Editorial: The NHS, on its 75th anniversary, is rightly a source of pride but it badly needs reform to be effective in modern age

Today, the NHS is set to mark its seventy-fifth birthday. The celebrations will feature events in Northern Ireland, including a reception at Parliament Buildings at Stormont, and there will be a service at Westminster Abbey.​

This anniversary will generate enthusiasm, but its timing could trigger mixed emotions. We are rightly proud of the NHS and its commitment to providing essential healthcare, free at the point of use. At the same time, our hospitals and GP surgeries are currently overwhelmed, meaning that many people experience delays, long waiting lists and outdated facilities.

In the aftermath of the Covid lockdown, and against a backdrop of financial constraints, the NHS is struggling across the UK. In Northern Ireland, though, these problems are particularly severe, because successive executives failed to reform our system, despite commissioning multiple reviews over two-and-a-half decades.

All these documents recommended, broadly, the same thing. That we should centralise services in fewer acute hospitals and invest in community care. No health minister was unaware of what was needed, but mandatory coalition and the politics of devolution made it difficult for Stormont to take potentially unpopular decisions. If the assembly is restored, these much delayed NHS reforms must surely be near the top of any executive’s in-tray.

Most of us have had reasons to be grateful for the health service. Its staff includes some amazing people and, when it works, it is an invaluable institution. Too often, though, any suggestion of change by the government is cast as a threat to its public sector ethos or the principle, “free at the point of use”. That’s short-sighted, as the NHS clearly needs sweeping reforms if it is to continue to be effective into the modern age.