The formation of the National Health Service
The idea of national co-ordination of the health services and the supply of free medical care to all gained popular and political support during the 1930s and 1940s, and was included in the recommendations of the 1942 Beveridge Report. In 1944 the Ministry of Health (under the war-time coalition government) published a White Paper on a National Health Service, which put forward detailed proposals for a system of free universal healthcare funded by central taxation. In 1945 the Labour Party won a landslide general election and the new Minister of Health, Aneurin Bevan, was given the task of creating a workable system and manoeuvring all the various vested interests into agreement. His National Health Service Act of 1946 established a structure for the NHS in England and Wales, and, unlike the earlier White Paper, proposed that the health service should be managed by central government rather than local authorities. Strong disagreement over the proposed service, particularly between the government and the British Medical Association (representing doctors), almost threatened to derail the implementation of the Act, but the new National Health Service was launched as planned in July 1948.
Our digital collection contains various documents which relate to the debate around the formation of the National Health Service. A selection of these are linked to below.
The 1944 White Paper:
- A National Health Service: The White Paper proposals in briefLink opens in a new window, 1944. Pamphlet containing an "official abridged version of the Government's proposals in their White Paper on a National Health Service".
- A National Health Service: Report of the Council of the B.M.A. to the Representative BodyLink opens in a new window, 1944. Draft statement of policy by the British Medical Association, to "be the basis of discussion at meetings of the whole profession called by the Divisions throughout the country".
- The White Paper - An analysisLink opens in a new window, March 1944. Statement of principles and analysis of the government's proposals from the British Medical Association.
- A national health service: draft memorandum on the government's proposalsLink opens in a new window, 14 April 1944. "Considered opinions" of the British Hospitals Association, produced in collaboration with King Edward's Hospital Fund for London, and following informal consultations with representatives of the British Hospitals Contributory Schemes Association and the British Medical Association.
- Resolution passed by Chorley Division Trades CouncilLink opens in a new window "repudiat[ing] the statements" of the British Hospitals Association and the British Hospitals Contributory Schemes Association on the White Paper, 19 June 1944.
- Statement in regard to the Minister of Health's White Paper on the establishment of "A National Health Service"Link opens in a new window, 1944. General review of the White Paper ("a most disappointing document") by the Hospitals and Welfare Services Union.
- A National Health ServiceLink opens in a new window, 6 June 1944. Letter from the National Union of Public Employees, critising the White Paper's dismissal "in a cursory reference of a single sentence" of all medical staff who are not doctors.
- Resolution adopted at the Annual Delegate Meeting of the Association of Scientific WorkersLink opens in a new window, 27-29th May, 1944. It welcomes the government's proposals as an advance, but makes a series of criticisms about perceived failures and omissions in the White Paper.
- The Health Services White Paper: The Labour Party's policyLink opens in a new window, September 1944. Confidential memorandum produced by the Labour Party's Advisory Committee on Public Health.
- National Health Service: The Government's Policy (White Paper)Link opens in a new window, 1 March 1944. Confidential memorandum from the Trades Union Congress on the government's proposals.
- Minutes of Joint Sub-Committee of the Trades Union Congress, the Labour Party and the Co-operative CongressLink opens in a new window on the Government White Paper "A National Health Service", 5 September 1944.
- Common Wealth Information Bulletin. No. 4, The Health ServicesLink opens in a new window, May 1944. Pamphlet issued by the socialist political group Common Wealth, including criticism of the government White Paper.
The 1946 National Health Service Act:
- Proposals for a National Health ServiceLink opens in a new window, January 1946. Confidential version of the government's new proposals, sent to the Trades Union Congress by the Minister of Health, Aneurin Bevan, following his meeting with representatives of the TUCLink opens in a new window on 8 January 1946.
- National Health Service Bill: Summary of proposed new serviceLink opens in a new window, 1946. Outline of the government's proposals, presented to parliament by the Minister of Health in March 1946.
- British Medical Association and the National Health Service BillLink opens in a new window, 1946. Published response of the BMA to the proposed legislation, including an outline of the 'principles of the profession'.
- Your new health serviceLink opens in a new window, 1946. Socialist Medical Association leaflet summarising (and praising) the government Bill.
- National Health Service Bill: some initial notes on the provisions of the Bill as it affects the hospital services of the countryLink opens in a new window, April 1946. Memorandum produced by the British Hospitals Association. The BHA supported the idea of a free and comprehensive health service, but argued against the abolition of voluntary hospitals and the transfer of their administration to the national government.
- Report of meeting on the National Health Service BillLink opens in a new window between representatives of the British Hospitals Association and the Trades Union Congress, 25 April 1946.
- Trades Union Congress memorandum on the National Health Service BillLink opens in a new window, 24 May 1946.
- National Health Service: deputation to the Minister of Health on 17 June 1946Link opens in a new window. Report of a deputation to Aneurin Bevan by the Trades Union Congress to discuss the provisions of the new NHS Bill.
- National Health Service: You must decideLink opens in a new window, January 1948. Circular from the Medical Practitioners' Union, which contains "a few simple questions and answers [that] will make our present position clear and may help to clarify yours".
- Lord Horder on Medicine and "The State"Link opens in a new window, article published in the News Bulletin of the Society for Individual Freedom, June 1948. Lord Horder protests strongly against what he argues is an attack on the liberty of the individual through "domination of Medicine by the State" - "a greater disaster to the citizen than was its domination by the Church in the middle ages".
The new National Health Service:
- The New National Health ServiceLink opens in a new window, 1948. Government leaflet which explains the new service to members of the public.
- The National Health ServiceLink opens in a new window, 1948. Government booklet which provides an outline of the new service.
- Public health in 1948: Remarkable statistics. The first months of the National Health ServiceLink opens in a new window, 31 March 1950. Summary of the annual report of the Ministry of Health. It includes statistical information about changes to the national health during the first months of the NHS.
- Comments on editorial in American Medical Association JournalLink opens in a new window. The AMA journal of 25 September 1948 included a strong attack on the "folly" of the National Health Service. This response was produced by the British Trades Union Congress. It criticises the original article for inaccuracy and exaggeration, and puts forward a defence of the newly formed health service.