Healthcare for all

On 5th July 1948 the British National Health Service was born. The NHS is such an intrinsic part of our country that it is difficult to imagine a time when it didn’t exist. But it’s also fascinating to note the timing of its creation. Britain was coming out of the other side of six years of war. Six years when the political focus was on protecting our country from invasion. And yet, it was during those six years that the report leading to the creation of one of Britain’s greatest institutions was published.

In 1941, civil servant, William Beveridge, was asked to chair a committee to look at the ways Britain should be rebuilt after the war, looking more specifically at existing social insurance and allied services. As a result the report, entitled Social Insurance and Allied Services, was presented to Parliament and published in November 1942.

In the report Beveridge proposed that everyone in work should pay a weekly national insurance contribution, receiving in return a range of benefits. National insurance was not a new concept, but Beveridge’s report recommended the insurance scheme would ensure benefits were paid to people who were sick, unemployed, retired or widowed. The idea behind the system was that it would provide a minimum standard of living “below which no one should be allowed to fall”. The report made recommendations to the government that there were “five giants on the road of reconstruction” that needed to be combatted, namely: ‘Want, Disease, Ignorance, Squalor and Idleness’, also confirming the need for a new National Health Service.

The report was well received by all political parties, but of course, Britain was in the middle of a world war, a situation that determined other priorities. Prior to 1948 hospital care was provided by a mix of voluntary, municipal, and cottage hospitals, but all were struggling financially. Access to general practice services tended to be limited to those in work, with the National Insurance Act of 1911 providing access to GPs for manual labourers and lower paid non-manual workers earning under a certain income. By 1936 around half of the adult population (those in work) had access to a GP (known then as a ‘panel’ GP), but wives and children were not able to benefit from free healthcare, relying instead on voluntary services. The middle class and wealthy paid for their healthcare, relying on expensive private doctors.

And so, once the war was finally over, plans were put in place to create a National Health Service that would provide for everyone – ‘from cradle to grave’. It was Aneurin Bevan, Minister for Health, with the new Labour government, who was finally able to implement the comprehensive reforms necessary to ensure the NHS was available to all.