan.
17 Jesus asked, “Were not all ten cleansed? Where are the other nine?18 Has no one returned to give praise to God except this foreigner?”19 Then he said to him, “Rise and go; your faith has made you well.”