Battle for the birth of the NHS

Residents in the Duxbury Street (Camp Road) area of Leeds queueing to enter the mass radiography mobile unit in 1960.
Residents in the Duxbury Street (Camp Road) area of Leeds queueing to enter the mass radiography mobile unit in 1960.
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On July 5, 1948, 13-year-old Sylvia Beckingham was admitted to Park Hospital in Manchester with a liver condition. She was the first patient to be treated on the NHS.

Before the NHS, Britain’s 2,700 hospitals were run by charities or local councils. Patients generally paid for their care.

The war and chronic underinvestment in the preceding years had left the healthcare system nearly bankrupt, with medical staff working long hours for very little.

But in 1945, the new Labour government promised a revolution in how medical treatment was delivered in this country.

Charismatic Welsh leader of the left, Minister of Health Aneurin Bevan, said his ambition was to create a unified health service based on four simple principles: it should be free at the point of use, available to everyone, paid for out of general taxation and used responsibly.

The ideals were noble and democratic, but opposition rained down on Bevan from many doctors, the Tory Party and even members of the Labour cabinet.

They said healthcare was better left in the hands of local councils, but luckily for Bevan the country’s biggest local authority, the Labour-led London County Council, passed all of its hospitals to the NHS without a fight.

The rest then fell into line.

Seeing off his opponents in the medical profession was more of a headache. Many of them earned the bulk of their money from private practice and they were afraid of losing those earnings.

The British Medical Association argued that insurance, not taxation, should pay for health care, and the public were so worried that this might happen that there was a mass scramble for NHS treatment in the early months.

Some eminent doctors likened Bevan to the leaders of the Third Reich. He was called “a complete and utter dictator” by one leading physician, and the NHS was seen as the first step towards national socialism.

Some of the more privileged in society simply didn’t want to see the “feckless poor” receiving free treatment that they, the wealthy, were helping to fund.

Although the launch costs of the NHS were astronomical – including better pay for staff – the country embraced it.

However, the huge expense put paid to Bevan’s ministerial career and, to his disgust, in 1951 chancellor Hugh Gaitskell introduced prescription charges.

What Bevan and his supporters failed to predict was how funding would always lag behind costs, as technological advances soaked up ever more resources and kept more people alive to use the NHS another day.

Aneurin Bevan would doubtless be pleased that the NHS still leads the world at ensuring equal access to treatment.

It successfully treats millions and can perform miracles, but it underperforms when compared with other developed countries in preventing common causes of death, research by the Nuffield Trust revealed last week.

It also said that the UK has fewer doctors, nurses, hospital beds and CT and MRI scanners than 18 other comparable nations.

It seems that no amount of cash will quench the thirst to innovate and improve the nation’s health, and the Government’s promised £20bn boost up to 2023 amounts to 0.3 per cent less than the average annual rise of 3.7 per cent since the inception of the NHS in 1948.

As a nation we are wedded to our NHS, 
but the debate will continue to rage about whether this is a model that’s still fit for purpose, with a population that is growing and becoming more elderly, and ever-increasing numbers of people with chronic lifestyle-related illnesses.