25 February 2006
The creation of the National Health Service
in 1948 has been described (by Peter Jenkins in ‘Age of Austerity’, edited by
Michael Sissons and Philip French, 1963) as: “the most ambitious and one of the
most successful pieces of Labour legislation.”
Sixty years later, the NHS seems to have lasted better than other measures enacted by the post-war British Labour government. Nationalisation of coal, gas, electricity, steel and transport have all been reversed. Most of the 1,000,000 Council houses built between 1945 and 1951 have been sold under Right to Buy schemes, the maintenance of full unemployment is no longer seen as an obligation of government policy and the value of the basic old age pension has steadily eroded in real terms.
Between 1946, when legislation to create the NHS was first introduced, and the ‘Appointed Day’ on 5th July 1948 when it came into force, the British Medical Association (BMA) campaigned vigorously, but entirely unsuccessfully, against the terms of service offered to doctors.
A year later, most doctors had signed up. 41,200,000 people were covered by service – 95% of the eligible population. It employed 34,000 people and cost nearly £400m per year. 187,000,000 prescriptions had been written by 18,000 medical practitioners (an average of around 40 per day).
What really happened in the four years between 1944, when Henry Willink, the conservative Minister of Health in the wartime coalition, presented his White Paper on ‘A National Health Service’, and 1948, when the Service came into being?
The 1944, the White Paper had the support of all political parties. In a questionnaire issued by the BMA, a majority of doctors approved of its major proposals.
The NHS is still seen as, in many ways, the personal creation of Aneurin Bevan, the Minister of Health in the post-war Labour government.
What changed between 1944 and 1948? Why did the BMA first oppose the scheme, and then, reluctantly, accept it?
And what about Bevan’s own role? Did he only succeed in the end because, in his own words, he “stuffed the consultants’ mouths with gold”?
It seems to me there are some unanswered questions here which are worth researching further…