This July marks 77 years since the creation of the National Health Service (NHS), a cornerstone of British life and one of the country’s most ambitious post-war reforms.
Launched on 5 July 1948 by Health Minister Aneurin Bevan, the NHS was built on three founding principles: that it should meet the needs of everyone, be free at the point of delivery, and be based on clinical need, not ability to pay. These ideals made Britain one of the first countries to offer universal healthcare funded by taxation.
Decades later, the NHS remains a source of national pride and a vital service for millions. Every day, it provides care to over a million people, handling everything from routine check-ups to life-saving operations. Its role during the Covid-19 pandemic further cemented its importance, with NHS staff hailed as heroes for their tireless efforts.
Reflecting on this milestone, Dr Bhasha Mukherjee, NHS doctor and Miss England 2019–21, said, “The 77th anniversary of the NHS is a powerful reminder of how deeply embedded it is in the fabric of British history… The NHS is, at its core, a resilient organisation, shaped by history and carried forward by equally resilient people.”
However, today’s NHS faces immense strain. Waiting lists are at record highs, general practice is under pressure, and staff shortages continue to deepen. Funding gaps, an ageing population, and growing demand for mental health services add to the burden.
According to Dr Rahul Mukherjee, Consultant in Respiratory and Internal Medicine, “The fact that the NHS has endured for 77 years is remarkable… The focus now is on making the NHS more sustainable so we can continue delivering universal healthcare, something we should all be proud of.”
Challenges and Scandals
Seventy-seven years on, the NHS remains central to British life, still admired at home and abroad. But today it faces perhaps the most serious crisis in its history. With chronic staff shortages, soaring demand, and record waiting lists, the service is straining under the weight of decades of underinvestment and political short-termism.
Public satisfaction has dropped significantly in recent years. Patients now wait weeks or even months for treatment, with emergency departments and GP surgeries overwhelmed. Longstanding regional health inequalities persist, particularly in deprived communities, challenging the NHS’s promise of fairness. Meanwhile, the workforce, exhausted from the pandemic, is grappling with burnout, pay disputes, and low morale.
Scandals have compounded these problems. Failings in maternity services, especially in cases like Shrewsbury and Telford, have shaken public trust. Other reports have highlighted systemic issues such as bullying, racism, and failures in patient safety. These incidents have exposed the cultural and structural challenges that undermine the NHS from within.
Dr Ramesh Mehta OBE, Founder of the British Association of Physicians of Indian Origin (BAPIO), didn’t hold back, “While its founding principle of free care at the point of need still holds immense value, growing bureaucracy and poor management have eroded its effectiveness. Long waits and delays in emergency care are unacceptable and must be addressed urgently… My message is clear: we are proud of our NHS, but we need politicians to take responsibility and act now.”
Morale within the workforce remains low. Strikes by junior doctors, consultants, and nurses over pay and working conditions have drawn public attention to the system’s fragility.
British Asian contribution
From its earliest days, the NHS has depended on international doctors, especially from South Asia.
Thousands of doctors from India, Pakistan, Bangladesh and Sri Lanka formed the backbone of the service, often working in remote or underfunded areas. Despite systemic racism and limited recognition, many rose to senior roles and left a lasting impact. Today, British-Asian healthcare professionals continue to play a crucial role, comprising a significant part of the NHS workforce and contributing to its resilience.
Reflecting on these contributions and the legacy of South Asian doctors, Dr Mehta said, “Doctors from India and the wider subcontinent have been the backbone of the NHS since its inception. Without their sincere and honest service, the NHS would not have been able to function. Unfortunately, over the years, successive governments have failed to give these international medical graduates the recognition they truly deserve.
“There are several ongoing issues. The most pressing is the lack of clear opportunities for career progression. In addition, bullying and harassment remain serious concerns, and the basic principle of dignity at work is often lacking. These are not isolated problems, they are persistent and systemic.”
He further added, “It’s important to recognise the immense contributions our community has made to the NHS over the decades. Our doctors and managers deserve greater representation at senior levels, and it's time to address the lack of diversity at the top. The NHS leadership must reflect the workforce and the communities it serves. This means breaking down the ‘white peaks’ that continue to dominate senior management.”
In a statement to Asian Voice, Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, said, “The NHS is a well-regarded and much-loved institution; it’s perhaps the most visible expression of a shared social contract between people – and has been for 77 years. However, to be proud of the NHS is not to be blind to its imperfections, and the inequalities that often exist for patients and for the staff working in the NHS are some of those imperfections.
“The good news is that the government has outlined a clear commitment to tackling inequalities and placing a duty on healthcare providers to identify and address disparities in access, experience and outcomes for patients, and in the experiences and opportunities for staff. However, much work needs to be carried out to build and rebuild levels of trust and confidence in our diverse communities and amongst the workforce. The Observatory remains committed to supporting the government, and the NHS, on the pursuit of equity – the very principle upon which the NHS was founded 77 years ago.”
The NHS's relevance in a changing world
Despite its many challenges, the NHS continues to be viewed as one of the world’s most effective models of healthcare—especially when compared to expensive, insurance-based systems.
“Healthcare is built on trust, not transactions,” said Dr Rahul Mukherjee. “In the NHS, patients know doctors are working in their best interest. That trust is priceless. Countries like the US and India spend more on healthcare but often get poorer outcomes. In contrast, the NHS provides value for money while maintaining public trust.”
Dr Mukherjee added that he is personally involved in green and cost-saving projects, such as refurbishing ventilators and CPAP machines. “It’s part of our ‘three Ps’ approach: better for the Patient, the Planet, and the Pocket.”
For Dr Bhasha Mukherjee, the NHS’s strength lies in its ability to adapt. “There have always been challenges, from historic pressures to Covid. But what stands out about the NHS is its remarkable ability to evolve. That’s what has kept it alive for 77 years.”
Still, she cautions against burdensome bureaucracy that frustrates frontline workers. “We waste so much energy on red tape, training for the sake of training, forms for the sake of forms. That breeds cynicism. We must bring back empathy, compassion and human connection to the centre of NHS care.”
Hopes on the horizon
Amid the crisis, there are signs of hope and with one year of a Labour government in place, many healthcare professionals are cautiously optimistic.
The government has launched a ten-year NHS reform plan focused on prevention rather than just treatment. The strategy aims to tackle issues like obesity, improve access to primary care, and reduce the burden on hospitals. Technological innovation is also being embraced, with AI tools set to monitor patient safety in real time and help prevent future scandals.
Professor Partha Kar, National Specialty Advisor for Diabetes at NHS England, said, “The NHS continues to be one of the biggest political and public issues. Labour’s upcoming 10-year plan will show their direction, but the key issue is implementation. That’s been the biggest bugbear in recent decades.”
Dr Bhasha Mukherjee echoed this hope, “Labour has spoken about cutting red tape and I hope they mean it. We need to move away from a tick-box culture and put patients, not paperwork, at the heart of the system again.”
As the NHS enters its 78th year, it stands at a crossroads. Its founding ideals remain relevant but real reform is needed to ensure its survival. Better management, meaningful diversity in leadership, investment in sustainability, and reducing bureaucratic drag could all help the NHS thrive once again.
In Dr Rahul Mukherjee’s words: “Being pro-NHS doesn’t mean ignoring productivity.” If we care about the NHS, we must also make it work smarter.
The NHS is still one of the most trusted institutions in the UK, but it cannot run on legacy and goodwill alone. If its next chapter is to be one of revival, not decline, then action and not just admiration, must define the years ahead.
