It was the year of the austerity Olympics in London, the first Polo mint rolled off the production line, bread was tuppence a loaf, and the NHS was born, along with 905,000 babies in the UK. Bernadette Friend tracked down some of Bevan's 1948 babies - who went on to work in the service they grew up with - to find out about their experiences of the NHS and hear their prognosis for its next half-century

Name: Marianne Rigge

DOB: 10 May 1948

Occupation: Director and founder, the College of Health

At seven, Marianne Rigge experienced the best of times and worst of times in the health service in London. Given her early experiences, it is hardly surprising she went on to found the consumer health and research group, the College of Health. One third of her body surface was burned when her nightdress caught fire. She was admitted to a burns unit where the children's hands were tied to stop them scratching. And that was not the only harsh aspect of the ward regime.

'I dropped this horrible pudding with custard off the bed because it wasn't so easy to eat with your hands tied up. The punishment was to have your bed rolled into this large bathroom and you were left there. They did the same if you cried when your parents left. It was a total nightmare; they were so cruel.'

Her father was a GP and saw her regularly in hospital, although, strictly, parents were only allowed to visit on Sundays. After about a week, in which she ate hardly anything, her father had her transferred to Great Ormond Street Hospital.

Etched in her memory is a blissful image of a nurse who sat by her bedside and peeled her a fresh peach, a rarity in those days, cutting it into the shape of a flower.

Her father did a lot of his own house calls and often asked a consultant to accompany him. Waiting lists were almost unknown. She remembers taking on the role of receptionist, answering the phone in the middle of the night and helping to file the patients' records. She learnt to drive so that she could take her father on his house calls.

Hers has been a strong voice for patient improvements. Among other things, she wants them to have access to information about the doctors they are being referred to; their specialist interests, training and qualifications. More still, about the numbers of procedures they do. She knows this is 'light years off', but points to the Patient's Charter, which declares that patients have the right to be referred to a consultant who is acceptable to them. 'Without this sort of information,' she asks, 'how are patients to know?'

Her daughter has had 13 ENT operations for glue ear. And this has brought home the importance of staff attitude. 'It doesn't cost anything to be kind, or smile, or say your name,' she says. And she adds that through her work with the college, 'we have found that it is possible to change the hearts and minds of people when they realise just how important these teeny things matter to an individual'.

Name: Virginia Bottomley

DOB: 12 March 1948

Occupation: Conservative MP for Surrey South West, former health secretary

'The first hospital admission I remember must have been when I was about six and was to Moorfields to have a squint rectified. My eyes were bandaged for what seemed like a week. I was only allowed to sit there and not look out. It was frightening.'

Coupled with the maxim that children should be seen and not heard was the belief that parents should not be allowed on the wards to 'trouble' the children. 'I remember waiting wretchedly for the precious visiting- time hour.'

As a parent herself, she recalls that when asking even a mild question about her children she was 'effectively told that if I was so cheeky as to ask questions, I would certainly be put to the back of the queue'.

She was born in a nursing home in Dunoon, into a family steeped in medicine. Now her daughter is a junior doctor and 16 immediate family relatives are doctors. 'I have only ever used the NHS and I was totally a child of the NHS generation. I profoundly believe in its values and ethos. I have always had 100 per cent confidence that if anyone was seriously ill they could not beat the service provided by the NHS.'

She believes that, as patients become better informed, the assertive ones will press for the healthcare they want rather than that which someone decides they need. 'This will put enormous pressure on the professionals, on how they respond to extremely well-informed, articulate patients who expect to have those wishes met.

'What are they going to do about people's health wishes and wants as opposed to their health needs? This will be the challenge for the health service in the years to come.'

Name: Peter Coe

DOB: 22 August 1948

Occupation: Chief executive, East London and the City health authority

Two years before he was born, Peter Coe's mother was seriously injured in a motorbike accident. Her pelvis was crushed and she needed months of hospital treatment. She later went on to win a damages claim on the basis that she would not be able to have children. But almost all the money was paid back to the hospital for her care. 'I was a very difficult Caesarean, a blue baby,' he says. But for the advances made during the war years in haematology and orthopaedics, he is convinced he would not have survived.

In 1956 he had his tonsils out, practically a requisite for this generation. He recovered well, but it was discovered he had measles and he spent three weeks 'with no parental visiting, in the most awful children's ward. I just remember the nightmare of waking up and trying to sleep again as fast as possible. It was a ghastly experience.'

Another time he was referred to hospital for breathing exercises, aimed at remedying his breathing difficulties. Part of the regime involved running around and jumping in the air. 'I sprained my ankle so badly I couldn't get my shoe off, so my mother never took me there again. More poignantly, he remembers, as a schoolboy of 13, his mother being ill with cancer. 'But there was no thought other than it was going to be the most excellent, wonderful care.'

He believes his parents' generation is too stoical about the health service and should be more demanding. 'My generation grew up in an environment where education was going to be the best and health was going to be the best and those were things you grew up to expect.'

The increasing difficulty of recruiting into the caring professions concerns him. But he believes there may be a resurgence of the values of caring, community and neighbourliness.

Name: Sarah Bazin

DOB: 2 July 1948

Occupation: Therapy services manager, Solihull Hospital, part of Birmingham Heartlands and Solihull trust

Sarah Bazin arrived too soon for the NHS. She was expected to be born 14 July, by which time the cost of care would have been covered by the health service. In the event, she came early and was born in a nursing home.

'As a child I remember going with my mother to the welfare clinic.

'It was always very hot and airless. When I was a physiotherapy student I went back to the same clinic building and all that just flooded back.'

The 1950s was a boom time for health check-ups. She remembers lots of children, aged about three or four, sitting in rows waiting to be seen. 'We undressed down to our vests and pants and they did our heights and weights to see whether we were thriving.'

During a smallpox scare a huge line waited outside the public health building, 'to have these awful injections with syringes that looked like they came from the Dark Ages'.

'When I started here in the early 1970s we were still in the days of men coming on Mondays, Wednesdays and Fridays and the 'ladies' coming on Tuesdays and Thursdays, and you could not mix the two. But there was a great problem which we tried to explain, which was that there were more ladies than men and shouldn't we change the days round?'

At that time, physios were still paid sessional rates for up to 12 hours and were not paid for holidays or sickness. 'You could take as much holiday as you liked but you weren't paid.

'I think healthcare should be free at the point of delivery and then talk about the money afterwards if you need to. Today, expectations are higher because technology has advanced and the baby-boom generation is growing older and likely to live longer. Somebody is going to have to make some decisions about rationing, or we are going to have to be prepared to pay for the care we want in the future.'

Name: Ann Church

DOB: 5 July 1948

Occupation: Ward sister, Macmillan Unit, Christchurch Hospital, part of Royal Bournemouth and Christchurch trust

Daily dollops of malt with cod liver oil, sweet concentrated orange juice from the clinic and crates of mini milk bottles at school were the stuff of Ann Church's childhood. And too many visits to the dentist.

'He used to use a foot pedal for the drill. I can still see his foot going up and down on the pedal. It was dreadful. I remember the orange juice had such a distinctive orangey smell. It was wonderful, really sweet, but what did it do to our teeth? No wonder I was at the dentist's so much.'

She started nurse training in 1966 at Stoke Mandeville Hospital. 'The thing I remember most was the uniform - mid-calf dresses, gathered in at the back like a bustle and long starched white aprons and crown caps. At 18, you felt so important.'

Sterilising duty also sticks in her memory. 'If you had a week or couple of weeks sterilising, you were scarred for life because it just burnt your arms and hands. You came out like a washed-out cabbage at the end with your hair dripping everywhere.'

She thinks some of the patient contact has been lost in nursing in the past 50 years. Of the next

50 years, she says: 'I have always felt the NHS has been used and abused and it is so precious. I think we really have got to look after it. It is a wonderful, unique service.We have got to stick together to keep it.'

Name: Keith Hine

DOB: 5 July 1948

Occupation: consultant physician (gastroenterology), Princess Royal Hospital, part of the Mid-Sussex trust

Keith Hine's arrival on the day the NHS began meant his parents landed a bigger-than-expected maternity grant. 'I think my parents would have got only 7/6d before.'

He remembers his family doctor visiting him when he had pneumonia as a child. Because it was suspected he was allergic to penicillin, he was given tetracycline, an antibiotic not given to children now because it can weaken bones and discolour teeth. He survived without harm.

Over the years, his GP left a strong impression on him. 'He always came to the door to greet you. When you went to his surgery he would be standing up and would look you in the eye and shake you by the hand. That is very unusual in GPs nowadays. I usually shake the patient by the hand and look them in the eye so they know they are being treated as a person and not just as a NHS number.'

He trained at Birmingham Medical School. It was 1967 and the Beatles and their hairstyle were proving irresistible. He remembers an embarrassed fellow student being given some money and sent off the ward to get a hair cut. 'A major change over the years has been the growing emphasis on money and finance which today rules the NHS. I have to say that 25 years ago we didn't think too much about it. We were more concerned with just managing the patient. But I think we have to be conscious of the costs we are making to the community.' In time, he sees the NHS becoming more privatised. 'I suspect that we may see a move where the edges of the NHS will be chipped away by private enterprise.'

Name: Ann Keen

DOB: 22 November 1948

Occupation: Labour MP for Brentford and Isleworth, former nurse

Ann Keen's grandfather and father, who were steel workers, both worried that if sickness struck the family, they might be unable to pay the medical bills. 'They each contributed to a special sick fund at the steel workers' working men's club and, when they could, would try to put something by.'

As a child, she remembers rosehip syrup, and the school nurse. 'She was a very robust woman. She did the hair checks. And I remember having to stand in your knickers and your vest to have your height checked, and the smell of the school dentist, and the gas, and having your teeth out.'

She joined the health service as a hospital outpatient clerk and progressed to being a medical secretary. But she was shocked when she took up nursing as a mature student at 27. 'I could not believe it. On my first day in the nurses' home, the bed wasn't made. It was just the mattress and everything folded, with the uniform on top. Everybody referred to me by my surname. I thought I had joined the army.'

The future NHS must carry on the tradition of the 1948 Labour government, she insists. 'It will be there from cradle to the grave and will be available to everybody on the basis of need.'

More immediately, as a member of the health select committee currently examining the relationship between social services and health, she is looking forward to the day 'when a bath is a bath and not a health bath or a social bath'. After 50 years the NHS could do better, she suggests, when it comes to defining needs.

Name: Ann Lloyd

DOB: 22 April 1948

Occupation: Chief executive, Frenchay Healthcare trust, Bristol

The arrival of the NHS was a blessing for Ann Lloyd's family. After many operations her father, a manager in a cotton exchange, had to have his leg amputated. He had paid into a health scheme, which was topped up by Liverpool council, but he had to buy his own artificial leg and special socks, which were very expensive. When the health service began, replacements were supplied free of charge.

She remembers her mother telling her that when she was training to become a nurse, breakages on the ward were paid for out of the nurses' wages. None of the students wanted to be rostered on to the children's ward where the risk of something smashing was high. She remembers frequent visits to the hospital where her mother worked and the smell 'of years of cabbage and Dettol'.

She thinks the next half-century will be very exciting for the health service. 'But we are going to have to be more explicit and determined about what the health service is able to offer. We have pushed out the boundaries of care so much in the past five years and I don't see that stopping.'

The health service will look quite different. But, she says: 'There are some things that will never change. We will always have to manage effectively the care of a person who is critically ill. We will

just get better at it.

Topics