Gerry,Aneurin Bevan's achievement in driving through a centralised, monolithic NHS needs to be seen in the context of its time which few people remember or have studied. The NHS creation myth is just a myth. The way it has been appropriated by Labour is a concerted act of misdirection. It was the Liberals in the early 20th century who started monitoring child health in schools (1907) and introduced health insurance for working people that gave people treatment that was free at the point of use. Before the war there was a vast network of voluntary and local authority hospitals and health schemes. It was a patchwork though. The pre-war Conservative government set up the wartime Emergency Medical Service which took control of hospitals and delivered free healthcare through the war. It was this precedent that made a peacetime national health service feasible. The 1944 national health service white paper was produced by the Conservative Minister of Health, Henry Willink. It is well worth reading. It was the long negotiated compromise between the main Conservative and Labour members of the coalition that aimed to deliver comprehensive healthcare, free at the point of use. It squared the medical vested interests. It was based on the idea of local authorities playing the main role in "joint authorities" (and therefore making sure that service was local and accountable). It left the vast voluntary hospital movement intact as a service provider to the "joint authorities". It was an incremental approach that built on the existing very well developed health system. The NHS creation myth does not acknowledge that there was already a huge health system in place before the NHS. With its massive majority the new Labour government was able to do what it liked and to ignore the carefully negotiated solution produced by the wartime coalition. Labour's taste was for control and nationalisation. Instead of the agreed approach in the white paper Labour forced through a mass nationalistion of the existing health infrastructure producing the unresponsive, monolithic monster that we know and love/hate today. It is worth noting that all Bevan did was to nationalise the existing health infrastructure. The NHS didn't manage to build ANY new hospitals until the 1960s. The "creation" of the NHS didn't create any hospitals or GP's surgeries. They were all there already. All Bevan did was appropriate local authority and charity assets. He didn't take on the doctors though so he didn't steal their businesses and they remain private contractors to this day. He famously “stuffed their mouths with gold”. He had no compunction though about stealing from charitable institutions and the NHS has been selling off these assets ever since. Land and buildings bought through legacies and donations of the public have been on sale ever since 1948. Just go and look at the railings in front of the Mattock Lane health centre and imagine the hospital that used to be there. Often some of the most respected and effective bits of the NHS are those that retain their pre-NHS identity, for instance Great Ormond Street founded in 1852. The hospital was funded by subscriptions and donations. Its services were provided free of charge, exclusively for the children of the poor. Bevan is to be respected for his drive and his achievement. We might all be better off if he had compromised on the 1944 white paper produced by a Tory Minister of Health. When Labour politicians say the Tories voted against the NHS they are telling a huge lie. A comprehensive health service, free at the point of use was Conservative policy and in their 1945 manifesto. They voted against Bevan's centralised, nationalised structure. Quite rightly.
Phil Taylor ● 4203d