It shall be the duty of the Minister of Health... to promote the establishment in England and Wales of a comprehensive health service designed to secure improvements in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness...
The services so provided shall be free of charge
So reads the first two clauses of the National Health Service Act of 1946. 18 months after being given Royal Assent, the law came into force. On the 5th July 1948, the British National Health Service was born.
How great a leap of progress this was can be seen from the uptake of the new service. People presented themselves at hospitals, doctors, dentists, and opticians, many for the first time in their lives. Doctors were shocked at what they saw, appalled at the ill health of the nation. Many people had endured decades of chronic pain, living with conditions not expected to be seen in a modern democracy. Before 1948, disease and pain had been balanced by the shadow of the cost of seeking treatment. The ragtag of insurance schemes, benevolent funds, and company insurance schemes didn't even begin to cover everyone. For millions, they suffered in silence and in the shadows. But now, with the fear of not being able to afford it gone, things were different. The NHS had sent those old fears packing, forever.
It is often said to be Labour's greatest achievement. From the ashes of a difficult war and cripplingly expensive victory, Clement Attlee and his government had taken a huge step towards slaying Disease, one of the Five Giants laid out in the Beveridge Report of 1942. It was to be a pillar of the New Jerusalem they were building.
In reality, it was more complicated than that. Nye Bevan, the strident left-winger appointed as Minister of Health, cut deal after deal with deeply sceptical, conservative, medical practitioners to get the new NHS off the ground. "I stuffed their mouths with gold," he is reputed to have boasted afterwards about the consultants. And the entirely free nature of the service didn't last long. Charges were brought in the early 1950s, to pay for Britain's involvement in the Korean War. Although they were abolished in 1965, they returned after devaluation in 1968, never to be rid of again. And since the day the NHS launched, there have been arguments over the cost, waste, management, organisation, and level of private involvement. And the rumours that it is to be abolished have always swirled, never far from the surface.
Yet despite all this, the NHS is one of Britain's proudest achievements. It was the first truly universal healthcare system established anywhere in the world. It is the largest free at the point of use healthcare system anywhere in the world. It is one of the world's largest employers, and at the forefront of medical progress.
Nigel Lawson, Margaret Thatcher's Chancellor, once said of the NHS that it was the closest thing the people of England have to a religion. For once, I reckon he's right.
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Nye Bevan, speaking to patients on the first day of the NHS, 5th July 1948
