Did the Tories come up with the idea of the NHS first?
Published: August 25, 2015 10.01pm NZST
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Nick Hayes
Reader in Urban History, Nottingham Trent University
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Bit of bourgeois David? Reuters
In outlining his 25-year vision for the NHS, the secretary of state for health, Jeremy Hunt, has been at pains to highlight the important part played by Conservatives in the founding of the service and in its subsequent guardianship. The implication was clear, as prime minister David Cameron,
has said for nearly a decade: “The NHS is, and always has been, safe in our hands.”
It’s easy to understand why Hunt might try to make this claim. Four years before the NHS officially came into being, the wartime Conservative-led coalition
published a 1944 white paper that certainly set out the need for a “free” and “comprehensive” healthcare service. It was presented as a natural evolution from past provision. But how different was it from the later NHS blueprint?
Under the 1944 white paper, voluntary hospitals (financed by local fundraising and workers’ contributions) would remain independent, not be taken over by the state. They would instead contract services from newly established local joint authorities, comprising amalgams of city and county councils. These authorities would also run the existing municipal hospitals. The white paper placed local authorities at the centre of hospital governance.
It was planned, also, to establish local authority health centres, where GPs would provide primary care for the community. In short, the Conservative emphasis was decidedly more pluralistic than the state-centric nationalised service we got in 1948, similar in some way to the “internal market” in health set up after 1989.