The Origins of the National Health Service in the UK: A Misconception

It is widely believed that the National Health Service (NHS) in the UK was introduced as a new concept after the Second World War. However, this assumption is inaccurate. What actually occurred was the extension of existing benefits to cover the entire population. The roots of the NHS can be traced back to the 1911 National Insurance Act, which laid the foundation for the system.

Origins of the National Insurance Act

The 1911 National Insurance Act, introduced by the Liberal government under Herbert Asquith, created a contributory system of insurance against both illness and unemployment for British workers aged 16 to 70 who earned less than ￡160 per year. Workers contributed 4d per week, employers contributed 3d, and the state contributed 2d. Under this system, workers were entitled to free medical attention, including prescriptions, and sick pay for up to 26 weeks. Basic maternity benefits were also covered.

In the case of London, the Insurance Committee for the County of London (ICCL) was established in June 1912. By the start of 1914, it had 1.6 million registered contributors, which represented just over a third of the total population of 4.5 million at that time.

The Expansion of Medical Benefits

In 1948, the existing medical benefits scheme was expanded to cover the entire population, including rich and poor, workers and non-workers, and children. The insurance committee structures were essentially left untouched, merely being renamed and expanded accordingly.

The Beveridge Report and Conservative Hurdles

The principles behind the NHS were further solidified by the Beveridge Report of 1942. However, most Conservatives were deeply opposed to the implementation of the report's recommendations due to the significant financial expenditure required. The medical profession, which was predominantly Conservative, was also hostile to the establishment of the NHS, particularly among higher ranking members of the profession and among Conservatives.

On the eve of the NHS's launch, Aneurin Bevan, the Minister of Health, gave a speech in Manchester on July 4, 1948, where he described the obstacles placed in his way in creating the NHS. Bevan said that his experiences had led him to regard the Tories as 'vermin.' This statement, which was unusual even in the realm of British politics, highlighted the intense controversy surrounding the NHS. Reporters asked Bevan if he had really called the Tories 'vermin,' to which he replied 'No, lower than vermin.' This remark underscored the bitter and contentious nature of the situation.

The Conservative Government and Hospital Expansion

It is important to note that even when the Conservatives were in power after they won the 1951 election, not a single new hospital was built between 1952 and 1960, despite the recovery of the economy. This period saw no substantial increase in healthcare infrastructure under a Conservative-led government.

Conclusion

The creation of the NHS was not a Conservative-initiated effort or a sudden development after the Second World War. Instead, it built upon existing insurance systems established decades earlier. This article has sought to clarify the origins of the NHS, highlighting the contributions of the 1911 National Insurance Act and the strongly contested nature of the NHS by political and professional circles at the time.