by
Les May
EVERY TIME
I hear a Tory minister talk about ‘Our
NHS’ I wince a little.
The National Health Service
was the creation of the post war Labour government. But even that is
not quite true; the NHS as
we know it was the creation
of one man, Aneurin Bevan,
better known as Nye Bevan,
which is why we have an NHS facility named after him in Rochdale.
Certainly
there were other people who
deserve credit,
especially
William
Beveridge whose
1942 report fed the appetite for the state to take better care of its
citizens.
Beveridge
advocated a scheme that was universal
in that it was to cover all people and comprehensive
in that it would cover all needs. He assumed that it would be run by
local government and that it would be a social insurance scheme with
a contribution from the government of the day. Beveridge
also favoured
patients paying ‘hotel’
charges for their stay in hospital and charges for ‘appliances’.
His
scheme would have replaced the one that had gradually evolved so that
in the 1930s about
90% of the workforce had
social insurance, which
covered
the of the GP
service and sick pay. The
other 10% and all dependants
either had private insurance or made full out-of-pocket payments.
The costs of
hospital care
were met by private
insurance, such as workers'
contributory schemes. This
met the needs of about 10 millions of the population and
the rest paid means-tested charges. Local and national taxes funded
public health, hospitals and the
specialist clinics run by
local authorities.
Bevan
saw things differently and
effectively nationalised the health service.
He favoured a
fully
tax-financed system.
He
did this because funding based upon national taxation is inherently
more redistributive. He
also
regarded
free access to health care to be a citizen's right and not
something conditional on the payment of contributions. In
addition a tax based scheme neatly
sidestepped the problem of how, politically
and administratively, the non-insured could be turned away from a
universal service.
‘The
collective principle asserts that... no society can legitimately call
itself civilised if a sick person is denied medical aid because of
lack of means.’
— Aneurin Bevan, In Place of
Fear, p. 100
We
should be thankful that we have a tax based system. Imagine if you
felt ill and found that your insurance would pay for a test for
Covid19, but not for your treatment or care. It has happened in the
USA.
Imagine if you have just recovered from a stay in hospital being
treated for a Covid19 infection and then someone starts chasing you
for ‘hotel
charges’.
What
Bevan did not solve in 1948 was the question of who should pay for
the care of the elderly. Should it be the NHS and its tax based
system or local authorities who were free to make a charge. No one
else has shown the will to solve it since.
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Posts
3 comments:
It could be argued that is was predictable that the NHS was established by a Labour government due to it being elected in 1945 - when plans for what was to be called the NHS were well advanced but lost in the mists of time.
Contemporary news reports from 1944 demonstrate that plans for the NHS were already well advanced. They had moved on considerably from the Beveridge Report in 1942 (see: Towards A Healthier Britain - (Minister Of Health's Speech 1944)
Unfortunately, the whole issue has been claimed by Labour and its supporters as 'theirs', with seemingly total and utter reverence towards one man.
Like the substitute who makes his first appearance late on and scores the winning goal in the FA Cup finaal, it is often the politician who is in the right place at the right time, who receives all the praise - even if they never claimed nor asked for it themselves.
https://www.youtube.com/watch?v=qyjbUK88CB4
I can't find where I read it but I seem to remember Malcolm Muggeridge saying that shortly before the 1945 General Election he bumped into Clement Attlee coming out of the gents urinals at the Reform Club. He was shocked to see citizen Clem's chest was smothered in medals. After that he considered him 'a light weight' and duly voted against Labour when he went to the polls. Of Aneurin Bevan, Muggeridge wrote: 'Although so far as the Conservatives were concerned, in the current political morality play he was cast for the role of villain, actually he'd mixed more with the upper classes than most Labour Party leaders. His refusal to wear evening dress was sound demagogic instinct, but in point of fact evening dress occasions were far more familiar to him than say the respectable Mr Attlee. All the same, he was the most interesting and considerable figure in English politics at this time. His greatest weakness was his mistaken belief in himself as a political theorist; his greatest strength his love of power, which would prevent him from ever in any sense being a fellow traveller or accepting stooge positions vis-à-vis the Kremlin.'
CARL Faulkner’s comment above about my original article rather misses the point of what I was trying to say. As my Libertarian friends endlessly remind me there were other schemes in operation even before the NHS was a gleam in anyone’s eye.
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