NHS Birthday Celebrations: Today the National Health Service marks its 75th Anniversary, founded thanks to the efforts of the Labour Party and in particular Aneurin Bevan, following on from the 1942 report by Liberal economist William Beveridge which had proposed wide-reaching social reforms to tackle the “five giants” of “Want… Disease, Ignorance, Squalor and Idleness” (Idleness meaning of course unemployment.) The pictures in this post come from the 65th anniversary ten years ago today, Friday 5th July 2013.
Beveridge was opposed to means-tested benefits which he stated were unfair on the poor, and although the wartime coalition government set up committees to look at how his reforms could be put into practice they were from the onset opposed by many Conservatives and some on the Labour right.
But Labour stood in the 1945 elections promising to put the proposals into effect, and after their victory passed the National Insurance Act 1946, the National Assistance Act 1948, and the National Health Service Act 1946 and other Acts to do so, founding the UK’s modern welfare state.
Bevan was the wizard who integrated the multifarious per-existing medical services into the single functioning state body of the National Health Service, though he had to make many compromises to do so, working against considerable opposition both political from the Tories and from the medical bodies which were dominated by old men, many with fixed ideas.
The 75 years since then have seen many changes in the NHS, not all for the good, with both Conservative and Labour governments determined both to penny-pinch and bring in private enterprise to profit in various ways from our health service. The last 13 years have been particularly tough for the NHS, with disastrous reforms brought in and cuts which have made it impossible for NHS workers to provide the services and care they desperately want to do.
Covid of course didn’t help – and the failure to provide proper protective equipment, with too many contracts going to cronies who didn’t deliver – and fraudsters – was a real disaster, killing far too many health and other key workers. Despite a magnificent effort by health workers too many died, and the only reward for the huge efforts made by the NHS was claps.
Currently we have a government which refuses to talk sensibly with workers across the health centre, instead simply saying that the below inflation rises it is offering – essentially wage cuts – are fair. It obviously hopes that by provoking strikes and getting its friends in our billionaire owned right-wing press to condemn the strikers for the cancellations, increase in waiting lists and possible deaths it will get the public on its side against the NHS.
Instead we need policies which will engage with the problems the NHS faces after years of underfunding, overwork and shortages. The recently announced workforce plan at least is a plan to do something, though it seems unlikely to prove workable. The shortage of doctors, nurses and other medical staff has been clear almost since the start of the NHS, and certainly critical for many years.
We need to both increase the number of training places and tackle some of the other causes. Private hospitals rely on publicly funded doctors and nurses – and should at least have to pay the training costs for those they employ – although personally I’d prefer to see them being brought into public ownership. As well as poaching staff they also cherry-pick offering care for simpler cases but largely passing back more critical care to the NHS.
There needs to be an end to the expensive and somewhat unreliable use of agency staff, at least by the NHS setting up its own temporary staffing organisation and also by ending payments for work at above normal rates. The NHS also needs to become a much friendlier employer in terms of flexibility of shifts etc.
And of course we need to remove the caps on training for doctors, nurses and other staff, and to provide proper bursaries to cover both fees and maintenance for these vital workers. The proposed ‘apprenticeship’ scheme for doctors seems unworkable as such, but all medical course are already in some part apprenticeships, including some on the job training. Finding the additional mentors needed for more work-based schemes seems an example of cloud-cuckoo land thinking, and the setting up of a two-class system of doctors seems highly undesirable.
Importantly too we need to drastically reduce the bureaucratic workload of all doctors and health staff at all levels. Theoretically the increased use of IT could play a role in this – although the NHS has been disastrously shafted by its IT providers in the past, promising much but delivering mainly greater complexity. So far bringing in IT has increased the amount and time spent in form-filling at the expense of treating patients, partly because the various levels of administration up to the government has seized the opportunity for the greater demands it makes possible.
I was born before the NHS and looking at it in recent years I’ve sometimes wondered if my own death will be due to its stuttering demise. I hope not. But the NHS is certainly not safe in the hands of the Tories, and little that we have so far seen about Labour’s plans give me confidence it will be safe in theirs.
The two events I photographed on the NHS’s 65th Birthday were all concerned with its problems and doubts about its future, The GMB trade union came to Parliament with 3 vintage ambulances saying the NHS Is At Risk, campaigners at Lewisham Hospital celebrated hoping and fighting to keep their busy, successful and much needed hospital open and stop it being sacrificed to meet the disastrous PFI debts of a neighbouring hospital. I’d taken my bike to ride to Lewisham, and made a leisurely ride through Deptford on my way back to Westminster.
At the Ministry of Health, then still on Whitehall, Dr Clive Peedell was about to begin his 65 mile ultra-marathon run to David Cameron’s Witney constituency where he was to ceremonially bury the NHS coffin and launch the National Health Action Party plan by doctors and health professionals to revive the NHS. Their 10-point plan included “policies to restore the duty of the Secretary of State to provide comprehensive NHS care, and return the NHS as the preferred provider of services.”
More about the events on the 65th Birthday of the NHS – from which all the pictures in the post come – are on My London Diary.