NHS 70: How the birth of the NHS was covered in the Argus

Friday March 22 1946
The British Medical Association (BMA) struck back. While stating that it was “anxious and willing to co-operate with the Government in evolving a complete health service” it objected to “certain important features” of the White Paper on “public interest” grounds. The chief objection was to “any form of service which leads directly or indirectly to the profession as a whole becoming full-time salaried servants of the State or local authorities”.

April 27 1946
The Argus reported that the National Health Service Bill was set for a thorough going over in Parliament, with the Conservative Opposition implacably against it. But it was predicted that Bevan would commend the Bill to the House of Commons by claiming “that no other country in the world has a free health service for everyone, and that it is a memorable milestone in the progress of civilisation”. November 6 1946: After months of scrutiny and at times rancorous debate in Parliament, the National Health Service Act received the Royal Assent. But Bevan’s battle with the BMA was hotting up.

January 27 1947
Referring to Bevan, Dr J A Pridham, of Weymouth - at a special representative meeting of the BMA - stated: “We are faced with a very cunning gentleman, and it behoves us to fight, not only with our hearts, but with our heads, and to be equally cunning.” Doctors were split on the issue of even negotiating with the Government, but BMA Council chairman Dr Guy Dain stressed that a failure to do so would likely be viewed negatively by the public. He emphasised too however, that negotiations must be on the BMA’s terms.

January 9 1948
After almost a year of negotiations, “a resolution recommending the rejection of service under the National Health Act in its present form” was passed unanimously by the BMA, backed by its branches.The Act was considered “so grossly at variance with the essential principles of our profession” that absolute rejection was the only course.The BMA Council also issued Bevan with a ‘think again’ challenge in relation to the Act.

January 23 1948
‘120 Say ‘No’ to State Servants Plan’ proclaimed the headline on the front page of the Argus, which reported that a ballot of Monmouthshire doctors - consultants and GPs - resulted in 120 rejecting service under the NHS Act. Just three voted in favour. The story indicated that the BMA’s negotiating committee had submitted a report on what, in the opinion of doctors, would comprise an efficient state medical service. But this, according to BMA assistant secretary Dr D P Stevenson, had elicited a response that amounted to an attempt at “ministerial seduction”, pretending that all was rosy. Under the Act as presently constituted, he added, it would be difficult for a general practitioner to make a living, while patient lists would be so large as to make it “almost a physical impossibility” to attend to their needs.Fears were expressed by consultants of a “state monopoly” of hospital beds, while doctors’ freedoms - such as over where in the country they practised - were also considered to be under threat.

February 18 1948
The Argus reported that doctors voted overwhelmingly against both the NHS Act and serving under its terms. The results of the BMA plebiscite revealed that “medical practitioners, consultants and specialists” voted around six-to-one (25,310 to 4,084) against accepting service under the Act. Approaching nine-to-one disapproved of the Act (38,534 to 4,479). February 19 1948: It was reported that at a Cabinet meeting, ministers were “unanimous in their support for Mr Aneurin Bevan in his struggle with the doctors”, despite the extent of the opposition revealed by the BMA plebiscite.” “The Act will go forward and come into full operation on July 5, by which time it is expected that tempers will have cooled a little”, ran the Argus story.

March 17 1948
BMA delegates from across Britain gave unanimous backing to a Council resolution declaring that it was “not in the best interest of the public or medicine for doctors to enter the service until changes were made (to the NHS Act). The BMA’s chief negotiator Dr Guy Dain denied Bevan’s suggestion that the plebiscite had been unfair, and denied too that doctors were sabotaging an Act of Parliament. Dr Dain noted that the Act gave doctors the freedom to decide whether or not to come into the new service, and he added: “We are engaged in a life and death struggle for our freedom and independence.”

April 9 1948
The South Wales and Monmouthshire branch of the British Dental Association (BDA) voted overwhelmingly to reject working under the NHS Act until its regulations were amended. Concerns centred around clinical freedom for dentists, and payments for work carried out.

April 27 1948
Newport and Monmouthshire medics once more voted against the NHS Act in its present form. While agreeing with the Act’s main structure, concerns persisted over potential effects on the doctor-patient relationship. May 6 1948: The BMA Council decided to recommend that doctors enter the NHS from July 5, subject to confirmation by the organisation’s representative body. The decision followed another plebiscite in April - 23,842 doctors voted against the NHS Act despite Bevan’s modifications, compared to 12,640 who voted for it. But in what the Argus described as the “vital” GPs’ vote, “there was not the 13,000 majority against acceptance of service on which the BMA Council would have to continue to advise the doctors to stay out”. The Council accepted Bevan’s invitation to discuss the Bill that would amend the Act, stressing that the goodwill of those still opposed would be essential if the service were to succeed May 6 1948 In a separate front page story, a then rare example of a Royal opinion made public - the then Princess Elizabeth, opening the Health of the People exhibition in London, said: “If the new Health Act is to be the success we all want it to be, there is room for even more public co-operation with the medical authorities, and there are still ignorance and laziness to overcome.”

May 28 1948
A report in the Argus of a BMA representatives’ body meeting revealed that April’s plebiscite and its results “had split the profession much more effectively than Mr Bevan ever dreamed of”, according to one delegate. A motion to censure the BMA Council - effectively depriving it of its right to act on doctors’ behalf - was defeated, but emotions ran high. Council chairman Dr Guy Dain said that while the amendments offered by Bevan in April satisfied a large number in the profession, there remained “a substantial majority in disfavour of the Act”. One delegate claimed that holding another plebiscite so soon after the previous one (in January) was “premature and prejudiced voting”. Another called it “a tactical error of the greatest magnitude, not justified by the meagre concessions the Minister has made to us” and argued that the Council had “surrendered an almost impregnable position”. A third delegate said that doctors felt they had been “outmanoeuvred and mismanaged”.

June 14 1948
Dentists were advised by the BDA Council to stay out of the NHS “because of the refusal of the Minister of Health to recognise the principles laid down by the Association”, irrespective of fee scales.

June 23 1948
It was reported that the board of directors of the Royal Gwent Hospital would cease to exist on July 5. But the board’s final annual report stated that the hospital “will continue and will help in every way to make the new health service a success for the benefit of the residents of Newport and Monmouthshire”.

July 1 1948
In an extraordinary attack upon the principle of a National Health Service and upon the Labour Government, Lord Tredegar, in his soon-to-be-extinct role as President of the Royal Gwent Hospital, was quoted in an Argus front page story saying he feared the place would be turned into “a second class maternity ward”. He told the annual general meeting of subcribers: “As an old Tory, I abhor this Government and everything they do. I particularly abhor the way they attack private enterprise, and I particularly object to they way they have brought this into the field of medicine. “I am supported by a very large number of extremely distinguished doctors. It is truly deplorable that any Government boast that they are going to look after us from the cradle to the grave.” He added that he was proud that it was he who had requested that the hospital became the ‘Royal’ Gwent, and he also said: “You need not doubt that my blessing goes with the new endeavour, whatever may happen.” He was then formally re-elected as President of the hospital - for less than a week.

July 1 1948
Bevan told the House of Commons, in answer to a question from an Opposition MP, that delays in providing lists of doctors who had signed up to the NHS - in order that patients could themselves register - was because of doctors’ tardiness in agreeing to work for the service, and because the “official propaganda” of the profession itself had told them there was no hurry to sign up. July 3 1948: Two days before the service launched, the Argus reported that 75 per cent of the 415,000 population of Monmouthshire and Newport had signed up to doctors’ lists.

July 5 1948
Aneurin Bevan travelled to Park Hospital, Davyhulme, Manchester - now Trafford General - to formally launch the National Health Service. The Argus marked the occasion with a single column front page story headlined ‘Health Of All Now Concern Of State’. Prime Minister Clement Attlee made a special broadcast to the nation. He heralded four Acts of Parliament - National Insurance, Industrial Injuries, National Assistance and National Health Service - as creating “the most comprehensive system of social security ever introduced into any country”, but sounded a note of caution. “All our social services have to be paid for. We cannot create a scheme which gives the nation more than they put into it. “...It is I think, fair to say that the new scheme comes into operation with the approval of the nation.” With post-war privations in mind, Attlee then cautioned that the new system “will take time to develop”. “We shall have to start with what we have and then work up to a full service when our present shortages have been overtaken.”

And with that the NHS was born