The History of the NHS

25 March 2021 By Michael Bowyer

The National Healthcare System (NHS) is one of the backbone institutions of the UK, allowing every single British access to free healthcare, prescriptions, and expert advice. It has a long and complicated history that spans more than a century till it reaches the familiar, exceptional standard of care we know and appreciate today.

What did we use before the NHS?

Before the NHS there was no nationalised body of healthcare providers or hospitals. Doctors and General Practitioners were typically male and received academic training in city universities and nurses were women with very little formal training but much hands-on experience.

Healthcare facilities were provided by local councils, charities or private sponsors and dispensed health according to how much a patient could afford. This system was not ideal, and many were looking to form something more accessible.

Whose idea was the NHS?

It is difficult to pinpoint who originally had the idea of a nationalised healthcare service as there were many calling for a change to the current system.


In the early 1900s, Beatrice Webb produced the Minority Report for the Royal Commission re-evaluating the Poor Law of 1909. She argued very eloquently that a new system was required to replace the Poor Law’s current one as it was originally made to facilitate the needs of the Victorian-era workhouses. Unfortunately, this report was disregarded by the current government, but it planted the seeds for future discussions. ​

Dr. Benjamin Moore, a doctor in Liverpool wrote The Dawn of the Health Age, in which he coined the phrase ‘National Health Service’. He then went on to found the State Medical Service Association in 1912, which would lay the foundation for a united body of healthcare professionals.

Dr. A. J. Cronin has also been given credit for the ideas that would eventually establish the NHS. His 1937 novel, The Citadel, was a highly-controversial critique of the lack of compassion in the current healthcare system. He brought together powerful ethical metaphors and exciting possibilities that would inspire many to eventually embrace the idea of the NHS.


A brief history of the NHS:

In 1942, the Beveridge Report was produced as part of the process of agreeing to a post-war health policy and recommended “comprehensive health and rehabilitation services”. It was supported by all parties in the House of Commons and in 1944 the Minister of Health, Henry Willnik, put forward a White Paper that specified the guidelines for the NHS.


Funded by taxes rather than national insurance, this new service would be accessible to all. The project finally came to fruition when Aneurin Bevan became Health Minister in 1945, under the leadership of Clement Attlee, then Prime Minister. ​

Launched on the 5th July 1948, this new institution was based on the principles that it would help everyone, be free and would be administered on the basis of need rather than income. And, thus, the NHS born!

Opposition to the NHS in 1948 ​

Surprisingly, much opposition to the NHS came from the British Medical Association (BMA) itself, as between 1946-1948 the BMA compared Beveridge’s report and Willnik’s White Paper to the national socialism they’d seen put forward by the Nazi party. So soon after the end of the Second World War, this was an incredibly damaging label and impeded the creating of the NHS by many years. ​

How has the NHS changed since 1948?

The NHS has seen monumental changes since its establishment in 1948, with the ever-evolving nature of technology and medical advancements constantly changing the landscape of healthcare in the intervening decades. ​

Mortality rates for several conditions have dropped considerably, infant survival has increased, nursing and physician quality of education has been standardised with the same level of care accessible all over the country. A far cry from the level of healthcare available in the early 1940s.

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