Monday 12 January 2009
DOUG R. (England)
Your Free NHS
The NHS (National Health Service) was a great British institution, offering world class healthcare
free of charge at its point of need.
Last year it was 60 years old.
To some observers it is sad to witness what years of neglect and political
mismanagement have achieved.
Speak to any member of the public, and they will tell you horror stories of
how a friend or relative has suffered poor treatment and neglect in an NHS
hospital.
A recent study from Brunel University found that doctors played a part in
two out of three NHS patient deaths.
Many good doctors and nurses struggle daily through an ever growing mountain
of bureaucracy and indifference to care for their patients.
However I could list many personal examples where people have received good
quality treatment and service.
The politicians insist that the NHS is going from strength to strength.
What is the true picture? Has it gone wrong?
How did it start?
A small number of single minded and strong men were responsible for forming
the modern British NHS. All stood on the shoulders of one Welsh giant,
Aneurin Bevan, the Labour MP for Ebbw Vale.
The British NHS today is probably the largest organisation of any kind in
Europe. Like many developments with integrity and a sustained track record
it began in a very small way- in this case -in a very small town called
Tredegar, in South Wales.
Today the NHS is wrongly regarded as part of the British Welfare State as
established by another famous Welshman Lloyd George.
But the NHS has always been a separate entity.
Where?
Tredegar is a small town in South Wales. It is a concentration of coal mines
and steel mills producing incredible wealth for their owners.
These also produced those classic major health problems for the workers of
tuberculosis and pneumonia.
The origins of the present NHS was the Medical Aid Society under the
Tredegar Community Health Scheme.
Workmen members paid three pence in the pound for medical services.
Who?
Bevan was one of ten children of a local miner, who died in 1925 from
pneumoconiosis. The economic effect on his family was dramatic. It surely
provided a powerful spur to his socialist thinking.
A year later Bevan became a full time Trade Union official. He played a
significant local part in the General Strike of 1926, organising food and
money for the strikers.
This seems to have increased his interest in politics. He already had an
established reputation as troublemaker, becoming head of his local Miner’s
Lodge at 19 years old. He had attended the Central Labour College in London
from 1919, concentrating on the study of Marxism.
He was surprised to have his application for work rejected by the Tredegar
Engineering Company! They presumably decided he would be more trouble than
he was worth?
His reputation as a supporter of the working classes, in particular the
miners, helped him win the 1929 General Election, as MP for Ebbw Vale.
He later supported efforts by the Spanish Republican Army fighting the
Fascist Franco. He was a member of the Committee for the Relief of German
Fascism.
Having spent most of the 1930’s complaining about Churchill’s anti working
man attitude, during the 1939/45 war he reliably supported him as a war
leader.
As the end of the war came into sight, normal British politics were resumed.
The 1945 election was a landslide for the Labour Party, making Clem Atlee
Prime Minister.
Bevan believed this was a golden chance for the Labour movement to create a
genuine post war civilised improved society.
Appointed Minister of Health, he seized the opportunity to steer the
National Health Service legalities through Parliament.
The overwhelming Labour Party majority in Parliament ensured success.
Predictably the British Medical Association, which included most practising
doctors, was firmly against the scheme.
But, in 1948 the NHS, consisting of 2688 hospitals in England and Wales, was
established. It offered free diagnosis and treatment to all ‘according to
need.’ This important phrase implied ‘without the need to pay.’
Medical services were available from General Practitioners and Dentists.
People could still elect to have private treatment and pay for it
themselves.
Cash flow problems soon caused prescription charges to be introduced for
dental care and spectacles.
Bevan resigned from the 1950/51 Atlee government in protest.
In 1959 he was elected Deputy Leader of the Labour Party.
He died of cancer in 1960, aged 62.
His was not the first attempt to create a national system for dealing with
illness and disease. Various sporadic attempts had been made over many
years.
A target of the French Revolution had been to end all disease. This would be
achieved when everyone was properly fed, housed and educated.
The Jacobins considered premature deaths and diseases were due entirely to
poverty.
In Victorian England Sir John Simon tried to establish a national medical
service to provide diagnosis and treatment for all.
But since medical professionals made their living from selling their
services for money, they would not cooperate.
How could Government sources fund such a scheme?
Sir Simon made no progress.
The Boer War of South Africa shocked the middle classes of Britain. Not only
were military campaign results poor but large numbers of Army recruits were
being rejected on health grounds. What were the implications for the general
public?
Another famous Welshman and politician from an earlier decade was Lloyd
George. He became the prominent British leader during the 1914-1918 War with
Germany.
In his early days as a Member of Parliament his political nose had sniffed a
general European move towards socialism.
He noted how the German Chancellor Bismarck had introduced a State medical
insurance scheme.
Lloyd George introduced his 1911 Insurance Act based on German experience.
It was not designed to provide medical care, but sufficient cash for workers
suffering from sickness or injury to feed, clothe and house their families.
It later became incorporated into the State Pension Scheme.
Before Bevan.
Modern hospitals can trace their origins to monasteries established by
religious or grateful wealthy individuals, motivated by worries about their
personal future.
Journeys as required or stimulated by religious beliefs created a vast
potential market of mobile pilgrims. The church had thoughtfully provided a
range of artefacts and ‘holy places’ to be viewed or visited by the devout.
These journeys covered hundred of miles, over primitive roads and trackways.
Many river crossings had toll bridges built with monastery funds. A nearby
overnight rest house or catering establishment extracted extra revenue from
pilgrims.
Monasteries created substantial funds from farming and further processing
agricultural produce. They had access to large numbers of willing workers
some of whom became highly skilled.
Although King Henry the Eighth spoiled this cosy arrangement (see previous
article) the basic structures remained. Hospitals were funded by vast areas
of land and investments in their name and from grateful benefactors with
endowments.
After Bevan.
The proposed nationalisation would give London hospitals in particular a
problem, but the alternative municipalisation could be much worse.
Who owns the Chairs?
Local government had jealously guarded their control over hospital
management. The established teaching hospitals worried about losing their
own substantial assets. One famous argument raised was who would ‘own’ a
unique set of Hepplewhite chairs kept in the Victoria and Albert museum?
Bevan was careful to achieve an acceptable balance. He made efforts to keep
their goodwill allowing them considerable autonomy. In most cases hospitals
would be financially better off.
His plan was to establish regional boards of control, managing all medical
services and based on university medical centres.
The London teaching hospitals would have boards of governors reporting
directly to the Minister.
Many battles for acceptability remained. Bevan’s idea held firm.
To maintain local support by establishing regions with a teaching hospital
and medical school, but exclude local authorities and their influence from
hospital management.
DOUG R.
(England)
Recent articles of Doug R.:
Published in Woman's Magazine Russian Woman Journal www.russianwomanjournal.com - 12 January 2008
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