In Depth

NHS turns 70: how it began

A celebration of the largest publicly funded health service in the world

Exactly 70 years ago this week, the National Health Service was launched by then-health secretary Aneurin Bevan at Park Hospital in Manchester. 

“For the first time, hospitals, doctors, nurses, pharmacists, opticians and dentists were brought together under one umbrella to provide services for free at the point of delivery,” the NHS website says.

Today, workers from the NHS are celebrating the founding of the service and its rise to become the largest publicly funded health service in the world. More than a million patients are now dealt with by the NHS every 36 hours, according to latest statistics.

The service has become part of the fabric of British life and is regularly named as one of the things that make people feel proud to be British. 

So how did the NHS come to be?

Second World War

In 1942, Sir William Beveridge, a prominent government economist, was commissioned to write a report on how Britain should rebuild when the Second World War ended. The Beveridge Report, officially entitled Social Insurance and Allied Services, was published in November 1942.

In it, Beveridge identified society’s five “Great Evils”, which he deemed to be “want, disease, ignorance, squalor and idleness”. To counter these, he proposed a “revolutionary form of government organisation, with an ambitious system of social security designed to set new standards for citizen welfare, a system we now call the welfare state”, the BBC says.

A key component of this report was a national health service that was free at the point of access and paid for by taxation.

Remarkably, the report was seen as such a powerful piece of propaganda that British airmen dropped copies of it - translated into 22 languages - all over German-occupied Europe during the War. Two copies of it were found in Hitler’s bunker, The Times reports.

Labour’s shock victory

In the final stages of the War, in 1945, Labour pulled off a shock election victory that saw Winston Churchill replaced as prime minister by Labour leader Clement Attlee.

The party’s manifesto had been directly based on the Beveridge Report, promising a vast welfare state.

The new minister for health, Bevan, who had been a miner in Wales and a fervent trade unionist in the past, was tasked with leading its creation. 

“Many groups, including charities, churches and local authorities, didn’t want the government taking control of hospitals,” according to the The National Archives website. But “compromises were worked out” with senior consultants and dentists that allowed them to continue to work privately, much to the ire of Bevan, the site adds.

Launch

Following years of drafting, the National Health Service Act (1946) came into effect on 5 July 1948, creating the National Health Service in England and Wales. Scotland and Northern Ireland would create similar systems soon after.

The service was based on three core principles: that it meet the needs of everyone, was free at the point of delivery, and was based on clinical need, not ability to pay.

For the first few years, prescriptions were handed out for free, until a one shilling charge was introduced on 1 June 1952. Save for a brief period between 1965 and 1968, when they were free, prescriptions have remained available at a small charge ever since.

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