Not many people can say they have served as a doctor in the NHS for almost 50 years, making up two thirds of its 75-year life time, but Dr Hasmukh Shah can.
Dr Shah trained in MS University of Baroda in Gujarat state, India and has been working in the NHS for the last 48 years. For the last 36 years he has been working as a GP in the Rhondda valley. He is also secretary of the British Association of Physicians of Indian Origins, and champions the work of Indian doctors based in Wales.
In his own words, Dr Shah has reflected on the achievements of the NHS over the last 75 years, and looking towards the future, where he can see the health service going.
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NHS has increased life-expectancy in Welsh people
"The NHS in Wales looks after 3.21 million people. Life expectancy in Wales is currently at 82 years for women and 78 years for men, based on the most recent data. Since the NHS was founded in 1948, longevity has increased. Our patients are now 1 in 5 over 65 years and that is likely to grow. The NHS is now facing health needs relating to an ageing population, which is mostly the result of the elimination of infectious diseases like tuberculosis as well as the increase in cancer survival rates.
"We are doing more screening for cancers, congenital diseases and other medical conditions. Our childhood vaccination rate is very high, hence reduced infant mortality. We are doing more investigations like CT, MRI, US, hence early diagnosis and good outcomes."
Our NHS is built on shoulders of overseas doctors
"More than 30% of medics now working in Wales health system qualified overseas, majority of those have come from India. Overseas doctors have for many years made a valuable and important contribution to the NHS in primary, secondary and community care. They bring diversity of thoughts and experience. They are a hugely talented workforce.
"Many services in Wales would have struggled to provide care to their patients in Wales without doctors from overseas. Our NHS is built on shoulders of overseas doctors, they are backbone of NHS in Wales. Many of them overcome personal hardship and rejection along the way but now provide their expertise in Wales.
"Overseas doctors often work in the areas where no one else want to go. There is a historic shortage of UK trained doctors in secondary care especially consultant posts in emergency care, haematology and old age psychiatry. In primary care for many years, overseas doctors have worked in areas with high levels of deprivation in Wales, where workload is high and patient's needs are very complex due to deprivation, poverty, drugs and mental health issues.
"In 2016 I worked with the Welsh Government to recruit doctors from India to work in Wales, it saved more than £500,000 in locum costs. During the pandemic, overseas doctors saved many patient's lives working on the front line, despite the pandemic disproportionately affecting those from a black and ethnic minority background. Some of them lost their lives.
"Welsh people are warm hearted and we feel like we are at home here."
The future of the NHS
"Over the last 10 years, the NHS in the UK has received the lowest amount of funding than average European countries. There are over 130,000 unfilled vacancies in the NHS across the UK. We have the least amount of MRI and CT scanners when compared with other EU countries. As a result, services are under a lot of pressure and people are not being seen by specialists in time. There are very long waiting lists for elective surgery like hip replacements and the pressure on primary care services are unsustainable.
"I think in the future, the NHS will have a digital first model of care, within the next few years. By 2030, the vast majority of people are likely to be accessing healthcare via apps. I think we will also be using artificial intelligence in healthcare a lot more.
"It will take our IT systems up to speed and it could potentially reduce the burden of healthcare activity on the workforce by making the whole system a great deal more technology friendly.
"As a result of machine learning technologies, unsupervised machine learning, we may be able to get better diagnosis from imaging, from genomics and from structural digital data combining all these will give us much better diagnostic frame work which will be done without a huge amount of input again from the workforce.
"But the main question is, can we really afford to provide everything that is available for everybody across their entire life course?"
