The NHS: feeling well and thriving at 75BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7150.57 (Published 04 July 1998) Cite this as: BMJ 1998;317:57
- Donald M Berwick, chief executive officer.
- Institute for Healthcare Improvement, 135 Francis Street, Boston, MA 02215, USA
This article is based on a talk given to “The NHS: All our tomorrows,” the 50th anniversary of the NHS conference, London, 1 July 1998
It is a thrill and an honour to welcome you to the 75th anniversary celebration of the NHS. Time flies. It seems only moments ago that many of us here were assembled in 1998 for the glorious 50th anniversary celebration. That meeting, at the close of the last millenium, marked, as you know, a turning point for the NHS. We recognised and celebrated the achievements of the last half of the 20th century, but we also set the stage for the enormous leaps that we have made in the 25 years since.
A lot has changed since 1998. Who could then have anticipated that durable peace would finally settle not only on Ireland but also on the Middle East and the Balkan states? We could not then have known for sure that measles would now be eradicated, river blindness brought under control, and the worldwide epidemic of multidrug resistant tuberculosis stopped through unprecedented international public health collaboration. In the United States, where health care costs reached 22% of the gross domestic product in 2015, real reform finally took hold, beginning with President Whoopie Goldberg's famous call, paraphrasing Ian Morrison, that the United States become, “At last a nation where health care is a right and carrying a semiautomatic machine gun is a privilege, instead of the other way round.” Today American health care is administered under a single, government sponsored insurance scheme, with public accountability not at all dissimilar to the NHS. For the first time in nearly a century, American healthcare costs are falling (they are now only 50% higher than Britain's), the population's health is improving, and all Americans can get the care …