The National Health Service at 75
| Published date | 01 December 2023 |
| DOI | http://doi.org/10.1177/20419058231218322 |
| Author | Ben Williams |
| Date | 01 December 2023 |
22POLITICAL INSIGHT•DECEMBER 2023
Since its foundation 75 years ago,
the National Health Service (NHS)
has consistently aspired to deliver
universalised public healthcare
‘from the cradle to the grave’, directly
funded by government taxation, with
unconditional treatment regardless of ability
to pay. Inuenced by both humanitarian and
collectivist principles, the NHS’s integral values
were outlined in 1946 by Minister of Health
Aneurin Bevan, who declared in Parliament
that ‘a person ought to be able to receive
medical and hospital help without being
involved in nancial anxiety’.
Dierent governments of all parties have
competed for the mantle of who can most
eectively manage the NHS, and the health
service is a perennial issue at general election
time. Yet since 1948, the NHS has also become
a victim of its own success, a service that is
integral to an ageing population that lives
longer (UK average life expectancy rose by
30 years during the 20th century) but which
consumes ever greater amounts of public
money. The challenges of squaring this circle
remain acute, both scally and politically.
Post-war challenges
During parliamentary debates between 1946
and 1948, various Conservative politicians
dismissed the proposed NHS as an expensive
burden on the taxpayer, condemning it as a
The National Health
Service at 75
Ben Williams traces the political history of Britain’s NHS and finds
that difficult policy choices lie ahead, whoever is in power.
vestige of statist, wartime conditions. Tory MPs
consequently voted against its introduction, a
stance for which Bevan, the symbolic architect
of the NHS, described them as being ‘lower
than vermin’. The ‘One Nation’ Conservative
tradition pragmatically accepted an expanded
welfare state via the Industrial Charter (1947)
and its interventionist ethos, yet an upward
spiral of NHS cost and bureaucracy has seen
contemporary expenditure on the service
consequently increase tenfold from its original
1948 levels. Critical voices have lingered on the
political right ever since, as notably evident
in the emergence of bodies such as the
free-market Institute of Economic Aairs (IEA)
in 1955, which has often lobbied for greater
privatisation of British health care.
By the late 1970s, three decades of the
‘post-war consensus’ was collapsing, and the
political left feared for the fundamental basis of
© Mirrorpix / Alamy Stock Photo
Political Insight December 2023 BU.indd 22Political Insight December 2023 BU.indd 2210/11/2023 11:4010/11/2023 11:40
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