This Friday marks the 65th birthday of the National Health Service.  Founded in 1948, the NHS enshrines the principle that healthcare should be a universal service, not reliant on our ability to pay.

When the NHS was founded, average life expectancy was just 50, infant mortality was 20 times the rate today, and diseases related to poverty were still prevalent.  How different things are today.

There's been a lot of publicity recently about problems in the NHS, and we must ensure that deeply troubling cases of poor care in some hospitals are dealt with.  The Care Quality Commission is to be overhauled and a new Chief Inspector of Hospitals will give Ofsted-style ratings so that patients know how their local facilities compare with others.

And as I heard from local GPs when I met them in Arundel recently, there are real pressures facing the NHS, with an ageing population, ever rising expectations, and the growing costs and complexity of treatments.

But in this birthday week, let's just celebrate the achievements of the NHS in its 65 years: the first healthcare system to embrace universal coverage; the first national vaccination programmes; the first organ transplants, and the first national screening programme.

The NHS remains remarkably high in the public's affection: surveys show that it's the single biggest reason people are proud to be British, even ahead of Team GB, the armed forces and the Royal Family.

Today, the NHS treats a million people every 36 hours, including 21 million visits to A&E every year and 300 million GP appointments.  With government spending on the NHS protected despite cuts elsewhere, there are now more doctors, more funding and more operations than ever before.

Changes to the NHS organisation brought controversy, but my recent meeting with the Coastal West Sussex Clinical Commissioning Group, which has replaced the Primary Care Trust, reminded me that the development of care is going to led by GPs.

What does the future hold?  I foresee the integration of health and social care, new providers of services, the personalisation of care, and a refocus on prevention, rather than just treatment, of conditions.  What we must avoid is clumsy reconfigurations that 'salami slice' local services.

But for all the challenges, this anniversary provides an opportunity to restate our commitment to the values which underpin the NHS and show our support for the hundreds of thousands of hard-working staff on whom we all rely.  Happy Birthday to one of our most cherished institutions, and thank you.

Christopher N Howarth