Harold Ellis was paid £50 a year when the NHS started
By Jane Elliott
Health reporter, BBC News
Professor Ellis is still working in the NHS
For 60 years the NHS has been Professor Harold Ellis' working life.
He qualified the month of its inception in 1948 - today aged 82, he is still working in it, teaching clinical anatomy at Guy's Hospital, London.
Over his six decades Professor Ellis says he has seen health provision change dramatically with cures for some diseases and the emergence of others, a growth in litigation and some fantastic new inventions.
But despite his obvious passion for the NHS Professor Ellis admits he was originally rather underwhelmed.
"I qualified in July 1948, aged 22, from the University of Oxford. The very month the health service came in, funnily enough though it did not mean anything to us at all, we were just delighted to be doctors," he said.
I remember putting a woman on the operating table with no pulse and no blood pressure and opening her up with no anaesthetic and saving her life, but if that was to happen today the surgeon might say: 'What about the lawyer?'
"The fact that it was a national health service was something we never really thought about at all. You see the hospitals were all 'nationalised' during the war - under the EMS the Emergency Medical Service
"So there was no dramatic change for us.
"But I am devoted to it. I have spent all my working life in it - and still am."
Professor Ellis said the general atmosphere among his colleagues was very upbeat and cheerful, even though many had suffered terrible losses in the recent war.
"Everybody you spoke to had got family or friends who had been killed or maimed either in the armed services, or in the bombings, or in the camps," he said.
The early days of the NHS, Professor Ellis remembers, were good for young doctors who were treated well - but expected in return to devote themselves to the new service.
PROFESSOR HAROLD ELLIS
Born 13 Jan 1926 in East London
Pre NHS: Medical student at Radcliffe Infirmary, Oxford
1950-51: Royal Army Medical Corp
1952: Surgical registrar, St James Hospital, Balham
1953-1954: Registrar, Sheffield Royal Infirmary
1955: Registrar, Westminster Hospital
1956-60: Senior registrar, Oxford Radcliffe
1960-89: Foundation professor for a newly opened surgical unit at Westminster department of Surgery
1989: Retired from practice. Taught anatomy at the University of Cambridge
1993-present: Teaching clinical anatomy at Guys and St Thomas', London
"We had all our meals, our laundry and at the Radcliffe, because of some benefaction, we had free beer in the evenings," he said.
"We lived in the hospital and had very little time off. The hospital was our life and great it was too."
Initially most of the more wealthy patients went private as a matter of course, meaning the NHS cared for the ordinary citizen.
One issue on which Professor Ellis believes the NHS has made little progress is on keeping hospitals clean. He is not a fan of the deep clean strategy employed by the current government.
"After the war the hospitals were very tatty but clean," he said. "This was because nursing staff conducted their own cleaning purges as a matter of course.
"A lot of the wards were in temporary Nissen hut accommodation - my male surgical ward was in a hut.
"It sounds bad, but in fact, because of the fact that they were looked after by sister, they were scrupulously clean inside.
"If MRSA had dared to come inside, sister would have stamped on it.
"You have got to scrub the ward after every dirty case that has been admitted, which is what they used to do in my day.
"You can scrub a ward, but if you admit a tramp with a stinking ulcer on his foot as your first patient your ward is then heavily contaminated with MRSA."
Professor Ellis said that medical advances had led to shorter hospital stays and reduced mortality.
And that some diseases, which were rife in the early days, had been almost completely eradicated.
When he first started in surgery TB and polio caused vast swathes of the population to need hospitalisation.
Although TB is starting to re-emerge, the scale of its threat was vastly bigger when Professor Ellis started working.
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"We had TB hospitals and sanatoriums such as the Brompton, Papworth and Harefield. The orthopaedic hospitals was full of bone and joint TB, and the general surgical wards had cases of TB of the glands and neck, urinary system and abdomen.
"Each year we used to expect one or two of our medical students to be admitted to the sanatorium after contracting pulmonary TB.
"Being a Cockney from the East End of London I used to say, 'I bet I am so immune I won't get it'.
"But getting poliomyelitis (polio) used to scare me as a medical student. There were a couple of epidemics and one of my chums died in an iron lung in the Radcliffe so I knew I did not fancy that at all.
"I tell my students in my lectures that diseases they are seeing now are going to disappear in their lifetime.
"Now it is HIV, drug addicts did not exist then although there were alcoholics, you could not get hold of heroin and cocaine.
"Gun wounds and knife wounds were extremely rare and pathological obesity - that did not exist," he said.
He said dental care had also improved, adding that in 1948 a number of patients had to have teeth removed before surgery because their condition was so poor, clinicians worried they might come out during surgery.
End of paternalism
One welcome development over the last 60 years, says Professor Ellis, is the end of the paternalistic "Doctor knows best culture".
"In 40 years I have never had a medico-legal case and nor had anyone I worked with - but that was wrong," he said.
Harold Ellis operating in 1952
"Patients used to say 'Doctor knew best'. I worked for a terrible surgeon - something would go wrong and he would say to the patient, 'I don't want you to blame yourself' and they would say 'sorry my wound has gone septic'."
However, he feels things have now gone too far the other way, with doctors too worried about litigation to do their job properly.
"I remember putting a woman on the operating table with no pulse and no blood pressure and opening her up with no anaesthetic and saving her life, but if that was to happen today the surgeon might say: 'What about the lawyer?'."
His ideal NHS would be one free of too much government red tape - and targets which run the risk of skewing clinical priorities.
"We would say this guy is in terrible pain - let's get him in today', or 'this guy has terrible varicose veins for 20 years so he can wait a bit longer'.
"I would like to see the consultants having more involvement in the running of their hospitals, and nurses being left alone to run their wards."
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