Did you know that the NHS was formed in the same month that post-war bread rationing ended? Some may have said that July 1948 was not the best time to launch the NHS, giving the right to universal healthcare, free at the point of use. Overcoming concerns about its affordability, working out how it would operate and linking various providers with their own identity and entrenched values looked like a monumental task.
However, perhaps a more important question is: is there a wrong time to start doing the right thing? Does this not just require courage and individuals seizing the moment to end the dithering and the cycle of false dawns?
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So, how did Aneurin Bevan and co do it? The Beveridge report was produced in 1942 after a review into the operation of social insurance schemes. Recommendations on bringing them forward were made by Sir William Beveridge and the inter-departmental committee he led. The report is credited with paving the way for the birth of the welfare state.
But that was just not enough. There is no wealth without health. The political machinations of the Beveridge report caused consternation and at times even exasperation to many. However, it is a masterclass on how to turn a good policy paper into meaningful action, build consensus and rally the public to demand better. It was a masterstroke – a lesson for community pharmacy today.
The “great and novel undertaking”, as Mr Bevan described the NHS, is now facing unprecedented challenges. Its cradle-to-grave offer was never conceptualised as delivering convenience, and now that seems more true than ever. Yet our collective will to achieve what seems implausible must not waver but stand firm.
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A glance back through time will show that community pharmacists have come a long way from deciphering the doctor's handwriting, being converse in Latin and wearing white coats. We have also come a long way from only preparing nostrums, managing common ailments and preparing and dispensing prescribed medicines. Arguably, while we have been part of the NHS since its inception, we have been a wallflower. However, has our time now come?
For patients, community pharmacy is the first contact with the NHS and the most accessible touch point of this radical, bold and defining approach. For 75 years, countless people have experienced the NHS’s universal offer daily, in times of great need for care and reassurance. Community pharmacy is not just an asset or one of the cogs in the machinery of the NHS, but its very heartbeat. Despite all the strains and pressures, it never stops functioning. However, it must never die.
So, 75 years on, is community pharmacy still relevant? Of course. But how? Anecdotal evidence shows community pharmacists are best suited to deliver many aspects of care, including vaccinations and managing common ailments. We have a bedrock of trust, innovation and agility as well as an exciting prospect of a radical population health revolution. This will be shaped by clinical excellence and the right structures that will enable and sustain us. These could yet help us write the best chapters in the history of the NHS.
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I have an undying admiration for and commitment to the NHS. In my career, I have seen what a system of non-universal access fashioned around affordability looks like. If Mr Bevan walked into a community pharmacy in 1948, he might have thought: “This will do!” I can only imagine him seeing us in 2023 and exclaiming: “Now, this is it!”
If we as a nation are to prevent, protect and enhance health and wellbeing while obliterating health inequalities, community pharmacies must play a pivotal role. Let's not now spend two, 12 or 35 years realising this. Now is the opportune moment. We must not let it pass us by or suffer from a vision that lacks the ambition to match the class of 1948. If this seems far-fetched, please spend some time in a community pharmacy to see and meet those waiting for this moment of rebirth. Their lives and wellbeing depend on us.
Ade Williams is superintendent pharmacist at Bedminster Pharmacy in Bristol
