Magazine article The Spectator

Making It Nye Impossible

Magazine article The Spectator

Making It Nye Impossible

Article excerpt

THE 50th anniversary of the NHS provides an excellent opportunity for reflection. At the war's conclusion, Britons wanted a new order of things. It was intolerable to think of war veterans returning to civilian life and having to worry about the cost of medical treatment for their families. Medical care had made big advances in the war, and soldiers had been offered a higher standard of care than they were likely to encounter after demobilisation. Civil servants and politicians discerned these currents long before the war ended. They had already commissioned reports and drawn up plans.

Therefore, following the war, Britain would almost certainly have created a National Health Service without Aneurin Bevan, and even without a Labour government. Bevan had to work with the conditions that he inherited and he accepted much that had been planned during the wartime coalition government. He made relatively few big decisions, but those that he made have had a profound effect ever since on the way that the service has develoned.

Bevan held fast to the principle of a National Health Service funded by the taxpayer, and essentially by no other source. His resignation from the Cabinet on the issue of health charges had the effect of elevating that principle to the status of a dogma. In my view, that has been an important cause of the strain experienced by the health service ever since. It has been refused sufficient funds from the taxpayer, and has never had anywhere else to turn for money. What is worse, sensible discussion of alternatives has been made almost impossible ever since Nye Bevan very successfully made the NHS into a party political battleground.

Few politicians are as well, or as affectionately, remembered 50 years on as Bevan, and it is unusual for a politician's name to be so inextricably linked to a particular achievement as his is to the creation of the NHS. This is especially remarkable, because at the time Bevan was far from popular, and many pooh-poohed his claim to be the father of the National Health Service. Bevan had long been viewed by many - even in his own party - as a wild man. During the war, while his senior Labour colleagues held leading positions in Churchill's coalition Cabinet, Bevan railed against the prime minister and the conduct of the war. Churchill called Bevan at the time 'a squalid nuisance', but dislike of Bevan spread much further. A.A. Milne wrote a jingle: Goebbels, though not religious, must thank Heaven

For dropping in his lap Aneurin Bevan.

It summed up a feeling, widespread even in the Labour party, that Bevan's wartime tirades were close to treasonable.

On the eve of the creation of the National Health Service he made the famous remark that the Conservatives were `lower than vermin'. It was the sort of incident that led someone to remark to Ernie Bevin that Aneurin Bevan was his own worst enemy, to which Ernie memorably retorted, `Not while I'm alive he ain't.' So, as Bevan set about making the decisions that were to shape the NHS, a number of his colleagues were on the lookout for reasons to accuse him of making a terrible mess of the preparations. Bevan supplied them with ammunition, first by refusing to discuss his plans with the medical profession until after first reading the parliamentary Bill, thereafter by saying that whilst he would listen to them he would not negotiate, and subsequently by becoming involved in a bitter and protracted feud with the BMA, which seemed to risk failure of the whole project. Eventually, Bevan made concessions to both consultants and GPs. He cared so much about the central principle of a free health service available to all that he was willing to cede territory elsewhere to protect it.

The idea of an NHS paid for almost exclusively by the taxpayer has so deeply penetrated our national psyche that it is worth pausing for a moment to remember that it was not inevitable that it should be founded on that principle, and that other models might have been adopted. …

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