Friday 12 February 2016

Nye Bevan and the NHS

68 years ago it was the government fighting for the NHS; in 1948 the then Minister of Health, Aneurin Bevan, was instrumental in establishing a free health service for all.  Today, the government seems intent on destroying this system the British electorate hold so dear from the top down, bottom up and sideways.  Jeremy Hunt, the Secretary of State for Health, is determined to push through plans for a 7 day a week NHS at the same time as effectively cutting pay for junior Doctors, extending their working hours and all without any extra funding coming from central government.  The Conservatives have been accused of trying to 'privatize' the NHS (not unlike the Tories) and has continually come into conflict with the British Medical Association, who represent doctors in the UK.  Talks have been ongoing over the past three years.  Stalling and break downs in discussions has recently seen a series of 24 hour walk-outs by junior doctors who work for NHS England.  This is a sorry state of affairs when you consider the history of the NHS (and the Welfare State as a whole) which was hard won, philanthropic in nature and a body that intended to look after people 'from the cradle to the grave'.  Now, it is argued by the junior doctors subject to changes to their contracts, that the government are pushing through changes that will endanger the lives of patients. 
In 1942 a momentous document was published, called the Beveridge Report, which outlined the help that people could expect by recommending the extension of the Welfare State to tackle the 'Giant Evils' in society: squalor, ignorance, want, disease and idleness. This came during the midst of World War Two; people were suffering and the promise of a Welfare State was popular with the electorate.  It was on this basis that Labour won a landslide victory in July 1945 after adopting many suggestions made in the Beveridge Report into their election manifesto, including the creation of the National Health Service; a system where everyone could receive healthcare that was free at the point of service. Funding for this would come from expanding the National Insurance.  It was a momentous time and something the British felt they deserved after fighting two wars.  There was only one sticking point; getting the doctors on board!
Before the NHS healthcare in Britain was a patchwork of different provisions; Voluntary hospitals, Poor Law Hospitals and, if you worked and paid National Insurance, you could receive some free care, but this did not extend to your dependents.  Needless to say, it was a system that saw the very poor suffer as they could not afford treatment, care or medicines.  Whereas, the very wealthy could afford the best doctors that were based in places like Harley Street, London.  
Aneurin Bevan knew he had to get the majority of doctors on board to get the NHS up and running. The Labour government has passed the National Health Service Act in 1946 without consultation with doctors, promising to create a free health service for all.  Doctors were initially reluctant because of worries about a loss of income, as they would be moving over to a salary and becoming government employees.  Bevan had to overcome this to ensure the NHS could start on the agreed date of 5th July 1948.  Bevan was a force to be reckoned with; a once trade unionist and forceful politician, Bevan was even willing to alienate members of his own party to ensure a majority of doctors were onboard with the NHS.  Bevan negotiated with the BMA to ensure decent salaries for doctors and made allowances for doctors to continue to treat private patients, earning a lucrative private income, in NHS hospitals.  This was a compromise worth taking for a system that promised so much to so many.
If only we had politicians like this today.