It’s hot, and our regular supply of posts from you, dear readers, seems to have melted away. But we can’t let today go by without acknowledging the 70th Anniversary of the NHS.
Of course, we can’t do it justice in a short piece, but we can be proud that, for all its faults, we do still have a system that is not only valued at home but also admired by other countries. Indeed, many nations now have systems of health care which are universal and free at the point of delivery, even if they differ in the methods used to achieve that.
Yes, of course there are anomalies in the NHS – dental care and prescriptions are often not free, social care is still not integrated properly with medical care, treatment is rationed by Clinical Commissioning Groups, too many services are outsourced.
But what has always astonished me is the fact that this blatantly socialist project, vilified by many at the time (including the majority of doctors), is now seen as an essential component of British life by people from across the political spectrum. And what saddens me is that the American right still don’t understand why we love it, and have dismantled the progressive systems that Obama carefully constructed.
The challenge over the last 70 years has been for the NHS to keep in step both with research and with societal changes, and that challenge will go with it into the future.
So it is appropriate that Vince Cable has chosen today to highlight quite a niche subject – access to fertility treatment for female couples. He has written to Sir Andrew Dillon, the chief executive of the National Institute for Health and Care Excellence (NICE), and Health Secretary Jeremy Hunt, about ‘shared motherhood’. This is a treatment that involves one partner donating an egg which is then carried by the other partner, so that both women are physically involved. At the moment it is only available privately at a cost of £6000 per cycle.
Vince wrote:
The emotional pull of shared motherhood is clearly strong and should be an opportunity for all female couples, not just those who can afford it.
We are marking the 70th anniversary of the establishment of the NHS – but we cannot describe this as a universal system if, even unintentionally, poorer same sex couples do not have equal opportunities to have children.
At the earliest opportunity, please review your guidance and update it to make a specific provision for three cycles of treatment for reciprocal IVF to be made available on the NHS. Such guidance would put shared motherhood in line with similar processes for couples trying for children.
And while you are about it, please end the regional inequalities in access to fertility treatment for all couples.
So, Happy Anniversary NHS, and may you enjoy many, many more.
PS. NHS is one of the very few acronyms/initialisations that I permit when editing Lib Dem Voice. I only allow through those that are known by all our readers, such as BBC, ITV and, er, …
* Mary Reid is a contributing editor on Lib Dem Voice. She was a councillor in Kingston upon Thames, where she is still very active with the local party, and is the Hon President of Kingston Lib Dems.
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14 Comments
It’s a shame that Mary omitted some of the history here. The NHS is far from a “blatantly socialist” project. It was designed in 1942 by the Liberal MP, William Beveridge, who saw Disease as being one of the five “Great Evils” in society along with Squalor, Ignorance, Want and Idleness. Beveridge saw it as a liberal principle that people should have freedom from disease to maximise their potential as humans.
The specific implementation by Labour in 1946 was more socialist, centralised and bureaucratic than Beveridge envisioned, with less power and choice for patients and a one-size-fits-all approach. But the idea is something that we as Liberals should be proud to have created.
Thanks, Dave. Of course I should have acknowledged Beveridge – this was not an attempt at a history – but it is still surprising that a nationalised system of health care is universally loved.
The NHS is blatant socialism (as are the police and armed forces). Foreign corporations would provide better patient outcomes, than statism.
Absolutely Dave — and the NHS isn’t just a great Liberal invention, but also the notion underpinning the NHS as most of us understand it is fundamentally Liberal.
That’s why it lets us make “poor” choices over our own lives and helps to mitigate against excessive consequences, rather than othering us as having gone against the collective instruction as Socialists would or casting us on the scrapheap in a Libertarian / Tory fashion.
Though in places it is starting to drift into being that kind of Socialist project now…
Seth Thevoz wrote an excellent post on the history of the NHS here: https://www.libdemvoice.org/setting-the-record-straight-labour-and-the-nhs-15930.html.
I should explain that I wasn’t asserting that it was a Labour project, but it certainly had ‘socialist’ elements and was widely denounced as such at the time – just as opponents of ObamaCare dismiss it as communist.
I will admit that I used that term slightly tongue in cheek to elicit a response.
For goodness sake, stop trying to claim credit for something whose birth, if truth be known, encorporated many stands of political opinion. In fact, the main organisations that appeared at the time to be less than enthusiastic were the BMA and the Conservative Party. Bevan’s solution to get the former on board was to “stuff their mouths with gold”. By the time they had returned to power in 1952 the Tories were also enthusiasts.
We should not be blind to the fact that the NHS is far from perfect. If it is to get the kind of cash injection it undoubtedly needs, and to which most of us should be prepared to contribute, it has got to look at itself more critically. Just as in education, I just wish that the political dimension could be removed.
@ John Marriott Well said, John. Credit is due to where credit is due and the NHS is certainly not ‘a great Liberal invention’.
Beveridge was a civil servant in 1942 – and reluctantly joined the Liberal Party only after the death of young Charles Grey, the Liberal MP for Berwick, in Normandy in 1944. He was an MP for a mere nine months and obviously took no part in the debates leading up to 1948.
Personally, I rejoice in the fact my life was saved by a transplant and more recently I had a new hip. Thank you to Nye & Clem for being so determined despite austerity. Unlike my Grandparents I have never lost a child because I couldn’t afford to pay the doctor’s bill.
Just been listening to the 70th Anniversary NHS debate in the Lords. A powerful contribution from Lord Bird – Founder of the Big Issue.
He rightly points out there is an elephant in the room – poverty capitalism. The product of Universal Credit, Pip and zero hours contracts is a ticking time bomb for the NHS – add on all the pressure of poor diet and obesity and we have a ticking time bomb. Until we tackle inequality and poverty NHS costs will spiral out of control. It’s not blatant socialism – it’s poverty sticking plaster capitalism in society at large.
“and reluctantly joined the Liberal Party”
Citation needed. Personally, it seems to me that someone who was a member of the Radical Action Group, which called for Liberals to contest every seat rather than keep supporting the wartime electoral pact with Labour and the Tories, and to push for radical liberal policies, was hardly “reluctant”. People who reluctantly join parties don’t usually get put in charge of their election campaigns (as Beveridge was in 1945), end up as their leader in the Lords, and write books with titles like “Why I Am A Liberal”. He only joined the party in 1944, but was an adviser to Churchill and Lloyd George at the time of the People’s Budget, long before his brief wartime experience in the Civil Service, and was regularly involved in the Liberal Summer Schools which existed throughout the 1920s and 30s to try to provide a renewed intellectual framework for liberalism.
“only after the death of young Charles Grey, the Liberal MP for Berwick, in Normandy in 1944.”
Or “before” as we in the reality-based community call it.
“and obviously took no part in the debates leading up to 1948.”
Really? It’s “obvious” that Baron Beveridge, as a member of the upper house, took no part at all in the debates that led up to the implementation of the report he had authored? That seems… not very obvious… to me.
Beveridge was, of course, influenced by non-Liberal strands of thought, notably Fabianism (unfortunately so, in the case of his support of eugenics, a Fabian hobbyhorse of the time), but to deny that the man who wrote “Why I Am A Liberal” was a Liberal seems a rather bold claim given your lack of evidence…
The NHS is blatant socialism (as are the police and armed forces). Foreign corporations would provide better patient outcomes, than statism.
Would you like to comment on the reason several NHS and railway contracts have been handed back because they could not make a profit on the price bidded. Was it incompetent bidding or governments going for the cheapest price and how would you improve the system to get a balance between tax payer value for money and avoiding excessive profits.
David Raw is correct. Poverty and the results of poverty are a major factor in creating the illness that the NHS struggles to cope with. As a chap from the Health Foundation said on the TV recently, the long term answers to the NHS lie outside the NHS.
Unfortunately short term thinking prevails and prevents government from taking the kind of measures regarding diet, exercise and sport (less money for elite sport, more for grassroots) that might lead to a healthier population.
@David Raw
‘Beveridge was a civil servant in 1942’
Like many others for the duration of the war. Gaitskell and Wilson were also war-time civil servants too; all three were primarily academics, though Gaitskell had been a Labour candidate in 1935.
It’s worth noting that the post-1945 construction of welfare states was led in much of Western Europe by centre-right parties.
Conservative Manifesto 1945: “One of our most important tasks will be to pass into law and bring into action as soon as we can a nation-wide and compulsory scheme of National Insurance based on the plan announced by the Government of all Parties in 1944”.
“The health services of the country will be made available to all citizens. Everyone will contribute to the cost, and no one will be denied the attention, the treatment or the appliances he requires because he cannot afford them. We propose to create a comprehensive health service covering the whole range of medical treatment from the general practitioner to the specialist, and from the hospital to convalescence and rehabilitation; and to introduce legislation for this purpose in the new Parliament”.
As Beveridge pointed out at the time, the construction of the Health Service could have been different. Professor David Marquand reports the views of Herbert Morrison (Labour Home Secretary at the time) and the view of Aneurin Bevan that the structure would have been better based on local authorities than national and monolithic. In the end, Bevan and the Cabinet decided in favour of the NHS structure because it would have been too complicated to use the local government system at the time. We are now moving towards the idea of a more devolved system – Wales, Greater Manchester, Scotland.
The problem with the much-loved myths about the NHS and its foundation is that they are just that: myths. And they currently stand in the way of rational reform.
Andrew Hickey raises questions about comments I made on the relationship between William Beveridge and the Liberal Party. “Citation needed”. Happy to oblige. Beveridge was sixty five when he joined the Liberal Party – not without wobbles on the way.
He was mostly an academic (Oxford and LSE ) but also a civil servant (rose to Assistant Secretary, establishing Labour Exchanges with Churchill, National Insurance with LL.G.). He associated with Fabians, Tawney and the Webbs, but as a civil servant could join no party.
The standard biography (Jose Harris,1977) makes clear he was a difficult colleague – unpopular at LSE because of an autocratic management style. Andrew rightly mentions odd views on eugenics (shared to an extent by Churchill & LL.G.. Calder (1969) describes him as ‘vain, humourless and tactless’.
In the War Coalition, he was appointed by Ernest Bevin – with Harold Wilson as
research assistant. He was angry when Churchill refused to commit to his report. In early 1944 talked with senior Labour figures about joining the Party. On 23 May he met Dingle Foot (Lib MP) and Party President Violet Bonham-Carter (Asquith’s daughter) telling them he might stand as an ‘Independent Radical’ (p302, B-C Diaries) but would reflect.
After prevaricating when asked to stand in Dunfermline on 15 August he was approached by Berwick Liberals after Grey’s death in Normandy. Party Leader Sir Archibald Sinclair (and Hugh Seely, former Berwick MP) were “opposed to Bev” (VBC p 315) but he was selected and won against nominal opposition. Within nine months he lost the seat.
Attlee’s overwhelming majority had no need of Beveridge – though Attlee gave him a peerage in 1946. In the Lords the party was led by Samuel until 1955 – and Rea until 1967. How active Beveridge was is open to question – he spent much time on the Peterlee project with Labour controlled County Durham.
After losing his seat in 1945 he told Lady Violet ‘how close to Labour his sympathies lay’. (VBC Diary p 302). After 1945, until Grimond’s days, the party was a mere shadow dependent on Tory electoral arrangements.
Yes, celebrate Beveridge as (for a time) a Liberal but don’t over egg the pudding. Don’t underestimate Attlee, Bevan, Bevin, and behind the scenes, Harold Wilson.
PS please explain what a reality-based community in leafy Tunbridge Wells is.