Page last updated at 09:41 GMT, Wednesday, 2 July 2008 10:41 UK

The changing nature of illness

By Jane Hughes
Health correspondent, BBC News

Childhood rickets
Rickets was a major problem in 1948
When he founded the NHS, Nye Bevan talked about caring for people from the cradle to the grave.

Our cradle-to-grave experience of the NHS has changed enormously since then - not just because the health service is very different now, but also because we now have very different types of health problems.

CHILDBIRTH

The changes are evident from the very earliest moments of life.

Childbirth is much safer now - in 1948, 39 in every 1,000 babies were stillborn or died within a week of birth. By 2006, only eight babies in every 1,000 died.

In the early years of the NHS, most mothers gave birth at home, and it was usually the midwife, not the doctor, who was in charge.

Today, the vast majority of babies are born in hospital.

There is far more technology available, including highly sophisticated neo-natal care, and even if they are born as much as four months prematurely, babies now have a fair chance of surviving - a chance that they certainly did not have in 1948.

"The availability of technology has changed a lot," said Louise Silverton, deputy General Secretary of the Royal College of Midwives.

"Foetal Monitoring, ultrasound scans, ante natal screening tests - women have a lot more choice."

CHILDHOOD

Children's health has changed enormously in the last six decades.

A child born in 1948 was likely to face illnesses like rickets, polio, measles, whooping cough and diphtheria.

Poor nutrition was a problem, and serious infections were every mother's worry.

Obesity
Childhood obesity is a now a serious concern

Dr Hasmekh Joshi has been a GP in Pontypool in south Wales for most of the last four decades.

In his first weekend in his practice, he says he saw 43 children with measles.

Today, vaccination programmes have virtually eliminated the risk from many infectious illnesses, and Dr Joshi's much more likely to be seeing youngsters with obesity related conditions like diabetes.

"The disease pattern has shifted," he said.

Excessive eating, rather than poor nutrition, is a big concern.

About a third of all 11-year-olds are overweight or obese.

Children also now go to the doctor complaining of mental health problems like depression and eating disorders - a radical change in the pattern of children's' illnesses.

ADULTS

Lifestyle conditions are now among the biggest problems for adults as well - in stark contrast to the problems of 1948.

If you went into hospital then, it was most likely to be for a fracture or injury.

Now it may be because of heart disease or stroke.

Alcohol related conditions are an increasing problem.

Dr Joshi said he also sees many more patients with cancer.

"People's perceptions of health have changed," he said.

Whereas people only used to go to the GP when they were feeling ill, he says he spends a lot more time now trying to prevent disease

ELDERLY

We are all living much longer than we did in 1948 - the average man in the UK now lives until he is 76, the average woman to 81 - ten years more than our life expectation 60 years ago.

That means doctors are treating many more chronic diseases which affect older people - arthritis, Parkinson's and dementia are far bigger problems than they were when the NHS started.

At the birth of the NHS it was thought better nutrition and improved healthcare would mean fewer illnesses - in fact, because we're eating more and living longer, doctors are now dealing with a whole new range of conditions.





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