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From the archive, 5 July 1948: Creation of NHS heralds new era in British healthcare From the archive, 5 July 1948: Creation of NHS heralds new era in British healthcare
(3 months later)
Today the National Health Service Act comes into force, and the passing of the milestone will be hailed with a chorus of praise, some of it perhaps too complacent. We are in process of making a great move forward. But only the first step, the legislative part of the move, is now completed. The larger part of the task is to come. It is a moment of opportunity, not of achievement.Today the National Health Service Act comes into force, and the passing of the milestone will be hailed with a chorus of praise, some of it perhaps too complacent. We are in process of making a great move forward. But only the first step, the legislative part of the move, is now completed. The larger part of the task is to come. It is a moment of opportunity, not of achievement.
The health service which comes into being to-day is only the ground floor of the building. The rest will come; but it still wants building, not by M.P.s or civil servants in Whitehall but by doctors and nurses and opticians and many more, by members of the regional hospital boards and the local hospital committees. There is now something solid to build on. The Act puts the hospital services as never before on a sound and rational base; the regional boards will be able to make the best use of what hospitals there are.The health service which comes into being to-day is only the ground floor of the building. The rest will come; but it still wants building, not by M.P.s or civil servants in Whitehall but by doctors and nurses and opticians and many more, by members of the regional hospital boards and the local hospital committees. There is now something solid to build on. The Act puts the hospital services as never before on a sound and rational base; the regional boards will be able to make the best use of what hospitals there are.
But they know better than anyone that new and better planned hospitals (and many more nurses in them) will be needed before we can call the hospital services wholly satisfactory. The whole population becomes, for the first time, entitled to the medical services hitherto available only to insured workers; the scandal of "under-doctored" areas will slowly disappear. But the full fruit of these reforms will not be ripe until the system of health centres has had time to grow, and that growth would be gradual even if lack of bricks and mortar did not inhibit it at the start. One must think of the health service as a huge natural organism in process of growth, not as a creature of magic, called out of the void by the wand of the Minister of Health.But they know better than anyone that new and better planned hospitals (and many more nurses in them) will be needed before we can call the hospital services wholly satisfactory. The whole population becomes, for the first time, entitled to the medical services hitherto available only to insured workers; the scandal of "under-doctored" areas will slowly disappear. But the full fruit of these reforms will not be ripe until the system of health centres has had time to grow, and that growth would be gradual even if lack of bricks and mortar did not inhibit it at the start. One must think of the health service as a huge natural organism in process of growth, not as a creature of magic, called out of the void by the wand of the Minister of Health.
The new system of social security, under the Ministry of National Insurance, also comes into operation to-day. The impact of this, unlike that of the National Health Service, will make itself felt at once; to many people in the disagreeable form of a higher rate of weekly insurance contributions, to others by a demand for contributions previously not paid at all. Most of the benefits will not be experienced until the need for them arises; and many people will wait long enough for that. Yet it too is a great step forward. One recalls the surge of enthusiasm with which the Beveridge Report was greeted. To millions of people below the "salaried job" level security is almost as tangible a thing as money itself; to know that bad luck will not mean acute poverty is to be free of the most persistent and stabbing anxiety which afflicts the wage-earner.The new system of social security, under the Ministry of National Insurance, also comes into operation to-day. The impact of this, unlike that of the National Health Service, will make itself felt at once; to many people in the disagreeable form of a higher rate of weekly insurance contributions, to others by a demand for contributions previously not paid at all. Most of the benefits will not be experienced until the need for them arises; and many people will wait long enough for that. Yet it too is a great step forward. One recalls the surge of enthusiasm with which the Beveridge Report was greeted. To millions of people below the "salaried job" level security is almost as tangible a thing as money itself; to know that bad luck will not mean acute poverty is to be free of the most persistent and stabbing anxiety which afflicts the wage-earner.
After these years of full employment that anxiety has perhaps lost some of its sting. But the nineteen-thirties are still near enough to be remembered with fear and bitterness, and with gratitude for the day on which Mr. Arthur Greenwood appointed Lord Beveridge to review the existing provisions for social insurance and to recommend plans for filling the gaps. The new security system which has grown out of this decision is on a tremendous scale.After these years of full employment that anxiety has perhaps lost some of its sting. But the nineteen-thirties are still near enough to be remembered with fear and bitterness, and with gratitude for the day on which Mr. Arthur Greenwood appointed Lord Beveridge to review the existing provisions for social insurance and to recommend plans for filling the gaps. The new security system which has grown out of this decision is on a tremendous scale.
These two reforms have sometimes been greeted as a large installment of Socialism in this country. They are not strictly that, for many besides Socialists have contributed something to them. What they mark is rather an advance of the equalitarianism which has been the mainspring, though not the exclusive possession, of the British Labour movement. They are designed to offset as far as they can the inequalities that arise from the chances of life, to ensure that a "bad start" or a stroke of bad luck, illness or accident or loss of work, does not carry the heavy, often crippling, economic penalty it has carried in the past. It is important to realise the fundamental change in attitude which this implies, and its consequences for our social evolution.These two reforms have sometimes been greeted as a large installment of Socialism in this country. They are not strictly that, for many besides Socialists have contributed something to them. What they mark is rather an advance of the equalitarianism which has been the mainspring, though not the exclusive possession, of the British Labour movement. They are designed to offset as far as they can the inequalities that arise from the chances of life, to ensure that a "bad start" or a stroke of bad luck, illness or accident or loss of work, does not carry the heavy, often crippling, economic penalty it has carried in the past. It is important to realise the fundamental change in attitude which this implies, and its consequences for our social evolution.
Mr. Churchill has, with his usual frankness and pith, defined the main process by which the powerful structure of our industrial society has been built up as "competitive selection." That process requires a sump, a bottom level to which the weakest and least fit are thrust down beyond the point of survival, or at least of reproduction. For a century we have been tending away from the logical application of this principle, and neither Mr. Churchill nor any other humane man would wish to see it whole-heartedly applied again to-day.Mr. Churchill has, with his usual frankness and pith, defined the main process by which the powerful structure of our industrial society has been built up as "competitive selection." That process requires a sump, a bottom level to which the weakest and least fit are thrust down beyond the point of survival, or at least of reproduction. For a century we have been tending away from the logical application of this principle, and neither Mr. Churchill nor any other humane man would wish to see it whole-heartedly applied again to-day.
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