“STATE TAKE OVER DOCTORS, HOSPITALS AND DENTISTS”, declared the headline of the Standard on March 21, 1946 after Health Secretary Aneurin “Nye” Bevan published his National Health Service act. Within two years, Bevan had officially opened the first NHS hospital in Manchester.
75 years later, the NHS remains Labour's greatest achievement in office. It has survived 33 health secretaries, countless reorganisations and a global pandemic to become one of Britain's most beloved institutions and a model for socialised healthcare the world over.
Before the NHS, Britons were forced to pay for a visit to the doctor or hospital treatment. Care for the masses was largely provided by voluntary organisations and insurance schemes, leaving most of the population in debt or with no access to quality healthcare.
When Labour took power following the Second World War in 1945, Bevan was tasked with bringing a wide range of medical services under one roof. Health services would be funded predominantly through general taxation and treatment free at the point of use.
Bevan faced an uphill battle, with doctors initially reluctant to become employees of the state and charities unhappy at the prospect of handing hospitals over to the Government. The British Medical Association (BMA), the doctors’ union, even threatened to boycott the new service and labelled Bevan “an uncontrolled dictator” before the two sides brokered a deal to allow consultants to retain their private patients while still working in the NHS.
In 1952, charges were introduced for prescriptions and dental treatment under a newly elected Conservative government to alleviate serious financial pressures on the NHS. The decade also brought significant medical innovation with the launch of a polio vaccination programme in 1956 and surgeons performing the first cardiopulmonary by-pass at Hammersmith Hospital.
The 1960s was a period of significant modernisation as then health minister Enoch Powell launched the Hospital Plan for England and Wales to repair the NHS' crumbling estate. This saw the creation of “district general hospitals” which would serve local populations and combine inpatient and outpatient services on the same site, breaking with the previous model of decentralised local community hospitals.
Targets for construction were never reached, with the Government accepting that the £500m pledged for the plan was insufficient.
The NHS also become a vehicle for progress for women’s rights through the widespread introduction of the contraceptive pill and the legalisation of abortion in 1967.
New technology transformed NHS treatment throughout the 1970s, with the first computerised tomography (CT) scanners rolled out to help diagnose cancer and other serious conditions. The world's first IVF baby, Louise Joy Brown, was born at Oldham and District General Hospital on July 25, 1978 to rapturous headlines across the globe.
In the 1970s and 80s, thousands of patients in the UK were infected with HIV and hepatitis C through contaminated blood products in what was labelled the worst treatment disaster in the history of the NHS. An inquiry is continuing to examine its effects.
The health service was left untouched by Margaret Thatcher's sweeping privatisation reforms in the 1980s but the period saw the introduction of general managers to take responsibility for cost control.
In 1985, two-year-old Benjamin Hardwick became the UK's youngest ever liver transplant patient at Addenbrooke's Hospital in Cambridge. Tragically, he died just 14 months later.
This was followed two years later by the world’s first heart, lung and liver transplant, which was carried out by Professor Sir Roy Calne and Professor John Wallwork at Cambridge’s Papworth Hospital.
The first 57 NHS trusts were established in 1991 and given responsibility for the ownership and management of hospitals. Three years later, the NHS Organ Donor Register was set up for people wishing to donate their organs. NHS Direct was launched in 1998 to provide the public with free healthcare advice over the phone, and went on to become one of the largest e-health services in the world.
Tony Blair swept to power in 1997 with the NHS at the heart of his policy agenda, famously telling voters they had “24 hours to save the NHS”. The New Labour period saw the introduction of a number of centrally-managed targets, such as the four-hour target for A&E waits. Walk-in centres were introduced in 2000 with the aim of offering easier access to a range of services.
But the most radical change to the health of the nation in NHS history came in 2007, when smoking was banned indoors as part of the Health Act.
Former Health Secretary Andrew Lansley sought to fundamentally transform the NHS with a set of reforms in 2011. A new body, NHS England, was created to run the health service and GPs were given significant power in how budgets were spent. The reforms proved deeply unpopular with frontline doctors, with the BMA pushing for Lansley’s resignation. Downing Street officials later told The Times that the reforms were a “huge strategic error”.
The opening ceremony of the London 2012 Olympics included the most memorable tribute to the NHS to date, with more than 600 workers taking part. Surgical innovation continued at a frenzied pace, with the first hand transplant and the announcement of DNA mapping for cancer patients that same year.
The NHS faced its most serious existential threat in 2020 with the advent of the Covid-19 pandemic, when the public was ordered to “stay at home, protect the NHS and save lives”. More than 220,000 Britons died from the virus, including hundreds of NHS workers.
Three years later, the health service is grappling with a workforce crisis, a record backlog in care and a wave of strikes by nurses, junior doctors and consultants. Emergency departments experienced their worst winter on record in 2022, with the longest ever waits for A&E treatment and for ambulances.
Bevan might not recognise the NHS today given the extraordinary pace of technological and medical change - but his pledge to create a health service to treat Britons “from the cradle to the grave” remains intact.
