A history of healthcare in Britain
Get those candles ready - the NHS is 70! Our National Health Service reaches its landmark birthday on July 5, with events lined up across the UK to mark the occasion. To celebrate the great work the NHS does, day in, day out, here’s a quick look back at healthcare through the ages!
Before the arrival of the NHS in 1948, healthcare was largely the preserve of the wealthy, but schemes to help poorer people weren’t as rare as we might assume. Way back in 1123, a monk and priest called Rahere founded St Bartholomew’s Hospital in the Smithfield area of London, to provide healthcare for the city’s poor. Today known as Barts, it’s provided continuous medical care for longer than any other site in the UK, surviving the Great Fire of London and the Blitz. When the hospital’s closure was proposed in 1992, more than one million people signed a petition to save it!
During the Middle Ages, there was a lot of superstition around disease and the belief that illness was caused by sin. Physicians were held in high regard but their knowledge of the human anatomy was very limited. When the Black Death took hold in 1348, it was thought it could be warded off with herbs, but doctors were powerless to stop it killing half the population of Britain.
Until the 19th century, the medical profession wasn’t regulated, but the Apothecaries Act 1815 introduced compulsory training and qualifications for general practitioners. And in 1832, the British Medical Association was founded, as a ‘friendly’ forum for doctors to share experience and knowledge.
The welfare state
The introduction of the National Insurance Act in 1911, following David Lloyd George’s ‘People’s Budget’, was one of the first steps towards the welfare state. The idea was to create a safety net for working people against illness and unemployment, with wage-earners contributing every week in order to benefit from free medical care and an unemployment income when they needed it. The scheme was initially administered by authorised voluntary friendly societies, before being nationalised in 1945.
These friendly societies were common in the 19th and early 20th centuries, with workers in towns and villages forming self-help clubs to pay for their medical care and other things. One of the most successful was the Tredegar Workmen’s Medical Aid Society in south Wales, which was initially formed for the benefit of miners and steelworkers and later extended its membership to include their relatives and other workers.
In 1897, a young boy called Aneurin Bevan was born in Tredegar, one of 10 children of a miner called David and his wife Phoebe. ‘Nye’, as he was known, left school at 13 and followed his father into the colliery, where he became a trades union activist and later emerged as one of the leaders of the south Wales miners’ strike in 1926. Elected as the Labour MP for Ebbw Vale in 1929 and inspired by his early experiences of poverty and health provision, he would go on to found the NHS with the vision of ‘Tredegarising’ the nation’s health!
Private medical insurance
Amongst other healthcare clubs operating at the turn of the century was the Reading Working Peoples' Hospital Contributory Fund, established in 1901. Each week, workers paid a portion of their wage into the fund, in order to access medical care when they needed it. Following an amalgamation of this and several other hospital funds in Bristol in the 1940s, the Western Provident Association (WPA) was formed shortly before the creation of the NHS, and is one of our health insurance partners today.
Similarly, BUPA was created in 1947 with the founding purpose to ‘prevent, relieve and cure sickness and ill-health of every kind’. Originally called the British United Provident Association - although never actually a provident association itself - it was formed by a number of smaller associations and hospital contributory schemes joining together. By July 1948, BUPA had 38,000 customers and an 80% share of the private health insurance market! Today it has more than 15m customers worldwide, including in countries such as Spain and Hong Kong.
Aneurin Bevan had been appointed Minister of Health following Labour’s landslide in 1945, and finally launched the NHS at Park Hospital, now Trafford General Hospital, in Manchester, following hugely ambitious plans to create universal healthcare. The NHS brought hospitals, doctors, nurses, pharmacists, opticians and dentists together for the first time, providing free services for all at the point of delivery, an ethos that remains at the organisation’s heart today.
In 1952, prescription charges of one shilling - five pence - were introduced and a flat rate of £1 for ordinary dental treatment was also brought in. The link between smoking and lung cancer was established in 1954 and, in the same year, daily hospital visits for children were introduced. Until then, young patients had been able to see their parents only for an hour on Saturdays and Sundays!
Other notable dates in the NHS’s history include the Mental Health Act 1959, which made mental health services available on the NHS for the first time, as well as the first kidney transplant in the UK in 1960 and the first heart transplant in 1968.
Today, with 1.3m staff and many more freelance workers, the NHS is the UK’s biggest employer and one of the largest workforces in the world. It faces enormous challenges, including an ageing population, long waiting times and budget constraints, but remains the healthcare envy of the world. Happy birthday NHS!