Repair, re-use, restore – maintaining the good health of the NHS

I recently visited Little Moreton Hall, a Tudor manor house in Cheshire, near Congleton. I mention this because it brought current problems with the NHS into sharp relief.

Little Moreton Hall looks like it is about to fall down. The wooden frame has shifted over the centuries, and the walls, floor and roof are bowed, with no straight lines to be seen. The house was expanded over the years, with a room added on here and there as needed. Look closely and you can see these extensions, but from a distance the architectural style is the same.

Other families took a different approach to the owners of Little Moreton Hall and replaced their Tudor manor houses with new houses. Fashion-conscious families sometimes knocked down and rebuilt their houses several times, at crippling cost.

Like many others, I have been reflecting on the results of the election with the future of the NHS in mind. Polling showed voters to be very concerned about the health service, so it came as no surprise that politicians put the NHS near the top of their election agendas.

Little Moreton Hall reminded me a lot of the NHS, which was also built quickly on limited foundations, expanded over the years to meet changes in need, and can look in danger of imminent collapse to a casual observer.

Perhaps the government could learn from how the National Trust looks after Little Moreton Hall for present and future generations. The Trust has a careful and long-term plan of maintenance. Repair is the first priority, and where that is impossible, sensitive restoration is done. The new materials are sympathetic to the old and work well together.

My plea to the government is to work as custodians of the NHS for the nation. They should maintain, repair, and allow it to evolve, and avoid further reorganisations that run the real risk of undermining the structure to the point of collapse.

About the author

Christopher Nicholson is lead clinician for the cardiac and respiratory service at the Minerva Centre, Lancashire Care NHS Foundation Trust, Preston