Martin Powell
1*1 Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK.
Abstract
The British National Health Service (NHS) celebrates its 70th birthday on July 5, 2018. This article examines this
anniversary through the lens of previous anniversaries. It examines seven documents close to each anniversary
over a period of some 60 years, drawing on interpretive content analysis, based on the narrative dimensions
of context (structure and finance); success or achievements; problems; and solutions or recommendations. It
finds that the anniversary documents tend to show change rather than consistency. For example, the Guillebaud
Report tended to dismiss the problem of ageing populations, for it to reappear in 1979 and 1989, to fade in 2009,
and reappear once more in 2017. Despite being downplayed or ignored in some years, the problems identified
by most of the documents such as demography and technology are unlikely to disappear. Some solutions such
as market-based reform have flowed and ebbed over the years, and the ‘solution’ of structural reorganisation in
one year has become the ‘problem’ in a future year. While predicting the future is always hazardous, it can be said
with some confidence that future anniversaries are likely to see discussion of similar themes.