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The National Health Service

At the start of World War Two the government realised that, if it was to cope with the huge number of anticipated casualties, it needed to increase spending on healthcare. It also began to plan for the future.

In 1942, a civil servant named William Beveridge produced a report, the Beveridge Report, which identified five evil giants - want, disease, ignorance, squalor and idleness. In identifying disease as a barrier to progress, he proposed a free national health service.

In 1946, the new Labour government passed the National Health Service Act. The model they used was based on one used in Tredegar in the 1930s, which was like an early, local version of the NHS. However, the new Minister for Health, Aneurin Bevan, who was MP for Tredegar, had to work hard to overcome opposition to the NHS.

• The BMA, who feared that doctors employed by the NHS, would lose income.
• Many local authorities and voluntary bodies, which ran hospitals, also objected as they feared they would lose control over them.
• Many people such as Winston Churchill and many Conservative MPs thought that the cost of the NHS would be too great.

5 July 1948

In spite of all opposition, the National Health Service came into being on 5 July 1948. It was part of a series of reforms which aimed to use money from taxes to provide support from the cradle to the grave. In terms of healthcare the NHS brought many changes to Britain’s health system. These included:

• free medical treatment for all British citizens
• the nationalisation of hospitals under the Ministry of Health and organised into regional health authorities
• the creation of health centres to provide services like vaccinations, maternity care, district nurses etc
• a better distribution of doctors around the country with GPs (general practitioners), opticians and dentists in every area

Since its inception in 1948, the NHS has made a major contribution to the quality of healthcare and raising life expectancy in Britain. However, its successes, particularly in raising life expectancy, has also increased the demand for services.

Successes of the NHS

• The NHS has made healthcare accessible to all members of the public.
• The NHS has made a major contribution to increasing life expectancy in the UK.
• There has been a continuing reduction in child mortality and in maternal mortality.
• There have been major medical breakthroughs in many areas, eg transplant surgery, cancer treatment etc.
• A wide range of services has been made available, eg cancer screening, asthma clinics etc.
• There has been an increasing emphasis on preventive medicine, eg mass vaccination against a variety of illnesses and health campaigns, eg to reduce smoking.
• The NHS helped reduce the pressure many women felt as main carers.

Problems facing the NHS

• From its very start in 1948 the cost of providing care has increased, putting pressure on NHS budgets.
• The NHS is no longer completely free. As early as 1952 prescription charges were introduced. Since then charges have been introduced on other services, eg eye tests and dental treatment. Free prescriptions were re-introduced in Wales in 2007.
• Lack of money means that there are now waiting lists for many operations. Some people have been refused costly services and medicines.
• As life expectancy has increased so has the ageing population which has lead to an increase in demand for services from the NHS.