I love old medical books - they often give a lot of insight into both what has changed, and what hasn’t, in the practice of medicine

For #NHSBirthday, a wee thread on this book, which sits on the shelves in my office

Written in 1965, it gives a fascinating glimpse into both the sort of place 60s Britain was, but also how the still young NHS was evolving

17 years in, the financial implications of sticking to the NHS’ founding principles were already clear

“Such a system must inevitably be costly ... where has the money gone? The short answer is - all over the place”

And what were those founding principles: “in a sentence...”

In 1965 the doctor was still King in the NHS (and resolutely male), and the memory of “mouths stuffed with gold” to silence those who had opposed the NHS’ creation was still strong

The hierarchical, and again very male, environment of the hospital was clear in 1965

( @EvelinaLondon in 2020 runs on very different lines!)

This, on the nature of medicine as a profession, still has a lot that rings true in 2020

There is advice on how to pick your doctor:

And having done so, you are reminded that your doctor “is a human being, with a breaking-point like everybody else” (something it is definitely just as important to remember today) and “longing for a cup of tea, or a glass of beer”

The attitude to doctors has - thankfully - changed a lot since 1965, as this admonishment on second opinions demonstrates

... and by the sounds of it, in 1965, if you’d got to lunchtime as a doctor without having an alcoholic drink, you were doing well!

ED: “Casualty officers face a steady stream of scroungers, crackpots and stupid people, demanding urgent attention for trivial complaints” - a blunt description

Geriatrics: “Psychologically, Britain is geared to the young”

(Note the implication though that “old” = “the over-forties” )

Geriatrics: “Plan with, not for, old people. To accept direction, very often correction, from those you used to have authority over in their infancy is a soul-destroying process”

Maternity: a very different experience to a modern maternity admission

Premature babies were those born weighing less than 2.5kg. Neonatal Intensive Care was still waaay over the horizon

Abortion was still illegal: “you cannot for one moment expect your doctor to prescribe pills or drugs that an in any way induce an abortion.”

“and calmly she answered all my questions ... she certainly saved me from sleepless nights”

One area I would put a *lot* more funding into in the NHS in 2020 would be health visitors

So much good, preventative, health care can be - and is - delivered by them, a huge resource

Similarly, more funding for mental health remains desperately needed in 2020 as in 1965

This sentence could easily be written now:

“In spite of the undoubted improvements in the mental health services of this country since the NHS, there is still a tremendous amount to be done”

“The Backward Child” ... reading this just makes me sad for all those kids whose needs should have been better recognised, and proper support provided for them

We do better now - but still lots of work to do

I didn’t know about this historical distinction between vaccination and immunisation (though can see where it tracks from)

Sexual Health: “control of venereal diseases is completely dependent on the moral standard of the country”

... with a helpful 60s guide to contraception

It’s a fascinating read ... wonder what the people in 2075 will think looking back to the NHS of 2020