75th Anniversary of The National Health Service

“Everyone – rich or poor, man, woman or child – can use it or any part of it”¹

Today (5/07/2023) marks the 75th anniversary of the National Health Service (NHS). On 5th July 1948, following the National Health Service Act of 1946, the first completely free healthcare service in the world came into operation. Since 1948 the NHS has provided healthcare services to millions of people, regardless of their financial means. In this article we will explore the history and legacy of the NHS. 

“The collective principle asserts that ... no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”² – Aneurin Bevan

After the Second World War, talks began on ensuring that healthcare would be accessible to all citizens regardless of their socioeconomic status. This idea was discussed in a report written by Sir William Beveridge in 1942. The Beveridge report discussed a system of social welfare, his main vision was to "battle against what he called the five giants; idleness, ignorance, disease, squalor and want". The report, as well as the work of the Minister of Health, Aneurin Bevan, laid the foundation for a healthcare system that would mark a historic milestone in the history of healthcare. 

“Hospital charges will cease on 5th July.”³

The origins of the NHS herald a new era in British healthcare. In Audrery Leathard’s Health Care Provision: Past, Present and Future, she mentioned how the intention of the NHS “was to universalise the best, to divorce the ability to get the best health advice and treatment from the ability to pay”.⁴ 

Prior to the NHS, healthcare had “consisted of an uneven patchwork of services that varied widely by region”.⁵ At its inception, the NHS brought together those previously disparate healthcare services, such as hospitals, clinics, and general practices, under a unified system. This integration aimed to ensure coordinated and equitable healthcare delivery across the country – healthcare became nationalised for the first time. Leathard mentioned how the main reason for a decline in “infectious diseases and in sanitary conditions was not the advances in medical sciences but the developments in the system of public health”.⁶ The pamphlet of the newly formed NHS outlined all the services that were available free of charge under this new healthcare system:

• “You will also be entitled to all forms of treatment in general or special hospitals.”
• “These include, maternity care, sanatorium treatment, care of mental health, and all surgical operations.”
• “Your doctor will give you a prescription for any medicines and drugs you need. You can get these free from any chemist who takes part in the scheme.”
• “A dental service will be provided…All necessary fillings and dentures will be supplied without a fee.”
• “If you need glasses these will be provided without charge.”

This was certainly a novel service, however one of the most radical aspects was the offering of dental services. Prior to 1948 dental care was almost unknown among the working population as there was little charitable provision for dental care. However, the army medical examinations for the  Boer War, as well as the First and Second World Wars confirmed the widespread effects of a lack of dental care.⁷ In particular during the Boer War medical examinations there were “6,942 hospital admissions owing to dental causes of which one third had to be sent home unfit to serve”.⁸ 

By 1948 the state of the population's teeth was extremely bad, to the extent  “more than three quarters of the population over the age of 18 had complete dentures”.⁹ Dental services changed dramatically under the NHS, pre war dentists largely extracted teeth whereas NHS dentists increasingly concentrated on filling teeth where possible. In particular, the greatest increase in the use of the dental service was by children and the encouragement of dental hygiene. 

Nurses outside Park Hospital in Manchester on 5th July 1948

The Park Hospital in Manchester, which is now called Trafford General Hospital, is widely known as the birthplace of the NHS. It became the first hospital in the world to offer free healthcare under the NHS. On 5th July 1948, in a symbolic inauguration ceremony, Bevan received the keys from the Lancashire County Council. The nurses of Park Hospital formed a “guard of honour” outside the hospital to meet him. An article in the Manchester Guardian, published on 6th July 1948, expressed how: 

“The handing over of this hospital to the minister was a symbol of the transfer that took place all over the country.”¹⁰

Sylvia meeting Bevan at Park Hospital in Manchester on 5th July 1948

Bevan also met with some of the patients at the hospital. Thirteen year old, Sylvia Diggory, who was suffering from acute nephritis, became the first NHS patient. Years later Sylvia mentioned how on that day Bevan had asked her if she understood the significance of the occasion, further stating that he said: 

“It was a milestone in history - the most civilised step any country had ever taken, and a day I would remember for the rest of my life."¹¹

There is no doubt that over the years the NHS has weathered numerous challenges and undergone transformative changes, whether that be with funding or staffing issues. In particular in its earlier years it faced threats of boycott by the British Medical Association (BMA) and a great deal of ridicule in the form of comical cartoons. However, despite the challenges the NHS has stayed consistent with its commitment to the wellbeing of the nation. 

Throughout its 75 year history, the NHS has been a unifying force that has brought communities together. For the majority living today the NHS has maintained a consistent presence throughout their lives. Cal Flyn reiterated this by mentioning how “it has assisted in their birth, nursed them through ill health and will tend them on their deathbed".¹² Today we should pay tribute to the generations of efforts from healthcare professionals who have made the NHS what it is today.

Happy 75th Anniversary to the National Health Service!

Footnotes

1. The New National Health Service (1948), Ministry of Health, Accessed via: https://commons.wikimedia.org/wiki/File:The_New_National_Health_Service_Leaflet_1948.pdf
2. Aneurin, Bevan,  In Place of Fear, (1952), p. 100. 
3. The New National Health Service (1948), Ministry of Health, Accessed via: https://commons.wikimedia.org/wiki/File:The_New_National_Health_Service_Leaflet_1948.pdf
4. Audrey Leathard, Health Care Provision: Past, Present and Future, (London: Chapman & Hall, 1990), p. 29.
5. Cal Flyn, The Birth of Britain's National Health Service", Welcome Collection, Published on 21st June 2018, Accessed via: https://wellcomecollection.org/articles/WyjHUicAACvGnmJI
6. Audrey Leathard, Health Care Provision: Past, Present and Future, p. 1.
7. Ibid, p. 14. 
8. "The Story of NHS Dentistry", British Dental Association, Accessed via: https://bda.org/museum/exhibitions-and-events/nhs70-celebrating-70-years-of-nhs-dentistry 
9. Ibid. 
10. Denis Campbell, "Nye Bevan's dream: a history of the NHS" (2016), The Guardian, Accessed via: https://www.theguardian.com/society/2016/jan/18/nye-bevan-history-of-nhs-national-health-service 
11. "NHS at 60", BBC, Published 4th July 2008, Accessed via: https://www.bbc.co.uk/manchester/content/articles/2008/06/17/nhs_60_your_stories_feature.shtml
12. Cal Flyn, "The Birth of Britain's National Health Service".