Aneurin Bevan served as the Minister of Health in Attlee’s Labour government in the post-WW2 period. Bevan’s political ability and oratorical skill earned him the respect of The Times as “the Labour Party’s most brilliant member in debate”. The son of a Welsh coal miner, Bevan witnessed the condition of the working class, including poverty, poor health and deprivation. He worked in the coal mines at the age of 13 and was later educated in London at the Central Labour College where he studied economics, politics and history. His leadership became recognized during the 1926 General Strike for his activism directed against management of the mining companies, thus gaining national attention and launching his political career. Bevan was elected as a Member of Parliament in 1928 and became an active critic of the nation’s weak record in providing unemployment benefits. His political views often differed from official party policies and in 1939 resulted in a brief expulsion along with four other Labour party colleagues, including Stafford Cripps (who later became Chancellor of the Exchequer). Despite his disciplinary record, Bevan was appointed Minister of Health by Prime Minister Clement Attlee in 1945, becoming the youngest member of the Cabinet at age 47. His program of social reform was based on the vision of William Beveridge as detailed in the 1942 Beveridge Report. The 1946 National Health Service Act proved to be Bevan’s crowning achievement when it came into effect on July 5, 1948. Beveridge as the architect, and Bevan as the builder, share the credit for creating the National Health Service (NHS) in Britain.
The introduction of the NHS, involving the nationalization of 2688 voluntary and municipal hospitals, created the cornerstone for the modern British welfare state. It provided free health care services throughout the nation, directed by a Central Health Services Council, regional hospital boards, and county councils to manage ambulance services and local health centers. The NHS provided free dental and vision care along with vaccinations and community nursing. Bevan’s design of the NHS was influenced by the Tredegar Medical Aid Society in his home town in Wales, where local residents paid subscriptions to fund access to local medical services. The provision of universal healthcare through the NHS was publicly funded. Bevan advocated an increase in government spending to pay for the welfare state that included raising marginal taxes for business owners and policies for the redistribution of wealth. The NHS was an immediate success, providing free healthcare to over 8 million patients in its first year.
However, the introduction of the NHS was a highly-contested political battle. Bevan found himself confronted with opposition both inside and outside of the Labour Party, particularly from the Conservative Party. In order to meet his vision for the NHS and fulfill the recommendations set forth in the 1942 Beveridge Report, Bevan had to achieve two major objectives, namely, nationalizing hospitals and employing full-time doctors. Bevan wanted to eliminate private medical practices and implement public ownership of hospitals, but these critical objectives were met with heated opposition. Fellow Labour Party and Cabinet member Herbert Morrison challenged Bevan, arguing that local municipal government hospitals should not be nationalized. Although Morrison’s main objections were divisive, several of his other ideas were compatible with Bevan’s proposals. Bevan won the debate, stating that the only way to provide the nation with efficient and good quality healthcare was to centralize control and responsibility. With the Morrison debate settled, Bevan’s major remaining obstacle was ensuring the employment of full-time doctors in the NHS system. Bevan fought an arduous battle with the British Medical Association (BMA), who threatened to refuse to comply with the proposed NHS legislation on the grounds that doctors would no longer be able to practice independently. Bevan initially opposed this BMA position quite aggressively since he needed to ensure that the NHS would be able to provide quality service by employing BMA doctors. The BMA refused to concede, and so Bevan shifted from an aggressive tone to one of positive reassurance by conceding that the employment of NHS doctors would not eliminate opportunities for consultants to conduct supplemental private practices. Bevan eventually won the BMA’s favor by offering some minor concessions after eighteen months of protracted negotiations. In a pivotal 1948 speech in the House of Commons Bevan predicted that individual doctors would eventually turn in favor of the NHS despite the public opposition shown by the BMA, and this speech clearly set out Bevan’s prevailing viewpoint for the historical record. Although Bevan was unable to eliminate private medical practice entirely, he was able to win over medical professionals without compromising the core values of the NHS. Bevan’s leadership and tenacious drive contributed to the social transition and economic recovery of Britain after WW2. His political views, particularly on labor relations and health issues, enabled him to succeed by articulating his passionate beliefs in social justice.
Summer R. Buffin, Assistant Editor