Opinion

The NHS: Origins and impact of the world’s first free health service

The 5thJuly 1948 is perhaps one of the most important dates in British history for modern society, yet few can pinpoint why. This is the date that the bold and forward-thinking plan was formed to provide the British public with a strong and reliable healthcare service, the birthday of the National Heath Service. Perhaps the coronavirus pandemic will brand this date into the minds of the British public as we witness the dedication of our NHS workers as they battle through exhaustion and inexplicable workloads. 

Even for those who are too young to remember the details will hopefully remember reviving community spirit on 16thMarch when doorways and windows were filled with clapping and cheering across the country. Maybe, for the first time in a long time, we can mark the birthday of the NHS this year with the same applause and feeling of celebration and gratitude. 

As the world was lifting itself from its knees once more in the wake of World War II, the Minister of Health, Aneurin Bevan, launched the NHS at the Park Hospital in Manchester. The drive for this came from a culmination of both pre-war and post-war voices who urged the government that a new system was needed. 

An impactful voice in this was that of Beatrice Webb, a socialist who headed the Minority Report of the Royal Commission on the Poor Law in 1909. She, amongst others responsible for the report, demanded a new system that didn’t expect those in poverty to fend for themselves. However, it was not until influential figures such as Dr Benjamin Moore, who first coined the phrase “National Health Service’, spoke out that the idea was genuinely considered. Growing discussion around the failure of the heath system came to a halt with the outbreak of the Second World War. 

In 1944, Minister of Heath, Henry Willink, put forward the White Paper, a set of guidelines for the National Health Service which was approved by the Cabinet. The following Minister of Health, Aneurin Bevan, took this framework and turned it into a reality with Clement Attlee in power. Bevan’s three primary aims for the service was that it was inclusive, free, and that the care provided was determined by need rather than ability to pay. 

When Bevan visited Park Hospital in Manchester he met with the first NHS patient, a 13 year-old girl called Sylvia Diggory who was suffering from acute nephritis. Later, Diggory spoke of this event saying that“Mr Bevan asked me if I understood the significance of the occasion and told me that it was a milestone in history – the most civilised step any country had ever taken. I had earwigged at adults’ conversations and I knew this was a great change that was coming about and that most people could hardly believe this was happening.”

Across Britain, new health boards took control of 2,751 out of 3,000 hospitals. By the day of the launch 94% of the public had already signed up to the NHS, chomping at the bit to escape the debt and stresses that costly health care had forced upon many households. However, Attlee anticipated that the first few steps of this new service would be wobbly, appealing to the public to be patient as “there are bound to be early difficulties with staff, accommodation and so on”. 

Attlee’s concerns were justified, as it took nearly a year to subdue the boycotts from the doctor’s union, the British Medical Association. Further, with the budget for the first year of the NHS being £15bn at today’s prices, this was a huge strain on the economy. The financial concerns led to new charges for prescriptions, dental care, and glasses, resulting in Bevan resigning from his position in 1951 with the belief that his project was on the road to failure. 

These financial setbacks have not prevented the NHS from pioneering in new medical discoveries and methods of preventing illness. In 1954, links were established between smoking and lung cancer. The 1960s saw the first kidney transplant in the UK and also the pilot attempt of its first heart transplant. The NHS also offered an array of vaccinations that had not been available on mass to the British public previously, for example, vaccines for polio and diptheria. 

The NHS was not only ground-breaking within the medical system, but also altered the foundations of family life across Britain. One of the most influential examples was the introduction of the contraceptive pill in 1961, which became available also for unmarried women in 1967. Further, the Abortion Act was also passed in 1967, allowing women to terminate pregnancies without the grave danger of backstreet procedures. Just over a decade later, in 1978, the world’s first test-tube baby Louise Brown, was born, marking a revolutionary moment for couples who struggled to conceive. It is undeniable that the extensive impact of the NHS reached beyond hospital beds to alter the foundations of home life across Britain.

Today’s date is also an important one for the NHS, Margaret Thatcher introducing the internal market on April 1st 1991. Health authorities began ‘purchasing’ care from hospitals instead of running them, allowing hospitals to become self-governing trusts. Competition between hospitals was also encouraged in order to attempt to improve efficiency. However, whether Thatcher’s ideas helped or hindered the NHS is still hotly debated today. 

Throughout the last decade the NHS has continued to face a number of problems with the radical shakeup in 2012, public inquiries into neglectful care as a result of staff shortages, and the threat of a £30bn hole in its budget by 2020. It is logical to imagine a student in the future listing the coronavirus pandemic as one of the major problems the service faced at the turn of this decade. However, despite the financial issues that have haunted the NHS since 1948, the problems we are currently facing act as a stark reminder that the staff who keep this service on its feet are simply heroic.

Let us remind ourselves that throughout budget cuts and bickering politicians our NHS staff have hoisted extra loads onto their backs and soldiered on, today, and for the last 72 years. We must remember that on the July 5th we are celebrating a service that has given the British public healthcare, improved home lives, and cohorts of workers who deserve at very least another tremendous round of applause.