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Wednesday, July 1, 1998 Published at 11:05 GMT 12:05 UK


Making Britain better

For Bevan the NHS was just one step down the road to a socialist Britain

When Labour health minister Nye Bevan opened one of the world's first and most comprehensive health services to the British people on July 5, 1948, it was the realisation of a socialist dream. The new National Health Service (NHS) was the cornerstone of the post-war Labour government's commitment to build a new Jerusalem in an impoverished Britain, painfully recovering from six years of war.


John Campbell, Bevan's biogrpaher, explains the political appeal of the health service.
Bevan had fought tooth and nail to ensure all the people of Britain could receive the best medical care available whether they were a banker or a miner, free at the point of use.

Overnight, the patchwork provision of medical services, which left millions of people with little or no reliable health care, was swept away. But the establishment of the new health service was strongly opposed by the Conservative Party and by the Doctor's professional body, the British Medical Association (BMA).

The medical fuhrer

They feared both the new service and the flamboyant socialist minister whose mission it was to create it. Once Bevan had published his Bill on the health service in 1946, one former chairman of the BMA described Bevan's proposals in the following terms:


[ image: Doctors initially opposed the new service by nearly 10-1]
Doctors initially opposed the new service by nearly 10-1
"I have examined the Bill and it looks to me uncommonly like the first step, and a big one, to national socialism as practised in Germany. The medical service there was early put under the dictatorship of a "medical fuhrer" The Bill will establish the minister for health in that capacity."

The BMA was concerned that by nationalising both the charity hospitals and the former poor law hospitals run by local authorities, Bevan would strike down doctors' cherished professional independence, and their right to buy or sell general practices.

They feared their new role, with a salaried income, would reduce them to the status of mere civil servants.

Meeting Hitler

But if Bevan was to establish his health service, he needed the co-operation of the doctors. After all, the NHS could not operate without doctors.


[ image: Before the NHS child mortality was high, several of Bevan's siblings died in childhood]
Before the NHS child mortality was high, several of Bevan's siblings died in childhood
He quickly set out to charm them into submission.

Bevan arranged to meet the leaders of the BMA in an exclusive London restaurant. Dr Roland Cockshot was one of those present.

"We screwed our nerves up_we might have been going to meet Adolf Hitler." But after noticing the Welsh class warriors well-tailored suit, Dr Cockshot was forced to revise his opinion of the charismatic minister for health, although he admitted afterwards: "We were quite surprised to discover he talked English."

Charmed as they may have been by Bevan's personality, the doctors remained flatly opposed to his health service.


Bevan reflects on the struggle to establish the NHS.
Non co-operation

Once the Health Bill became an act in the closing months of 1946, the BMA immediately adopted a policy of non co-operation with the health service and refused to negotiate with the minister on their conditions of service.

But Bevan was determined to prevent a sectional interest derail an act of Parliament. He described the BMA as a, "small body of politically poisoned people" who had decided "to fight the Health Act itself and to stir up as much emotion as they can in the profession."

But as Bevan's stormy relationship with the BMA carried on into 1948, the minister luckily managed to strike up a working relationship with the Royal College of Physicians headed by Churchill's personal doctor Lord Moran.

'Stuffing their mouths with gold'

By allowing the consultants to work inside the health service and at the same time still treat their lucrative private patients, Bevan bought the backing of the consultants by, as he put it, "stuffing their mouths with gold."


[ image: Bevan kept the consultants on side by
Bevan kept the consultants on side by "stuffing their mouths with gold"
Opposition among BMA members was now declining as well. The doctors began to realise that by refusing to treat health service patients they would lose a substantial source of income, and when Bevan promised legislation that ensured they would not become salaried civil servents, the doctors ended their resistance.

But Bevan had managed to take from them the right to buy and sell practices.


Dr Sandy Macara from the doctors' professional body, the British Medical Association, says Bevan had an abrasive style.
'Lower than vermin'

By NHS D-Day, July 5, 1948, 90% of doctors had signed up for the new service. But although Bevan had in the end comfortably won the battle, he could not resist one last attack on those who had stood in the way of his dream.

In a speech on the eve of the heath service's launch, Bevan called the Tories "lower than vermin". When the prime minister, Clement Attlee, suggested the opening of the NHS should be celebrated as a national institution supported by the whole nation, it was too much for Bevan, who replied:

"The Conservatives voted against the National Health Act, not only on the second but on the Third Reading. I do not see why we should forget this."



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