On 4 July 1948, the day before the introduction of the National Health Service, the Labour party held a rally in Manchester. The main speaker, Labour’s minister of health and housing, Aneurin Bevan, captured the significance of the moment: ‘The eyes of the world are turning to Great Britain. We now have the moral leadership of the world and before many years we shall have people coming here as to a modern Mecca.’
Yet Bevan’s high-minded rhetoric was in stark contrast to the painstaking work he had undertaken to make the NHS a reality. For the best part of 18 months he had been involved in a tough negotiation with the British Medical Association, persuading the at first reluctant medical professionals to cooperate with the new health service. Bevan’s dealings with the BMA were an example of how a firm strategy with flexible tactics could effectively deliver a set of clear aims.
One set of meetings encapsulated Bevan’s approach: when he, and the secretary of state for Scotland, Arthur Woodburn, met the BMA’s negotiating committee for a two-day session on 2 and 3 December 1947, a meeting documented in the BMA archives. The committee’s members included Dr Charles Hill, who later found fame as the ‘Radio Doctor’ and entered parliament, serving as a minister under the Conservatives. The issues were laid out before Bevan in fine detail. Key concerns including GPs’ ownership of the goodwill of existing practices; the freedom of doctors to practise where they wanted to, rather than being directed to a certain area; whether they could appeal to the courts against being dismissed; and payment: one issue was whether the medical profession could retain a degree of independence or be like full-time civil servants.
Bevan’s own phrase as to how he persuaded the medical profession has entered the national lexicon: he ‘stuffed their mouths with gold.’ Finance was certainly part of the bargain. Yet, over those two days, Bevan used a variety of tactics. He opened the meeting on the first day very aggressively. Having seen the negotiating committee’s ‘case document’ he attacked them, saying he ‘could not understand the committee’s state of mind. Was it, or was it not, a negotiating committee?’ Yet, later that same day, he revealed that he had £66m in compensation available, and said he would like the ‘help’ of the profession in handing it out. On the second day, he was in reassuring mode. He promised that there would not be a single salary as such, and that there could still be time available to earn an income privately. He even offered his own mathematical calculation for how he saw terms of payment.
Later, as negotiations continued, assisted by setting a firm date for the service to come into being, in April 1948, Bevan openly promised not to make a full-time salaried service a reality. Yet Bevan was able to bring the NHS into existence with its essential principles intact: healthcare free at the point of delivery, with treatment based on need, not wealth. Bevan had made healthcare a permanent Labour issue, and the NHS itself exemplified Bevan’s own political philosophy, emphasising collective action but respecting the importance of the individual. What is still greater is that the NHS became part of the fabric of British society; defending its founding values is as important today as in 1948.
The Aneurin Bevan Society in association with the Bevan Foundation presents the 2014 Aneurin Bevan Memorial Lecture delivered by Owen Smith MP, shadow secretary of state for Wales.
Nye: The Political Life of Aneurin Bevan by Nick Thomas-Symonds will also be launched.
Date: Wednesday 19 November 2014
Time: 5.30-7.30 pm
Venue: Committee Room 9, House of Commons
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