As the National Health Service celebrates its diamond anniversary, consultant obstetrician Ahmed Ali considers what this jewel of the public sector has to offer in the next 60 years. Ian Lamming reports. WEIGHING in at more than 9lbs, baby Metcalfe bellows her greeting to the world as her adoring parents smile down at the latest edition to their family.

Dad Stuart Hardaker and his partner Sarah Metcalfe chose to drive from their home near Bishop Auckland to Darlington Memorial Hospital for the safe birth of their daughter.

The choice was theirs as the principles of state medicine remain as solid today as they were at the inception of the NHS in 1948 - efficient and equitable health services free at the point of delivery.

"I have only had three experiences of the National Health Service, two babies and a relative's hip operation and every one has been fantastic,"

says Stuart, of St Helen's Auckland.

"It was no problem travelling through here; everyone has been so kind, brilliant and I sincerely hope things will stay this way for the next 60 years."

Looking on, consultant obstetrician Ahmed Ali smiles - it's difficult not to with so much joy in the room - as it is the perfect hospital scene and why he is so eager to come to work every day.

Mr Ali is clinical director for the women and children's division at County Durham and Darlington Foundation Trust.

He came to England from his home country of Egypt to complete his training. He was so impressed with what he found that he made the North-East his permanent home.

"I came here because it offers the best post-graduate training in the world," he says. "My intention was to go back home but in Egypt, I didn't like having to divide my time between private and public practice.

I hope medicine will stay free at the point of delivery as I think that is the best post-war achievement and the envy of the world."

By contrast, 7,000 miles away, an Englishman abroad marks his time in Hong Kong by receiving a collection from friends and colleagues.

Money goes into the hat, not for a commemorative trinket or flashy gift, but so he can have another dose of chemotherapy for the cancer that threatens to consume him. He has paid his taxes, he has medical insurance, but the money has still run out along with the care.

Mr Ali says: "I will never go back to any sort of private care. Free care must remain a core principle. Once you commercialise health then care isn't the first priority. I am certain about this because I have worked in both sectors."

And if the NHS remains a world leader for care despite being funded publicly, Mr Ali is convinced it is also at the cutting edge for research that will see the country's population leading ever healthier, happier and longer lives over the coming six decades.

"Sixty years ago maternal and prenatal deaths were much higher than the very low figures we have today," he says.

"Small babies are now surviving, babies so young that once they would have been counted as a miscarriage rather than a birth. There are amazing technological advancements. We have the technology to treat and prevent disease.

"Sixty years ago most people lived until they were about 60. Now we are living past 80 and I see no reason why 100 should not be the norm in coming years. We have advances in gene therapy, stem cell research, screening which means early detection and treatment. Drugs, surgery and radiotherapies are much more advanced while the side-effects are much reduced.

"In cardiac medicine we have the catheterisation of blocked arteries, transplants and the development of mechanical devices so we no longer have to rely on people dying to save others."

Mr Ali's vision for the future also sees the efficient use of the NHS's estate and facilities.

"We have to use sensibly what we have already got. We have big hospitals and a lot more smaller establishments and there are good uses for all. I see super centre for advanced care in the treatments of disease and transplants.

"Below that there's a place for the district general hospitals, which offer the best opportunities for training junior and senior doctors and other health professionals. And then there are important tasks for our smaller community establishments."

He strongly believes that if we are going to enjoy our prolonged old age and our tissues have to last so much longer, then everyone has a part to play. The key component to modern medicine today and for the coming decades is prevention. Change the public mindset; alter people's lifestyles so they don't develop the ailments that can be avoided.

"We have the benefit of advances in medical science, but it is more about prevention through education," Mr Ali says. "The whole of society will have to take this into consideration."

It is 60 years since the NHS came into being and the consensus is that healthcare has never been in such good shape.

"I have never stopped enjoying practising medicine, but as clinicians we also have a part to play in the successful management of the NHS - it's our duty," he says. "If we all care for the NHS as much as we care for our patients then the future is extremely bright."

10:41am Tuesday 8th July 2008

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