Health Improvement

In 1948, the risk of dying in childbirth was eight times greater than it is today. A boy born in the year the NHS was established had a life expectancy of 60 and a girl 65. Today, children can expect to live to 75 for boys and almost 80 for girls.

At the same time, on average today’s children are almost three inches taller and five pounds heavier than their counterparts in 1948 by the time they start school.

These simple statistics help to show how the health of the nation has improved over the past 60 years. The infectious diseases that were once killers such as diphtheria and smallpox have been conquered, the death rate at childbirth has fallen to its lowest ever level and extra years of life at a higher quality have been given to thousands of Scots.

The health service cannot take the credit for all of this. Improved living standards, the greater availability of fresh food, cleaner air and other factors have all played a part.

Major improvements have been seen for two of Scotland’s biggest killers – heart disease and cancer. Premature deaths from heart disease have fallen by more than half in the past 20 years in Scotland and survival rates for most forms of cancer have improved substantially. This has been aided by earlier diagnosis and better treatments offered by the NHS.

There has been a welcome reduction in the number of smokers in Scotland. Most Scots smoked in the 1950s which contributed to our high rates of heart disease and cancer in subsequent decades. Today one in four adults are smokers although many want to give up. Specialist smoking cessation services have been set up by the NHS and the 2006 ban on smoking in public places is a clear signal of the determination to act against the largest preventable cause of ill health in Scotland today.

Problems have been improved through the closure of long stay institutions. The policy of providing improved care in local communities was a major undertaking but one that has been achieved with notable success.

Health education has an important role to play in supporting people in Scotland to adopt healthier lifestyles. Indeed the Cathcart committee in the 1930s saw this as a vital tool. It recommended that health education should “be placed at the forefront of national health policy”.

It was not, however, until 1968 that this was given priority with the establishment of the Scottish Health Education Unit. It exists today in a different form as NHS Health Scotland and it is continuing to work with the people of Scotland to address issues such as poor diet, smoking, and drug and alcohol abuse.

Sixty years on from the establishment of the NHS, people are living longer, healthier lives although the benefits have not been shared equally. People in our most deprived communities continue to have the poorest health which is why a Ministerial Task Force on Health Inequalities was formed in 2006 to lead cross government action in this area.

Professor Peter Donnelly
Deputy Chief Medical Officer

Next: Tuberculosis

Baby sitting next to two adults smoking
 Credit: NHS Health Scotland advertising campaign

Over the last 60 years, smoking has gone from a social norm to a minority activity. In 1948, 65% of men and 41% of women were cigarette smokers.

Today, a quarter of Scots still smoke although many are trying to give up. Smoking rates are twice as high in deprived areas compared with the least deprived.


TB patients could spend a year or more resting in a sanatorium to give their bodies the chance to fight the disease. Existing surgery or treatment to collapse the lung sometimes did more harm than good.