This BBC2 documentary, The NHS A Difficult Beginning, focuses on those months immediately prior to the NHS coming into being on July 5 1948. Most people in Britain accept the notion of a universal health service, free at the point of use but few remember the struggle for its birth. And watching some of the debates currently underway in the US, it was fascinating to discover how this feat was achieved in Britain. And just like the US, it was extremely difficult to pull off.
Sixty years ago, the war had only been over for two years and times were still hard with rationing and shortages. Nevertheless, there was a new mood in the country. People felt optimistic and craved change. The hero of the war, Winston Churchill, had been voted out in the general election and a new left-wing labour government under Clement Atlee was in power.
Using dramatic reconstructions with actors playing the parts, old film, photos and interviews with those who were there at the time, the documentary takes us step by step along that rocky road. The man of the moment was the minister for health Anuerin Bevan. A working class man from Wales who used to be a coal miner, he had seen at first hand what lack of healthcare did to the poor. He saw miners die of untreated emphysema, babies who had not been inoculated die of typhoid, he saw the unsanitary conditions that led to disease, disfigurement and early death.
The documentary managed to get a sense of the excitement and stress of that time for Bevan. He had set a precise date – July 5 1948 - for when the NHS would come into being, the health service that would take care of the population from ‘cradle to grave’.
However, fearing loss of independence and private earnings and that they would just become tools of the state, the doctors were vehemently against it. The British Medical Association (BMA) held a referendum and the outcome was an overwhelming ‘no’. Bevan pressed on regardless andwas comforted by the fact that a Gallup poll showed the population in general were solidly behind him. He told the BMA he had been elected to change the system, and they would just have to accept it.
However, he compromised by telling doctors they could keep sections of their private work on a part time basis. In the end, everything went ahead as Bevan planned and as a result, the health of the population improved dramatically in a few short years – by that measure, it can be called a resounding success.
By contrast, Casualty 1909 shows how the health system operated before the NHS was instituted. This BBC1 drama is based on 100-year-old records from the archive of the London Hospital. The institution was run for the poor and sick of east London and survived by donations from wealthy individuals. A great deal of time was thus spent grovelling and pandering to Lords, Ladies and other members of the upper classes in the hope they would donate money.
The show depicts the sad creatures who came through the hospital’s doors in the early 20th century. Jewish refugees who had been beaten up by racists, young prostitutes in terror of their pimps, workmen injured in industrial accidents, children with diseases such as typhoid, cholera and scarlet fever.
The fierce hospital matron, played by Cherie Lunghi, keeps her army of well-disciplined nurses under tight control. They follow her instructions at all times – one nurse had to choose between her job and her love for one of the doctors as she couldn’t keep both. One episode showed the early days of X-ray and the resulting illness caused by lack of knowledge of its dangers. It’s a fascinating drama where people struggled heroically against the odds but no one would ever wish to go back to those days.
Interestingly, this humanitarian hospital took in the famous Elephant Man and cared for him until his death in 1890. His skeleton remains in the basement of the hospital but is not on public view.