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…
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