Today marks the 72nd Birthday of the National Health Service. It officially came into operation at midnight on the 4th of July 1948 and was the first completely free healthcare that was made available anywhere in the world on the basis of citizenship instead of through fees or insurances. It came at a time when the infant mortality rate for children less than 1 year old in Britain was around 1 in 20. Every year saw thousands die of infectious diseases like tuberculosis, diphtheria, meningitis, polio, and pneumonia. There is a common perception that the NHS was gifted to working people by the altruistic tendencies of the ruling political elites. This is simply not true. The creation of state medical services was a hot topic for debate within the Trade Union Council since the early 1890’s. With the incredible popularity of the Labour Party- which became an official party in 1906- and the massive rise in trade union activity around the same time, the two big-business parties now had to seriously address the concerns of the working class.
In an attempt to stop workers from flocking to the newly formed Labour party the Liberal Chancellor of the Exchequer of the time, Lloyd George, introduced the National Health Insurance Act in 1911. This act meant that lower paid workers had medical insurance as long as they paid fourpence a week. They had free access to a GP, medicine, and sickness benefit but it did not include dentistry, opticians, artificial limbs, x-rays, or any other kind of hospital treatment. Crucially, it also did not extend to unwaged workers or women and children. Understandably many workers were not pleased with the bill as it did not go far enough. The Leader of the Labour Party, Keir Hardie, had this to say on its introduction:
‘What was the answer received when a minimum wage of thirty shillings for all and eight shillings per day was demanded for those who worked underground in unhealthy conditions? No, say the Liberals, but we will give you an Insurance Bill. We shall not uproot the cause of poverty, but we will give you a porous plaster to cover the disease that poverty causes.’
From the passing of this Act to the introduction of the NHS as we know it today, there was a period of great tension between the working class and the ruling class; a back and forth of pressure from the working class and the political parties trying to placate them just enough that they would stop striking and pushing for social change. Around 1944 Tory health ministers started to put forward various plans for a National Health Service in response to the Beveridge Report and the worry of a demoralised workforce during the Second World War. There was no detail included as to when anything would be done and so the Labour Party came to power in 1945 in a wave of support. There was dancing in the streets and the Labour Party sang the Red Flag in the House of Commons.
Aneurin Bevan was appointed as minister of health and set out to organise the new NHS. Private practice was never fully disbanded, but healthcare was now available to anyone that needed it.
The NHS has faced difficulty since its inception. The Tory party has always tried to starve it and bring back more privatisation; in the early 70’s the only way the Tory government was willing to spend money on new facilities was by lowering the pay of the already low paid health workers; in the 80’s Margaret Thatcher would oversee massive cuts in public spending, a privatisation of many nationalised industries and a significant drop in funding for the NHS; hospitals were taken out of the control of district health authorities and run by trusts; an internal market was established, meaning that some parts of the NHS purchased services while other parts provided them. This effectively ended co-operation between districts. Between 1989 and 1992, an extra 30,000 administrators were hired for the NHS and the number of nurses fell by 26,000.
All of these decisions contributed greatly to the defeat of the Tory party in 1997. Tony Blair famously proclaimed in his campaign that he would save the NHS, but instead would only continue the process started by Thatcher as soon as he got into power. This new Labour stopped defending a publicly run welfare state and continued Tory spending plans for 2 years. Bit by bit, parts of the NHS have been given away to private companies. Starting in the early 2000’s, any new hospital that was constructed was owned privately and then hired out to the NHS with guaranteed profits for 30 years or more. Interest payments increased to as high as 16% and according to the trade union Unite private companies were estimated to have made £23 billion in profit over the length of their contracts.
This creeping privatisation has never ended. Back-door deals are constantly made to try and privatise more of the industry. Hospitals are even attempting to set up separate private companies to then hire cleaning staff and porters so that they can pay them lower wages and give them more unsociable hours.
All of this has meant a drop in the quality of outcomes, which the major parties use to sour public opinion on the NHS so that they can claim that people deserve “options”- which just means that they get redirected to private practices.
The current pandemic has been a clear indicator of the attitudes the modern political elites have towards the NHS. Supplying PPE has been an utter shambles, with frontline NHS workers only having surgical masks when dealing with seriously sick Covid-19 patients. The health secretary Matt Hancock simply urged NHS staff to stop overusing PPE and refused to discuss the potential of increasing the wages for the NHS staff that fully deserve it. Instead he claimed that nurses have already had a pay rise and so do not need one, a claim for which he has been roundly criticised. In reality, the findings of the independent fact-checking charity Full Fact make clear that nurses in 2020 are worse off than they were in 2010, as their wages have not kept up with inflation.
Around 200 NHS and social care staff have died due to coronavirus. As a people we seem to be perfectly happy to shower these workers in empty gestures and praise but do not push for any real change or recompense for the risks they take to care for us. If you really want to support the amazing staff of the NHS stop voting for the Tory Party and, just as the workers of the past did, show your solidarity by putting pressure on the government and refusing to back down. If the past teaches anything, it’s that progress can come when we speak out as one against injustice.
ACU 