National Health Service (England) - History

History

A national health service was one of the fundamental assumptions in the Beveridge Report which Arthur Greenwood, Labour's Deputy Leader and wartime Cabinet Minister with responsibility for post-war reconstruction had successfully pressed the cabinet to commission from economist and social reformer William Beveridge. The government accepted this assumption in February 1943, and after a White Paper in 1944 it fell to Clement Attlee's Labour government to create the NHS as part of the "cradle to grave" welfare-state reforms in the aftermath of World War II. Aneurin Bevan, the newly appointed Minister of Health, was given the task of introducing the National Health Service.

Healthcare prior to the war had been a patchwork quilt of private, municipal and charity schemes. Bevan now decided that the way forward was a national system rather than a system operated by regional authorities, to prevent inequalities between different regions. He proposed that each resident of the UK would be signed up to a specific General Practice (GP) as the point of entry into the system, and would have access to any kind of treatment they needed without having to raise the money to pay for it.

Doctors were initially opposed to Bevan's plan, primarily on the stated grounds that it reduced their level of independence. Bevan had to get them onside, as, without doctors, there would be no health service. Being a shrewd political operator, Bevan managed to push through the radical health care reform measure by dividing and cajoling the opposition, as well as by offering lucrative payment structures for consultants. On this subject he stated, "I stuffed their mouths with gold". On 5 July 1948, at the Park Hospital (now known as Trafford General Hospital) in Manchester, Bevan unveiled the National Health Service and stated, "We now have the moral leadership of the world".

After the publication by the British Medical Journal on 24 December 1949 of University of Cambridge paediatrician Douglas Gairdner's landmark paper detailing the lack of medical benefit and the risks attached to non-therapeutic (routine) circumcision, the National Health Service decided that circumcision would not be performed unless there was a clear and present medical indication.

The cost of the new NHS soon took its toll on government finances. On 21 April 1951 the Chancellor of the Exchequer, Hugh Gaitskell, proposed that there should be a one shilling (5p) prescription charge and new charges for half the cost of dentures and spectacles. Bevan resigned from the Cabinet in protest. This led to a split in the party that contributed to the electoral defeat of the Labour government in 1951. The one shilling prescription charge was introduced in 1952 together with a £1 flat rate fee for ordinary dental treatment. Prescription charges were abolished in 1965, but re-introduced in June 1968.

Dr A. J. Cronin's highly controversial novel The Citadel, published in 1937, had fomented extensive dialogue about the severe inadequacies of health care. The author's innovative ideas were not only essential to the conception of the NHS, but in fact, his best-selling novels are even said to have greatly contributed to the Labour Party's victory in 1945.

On 13 November 2011 the government signed off on the 10-year contract to manage the debt-laden Hinchingbrooke Hospital in Huntingdon, Cambridgeshire by Circle Healthcare. It was the first time that an NHS hospital was to be taken over by a stock-market listed company.