The Successes of Labour from 1945

Authors Avatar

Discuss the Successes of The welfare and social reforms of Attlee’s government,

1946-8

The flagship of Labour’s welfare reforms was the NHS. An Act of parliament in 1946 opened the way for the NHS but it did not begin to function until July 1948. Some form of a national health service had been discussed for several years but the actual NHS that was established was very much the work of Aneurin Bevan, Labour’s Minister for Health and Housing. However, Bevan’s ideas provoked considerable controversy.

Before 1945, health care was not free. National insurance provided some free medical cover, but did not extend to all workers or to wives and children, nor did it cover all forms of medical treatment. Doctors’ and hospital bills could be a heavy burden for the long-term sick or those on low incomes. Mothers tended to neglect their own health rather than their children’s, and serious illness was often diagnosed too late or could not be treated properly. This was the situation the NHS was supposed to put right. There was broad agreement on the principles behind Labour’s proposals, but actually implementing the plans for the NHS was a long and difficult battle, fought by Aneurin Bevan against vigorous opposition from elements of the Conservative Party and the medical profession.

The NHS, which finally began on 5 July 1948, made available all necessary medical services to the people without any financial obstacle; but, although there was noticeable improvement in general health in the first few years after the NHS was launched, it is difficult to assess how much of this improvement was specifically down to the NHS. For decades before 1948, the occurrence of infant mortality, TB and other diseases had already been falling steadily. Many outside factors affected health standards, such as housing, diet and employment. It is clear that the NHS made a significant contribution but it is important to make a balanced assessment of its impact.

Doctors were self-employed, earning fees from their patients or their patents’ insurance companies, friendly societies or trade unions. Hospitals funded themselves from patients’ fees, or through charitable collections. There were many types of hospital with little central control over the way they were run. The idea of doctors having to work as and where the State directed them was fiercely resisted by many doctors. Bevan faced stiff opposition not only from the Conservatives who felt that his ideas were too socialist, but also from vested interests in the medical profession.

Conservative opposition in parliament, though vocal, could easily be defeated given Labour’s huge majority, but Bevan needed the support of the British Medical Association (BMA) to run his NHS effectively. The BMA were opposed to doctors being salaried State employees, fearing that this would weaken their professional status and their independence. Some doctors and most consultants wanted to continue with private practice as well as working in the NHS. The ancient hospitals feared they would lose their wealthy endowments. Bevan had to compromise. Consultants were allowed to have private patients and work in the NHS. Doctors would have the basic part of their salary paid by the State but the rest from a fee for each patient treated. NHS hospitals would also be able to have a number of ‘pay beds’ and private wards. The medical profession was given a central role in the administration of the NHS. Overall, the NHS that emerged in 1948 was noticeably less ‘socialist’ than Bevan’s first proposals had indicated. In the end, the medical profession did well out of the deal. As Bevan said afterwards, he ‘stuffed their mouths with gold.’

Join now!

There were, in fact, several limitations on the success of the new NHS from 1948. First, there were the many compromises Bevan was forced to make with the medical profession. Another limitation was that there was no unified system of NHS administration. Although hospitals were now funded centrally, there were significant regional variations in the pattern of healthcare. Another limitation was the shortage of trained staff and of buildings, the main problem being the scarcity of dentists, with only 10,000 to cater for 47 million people. Hospital buildings were often dreary, old fashioned and ill suited for purpose. Local ...

This is a preview of the whole essay