Forest of Dean & Wye Valley

LOOKING BACK: Beveridge and the Birth of the NHS

In A.Graham, Uncategorized on May 5, 2018 at 9:49 pm

In the 1945 general election the Labour Party swept in to power, shocking the Tories (under the leadership of our wartime PM, Winston Churchill). But Labour had managed to chime with the mood of the electorate, who, after a grueling war, were yearning for change.

It was, after all, the first opportunity for many in the electorate to vote since before the war. All elections had been suspended for the duration of “hostilities” – and a lot had changed since the 1930s when Britain had faced up to depression and hard times.

The new Labour Government, under Clement Attlee, set about providing the change that was yearned for. Amongst many changes that were planned, a report was commissioned from a committee headed by William Beveridge, to provide a new welfare deal that would not be discriminatory but would embrace the entire population.

Beveridge was by no means a raving left-winger. Indeed, he was a progressive Liberal (with a capital L). But his Committee produced a report which was both thorough and comprehensive. And, for its time, it was revolutionary.

The legislation based on his report made its way through Parliament, and was introduced in the summer of 1948. The Daily Mail (not with any enthusiasm!) described it to its readers thus:

“… You will wake in a New Britain, in a State which ‘takes over’ its citizens six months before they are born. Providing care and free services for their birth, for their early years, their schooling, workless days, widowhood and retirement. Finally it helps defray the cost of their departure.”

It was all to be paid for by a new scheme of “National Insurance” (at that time fixed at 4 shillings and eleven pence a week).

There were, of course, some teething troubles, including the cobbling together of a National Health Service that could provide a unified level of care in all parts of the country (it had in too many ways been decidedly patchy, with the best services concentrated in large urban centres – particularly of course in London). Many doctors and surgeons just didn’t want to face the challenge of moving from a settled practice. Another problem was that existing hospitals and health centres were run by a disparate collection of bodies. Many came under the control of local authorities, others were run by health insurance schemes whilst many were wholly private. On top of that, a large number of GP’s were responsible for their own surgeries.

abevan2It was Aneurin Bevan who was given the responsibility of Health Care (which he combined with the equally challenging role of Minister for Housing). He tackled the problems with energy and finally won over the majority of doctors and a pattern of a new unified Health Service began to emerge.

By 1951, when the Conservatives were once again returned to power, most of the Tory critics of the new “welfare state” had been won over. There would be little or no change to the structure of the “Welfare State”, and the NHS continued with the task of modernising and improving the health care of the people. One example I remember as a youngster was the mass drive to inoculate the population against diphtheria.

Other elements of the “Beveridge Plan” continued to flourish, even though rising responsibilities meant that the concept of a regular “National Insurance” payment had to be modified to cope with rising costs and responsibilities.

And despite its technical, often heavy, nature the Beveridge Report was a best seller. No government report, before or since, sold as many copies.


CLOSURE OF FOREST  HOSPITALS CONFIRMED

On January 26th (as this issue of the Clarion was going to press) the news  was confirmed.  Gloucestershire Health bosses confirmed that it had decided unanimously to close the Forest’s two hospitals – Lydney and the Dilke, near Cinderford.

The public were told that they were “no longer fit for purpose”.  In their place a single hospital would be built  (no time scale was given), with facilities and services falling far short of what Forest people wanted. This number of beds remained a bone of contention,/ but in the final announcement it was suggested that it could be open to amendment.

As we go to press, no proposed site has been announced for the new hospital, but it’s more than likely that most patients will have to travel further for treatment. Just as likely, many may be sent outside the Forest altogether, perhaps even to Gloucester or Cheltenham.

QUESTIONS:

The news of the decision had been broken in the Review the day before the meeting took place, and a crowd of demonstrators assembled at Forest Hill Golf Club, Coleford (where the news was confirmed) to protest.  Many wanted to know why on earth if money was available, wasn’t it  being invested in the two existing hospitals rather a new build where there’s likely to be less beds available, no extra facilities available.

“CONSULTATION”:

A consultation exercise preceded the confirmation  of closure – but this was effectively a  whitewash. Questions were loaded, or so glib as to be meaningless. It declared that the aim of the changes was to achieve “Health and Wellbeing for all”, without explaining how this was to be achieved.

This was back in November last year. Time enough for opposition to mount (it emerged at a public meeting held in Lydney Town Hall) – and indeed time enough for the administration at  Gloucestershire Health to listen.  But instead the bosses voted unanimously to go ahead with plans. It seemed that they were all suffering from an attack of the Andrew Lansleys!

At present, Gloucestershire Health Trust tells us on its website that it has responsibility for seven community hospitals in the county, plus the surgeries in the Dean and those further afield in the county.  Now, it seems, the Trust wants to  reduce the two hospitals in the Forest to one single unit with facilities that local people regard as inadequate for their needs.

There has been a singular lack of local democracy here – but that’s not surprising considering the top down structure imposed on our NHS today. There was a time when the concept of local democracy was built in to the system, but that was demolished,  to be replaced by a tier of bureaucrats and managers who act as though they are the ones who know best.

Another question arises. Would our new hospital be a “PFI” construction (now, since the collapse of Carillion, a discredited approach to providing public works such as new-build hospitals).
FIGHTING ON:
Meanwhile, opponents of these planned hospital changes have pledged themselves to fight on. Opposition to the plans for a single hospital solution to meet the needs of Forest folk has intensified, rather than waning.
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