Early infancy
Bevan’s baby suffered its first case of colic before it reached its third birthday. The actual cost of the NHS was 40 per cent higher than had been predicted. The original estimate of £176 million turned out to be £235 million.
A subsequent inquiry found the increase was due more to general price inflation than extravagances in its early years.
That didn’t lessen the pressure to cut costs. Charges for dentures and glasses were introduced as part of economies to finance the Korean War. Bevan resigned from the Cabinet in April 1951 as a result.
Scotland was better provisioned with beds thanks to the Emergency Hospital Service.
But the pattern was set for years ahead – an NHS based on hospital treatment rather than prevention and health promotion.
Despite having more GPs per head of population there was no money for health centres, along the lines set out by Cathcart. The first was not built until 1953 at Sighthill followed by Stranraer.
The UK NHS family
From this time the focus was on the wider UK NHS family. It was the new welfare state which helped lay the foundations of the post-war British state. The NHS not only operated across the United Kingdom – it was a modern representation of it.
Money was to be a constant cause of friction and major decisions would mostly be made in London not Edinburgh.
After Bevan’s departure the Minister of Health no longer had a seat at Cabinet. And housing was no longer part of the Health Ministry.
Growing up
Education became a higher priority during the 1950s. The NHS share of the national spending fell from around 25 per cent to 20 per cent by 1963.
Charles Webster, the official historian of the NHS, sums up the early years:
“By virtually all criteria, over the 1948-64 period the NHS cannot be regarded as a drain on national resources. Indeed, its costs were contained without difficulty, to the extent that resources were denied for obvious and urgent prerequisites, such as those connected with demographic change, medical advance, capital investment, or policy changes needed to keep up with rising expectations and the pace of improvement experienced elsewhere in the Western world.
“The inferior status of the health service was disguised by political rhetoric; this effectively induced a sense of complacency concerning the state of the NHS, which vanished from the headlines. Owing to the effectiveness of this propaganda, reinforced by the evident improvement on the previous system, habitual stoicism and misplaced confidence among the general public concerning the prospects for improvement, and a general disinclination to criticize a cherished national institution, the new health service drifted back into a political limbo and thereby risked becoming a neglected backwater of the welfare state.”
Charles Webster, the National Health Service, a political history, 1998.
- Further information
- Bevan radio clip 1949
- Scottish NHS develops
“5 July 1948 was the second of Britain’s finest hours in the brave and high-minded 1940s. Like the Battle of Britain it was a statement of intent, a symbol of hope in a formidable, self confident nation. That should not be forgotten . . . when the trials and tribulations and the often fractious politics of health care are given their due place in the post-war history of the United Kingdom. The NHS was and remains one of the finest institutions ever built by anybody anywhere.”
Historian Peter Hennessy, Never Again, Britain 1945-1951
“It was the first health system in any Western society to offer free medical care to the entire population. . . .
“At the time of its creation it was a unique example of the collectivist provision of health care in a market society. It was destined to remain so for almost two decades after its birth when Sweden, a country usually considered as a pioneer in the provision of welfare, caught up.”
Rudolf Klein, The New Politics of the NHS, 2006