"I believe it will lift the shadow from millions of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering. It will be a great contribution towards the wellbeing of the common people of Great Britain."

These historic words were spoken in April 1946, at the second reading of a Bill proposing the creation of a National Health Service - or NHS - in Britain. It was the dream of Britain's then-Health Minister, Aneurin Bevan, who envisionedImagined as a possibility for the future. healthcare that would be available to all, regardless of their ability to pay, and that would meet the needs of every single citizen.

The National Health Service was created in 1948. It was the first ever healthcare system that was completely free at the point of use, available based on citizenship rather than fees or insurance. And it quickly became one of Britain's greatest triumphs.

But 1948 was a long time ago. In fact, this week marks the 75th birthday of the NHS. The service, which initially cost £30m annually, now costs a steep £190bn.

Nor is the service running smoothly. More than seven million people are currently on waiting lists; 370,000 of them have been waiting for over a year. Strikes over low pay for staff led to almost 200,000 cancelled hospital appointments in April. Last winter, victims of strokes and heart attacks had to wait over 90 minutes for an ambulance to arrive.

Demands on the NHS have also evolved starkly. When it was first created, the life-threatening conditions it treated were infections and heart conditions. Now, the most common causes of death are cancer, suicide and heart conditions - illnesses that pose very different challenges.

One of the biggest threats to the NHS is an ageing population. It is estimated that £7 out of every £10 spent in the NHS is on heart disease, dementiaA syndrome associated with memory loss and other declining brain functions.  and diabetesA medical condition causing there to be too much sugar in the blood. - all strongly associated with old age.¹

And with an increase in chronic health conditions preventing as many as one in 14 people from working, accessible healthcare seems more important than ever.

The approximately 2.5 million people unable to work because of health problems perhaps contribute to the UK's weak productivityThe rate at which an individual, company or group produce work or make something. growth - the US, France and Germany supposedly produce around one sixth more than the UK per hour worked. And weak productivity has long put a dent in Britain's economic growth.

Nigel LawsonA British Conservative Party politician who died in 2023. He was the father of celebrity chef Nigella Lawson. once described the NHS as "the closest thing the English have to a religion". But many think it will not make it to its 100th year. How has it got to this point?

The reasons are tenfold. The Covid-19 pandemic created a backlog of millions of operations that were cancelled in order to treat coronavirus patients. Over the past 30 years the number of hospital beds has more than halved.² Experts allege that the service has been underfunded for over a decade. A "crisis of morale" has left more than 130,000 unfilled vacancies as staff suffer from burnout, overwork and stagnatingStaying the same or not growing. salaries.

Some describe this as a tipping point. Whether because of mismanagement or a fundamental incompatibility with modern healthcare, many think that Britain's most treasured service is facing its own terminalWhen an illness is going to be fatal. illness.

Yes: The majority of the British public support the striking NHS staff. That will be reflected in future elections, as parties which promise funding for the service garner more votes. This is just a temporary setback.

No: The NHS is on its last legs. Experts are recording increasing levels of excess deaths year upon year, and the government is failing to negotiate sufficient pay for staff. Privatisation will soon be the only option.

Or... Britain should review whether a universal free healthcare system like the NHS really works in the modern world. Perhaps what worked in 1948 cannot work today.