Once more its election time and there are shrill demands to stuff another £350 million per week into the NHS, as though this is a complete and permanent solution to a giant nationalised industry that has been in crisis, for almost seventy years, since it was founded. This echoes the ignorance that surrounded the founding of the NHS and the lies that sought to conceal some very disturbing vulnerabilities.
When Beven claimed responsibility for creating the NHS, it was the first attempt by the Labour Party to weaponize the NHS for Party political gain. It ignored all of the people who had contributed to a health care evolution that was reached during the wartime coalition government of Sir Winston Churchill. It should have been taken forward with all-Party support as a public service for the good of all in Great Britain, free of Party dogma and petty politics. Sadly that was not to be.
Before the creation of the NHS as a major nationalised industry, there had been more than 150 years of hard work at many levels to develop a health care service that was able to serve whole communities. Hospitals of various sizes were created and depended in part, or in whole, on charitable donations. Some also benefited from money spent by companies on health care for their workers. Many offered private health care for a price, but that did not mean that the money went into anyone’s pocket. Part of the income went into investment in buildings and equipment and towards the salaries of medical staff. That resource was then also available for charitable work on behalf of those who could not afford health care. Insurance companies offered medical insurance and that bridged the gap between the rich and those who could afford little. Mutual Trusts and Charitable Trusts extended medical care to the poor. It was not a perfect service, but it was a huge step forward from what had gone before.
Charitable contributions took several forms and one very promising form was mutual societies that provided medical aid to those of limited means. In some cases these societies provided hospitals and staff but, more frequently, they funded health care in the most appropriate hospitals. Of particular merit were those societies that not only funded care in the best facilities, but recognized that a facility some distance from home required money for transport and an extension of that support to a friend or relative of the patient, so that the patient had the support of someone known to them at a difficult time in their life.
Politicians started to consider how they might produce a national service that was free at the point of delivery and which included the best of all the many different systems that existed at the time of consideration. The politicians never considered a completely free system and it would have been impractical to find magic funding that was not taken from someone else in taxation of some form. One of the theories behind the considerations was that however the basic funding was devised, Government would stand ready to top up that money from general taxation to help fund new and costly equipment and procedures that could not have been foreseen, and to deal with the sudden exceptional cost of meeting epidemics and other major demands. Turning this basic concept into a plan was never going to be easy and the involvement of a Government inevitably meant a new Department or Ministry with all of the financial overheads that new bureaucracy would introduce.
The second British National Socialist Government that followed the successful conclusion of World War Two was driven by dogma that demanded the nationalization of anything that moved and anything it tripped over. That represented an enormous cost in compensation for the businesses that had been disposed by the State. Prime Minister Atlee recognized that any attempt to just seize private assets for the State would cause major civil unrest. In the event, his Government paid over the odds for some assets, under for others, and then poured a huge amount of funding into bureaucratic management of the newly nationalised industries, before many were eventually sold back to private owners at knock-down prices. Haulage in particular benefited, but many other industries either remained in State control. or moved into a quazi-nationalized environment where some parts were run for profit by individuals or companies. The NHS was to become one of these hybrid organizations, from its inception.
Looking back it is clear that Beven lacked any real understanding of health care, was driven by national socialist/communist dogma, and paid insufficient attention to those who did have a reasonable idea of what health care involved and needed. He also appears to have been over-awed by the doctors, senior nurses and administrators who had previously run health care before the NHS. Beven infamously claimed that he had got what he wanted by stuffing the doctors’ mouths with gold, hardly the approach likely to guarantee a stable and effective long term solution. In reality, the NHS became the prototype for further left wing Governments where profits, where they might exist, were privatized and all losses and liabilities were nationalized. This was a model employed by the Brown Administration in 2008 in the panic nationalization of banking debt, whilst allowing the bankers, who had caused the disaster, to walk away, stuffing gold into their pockets.