National Health Service

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National Health Service

The Cabinet discussed the NHS on 11 October 1945.  The White Paper on the NHS had proposed that voluntary hospitals should be left under their own independent management though subject to a certain measure of control in return for financial assistance which they would receive from the Treasury and local rates.  However, it seemed that apart from the big teaching hospitals, voluntary hospitals were not providing a good service and it was therefore proposed that they should come under public control on a regional basis which was likely to be opposed by the voluntary hospitals.

The following extracts give a flavour of what was said in Cabinet:


No real diffy. in getting agreement with Scotland:  for I don't intend to
  leave the teaching hospitals as voluntary hospitals in old sense of term.
  No other way of getting proper hospital service. - or effic. nursing service.
  Can't entrust to l.a.'s because (even in London) the l.a. areas are not natural hospital areas.  Resistance of vol. hosp. is being entrusted to l.a.'s couldn't be overcome.
W. paper has to resort to Joint Bds., wh. is worst form of l.a. authy.
Argument: equal service for equal contributions.
Vol. hospital system has broken down.  Success of E.M.S. due largely
to its brkg. down local boundaries.
Revenue: 100% in some cases will come fr. rate & State funds: in other
cases 60% upwrds.
Rushing out endowments, less than 8% will be upd by vol. contribns.
Protection v. centralisation?
My conversn with drs. had me to suppose tht. this will be welcomed by
them & will reduce their opposn to rest of scheme.


In principle, I support this:
Careful prepn before announcement. made - propaganda too.
Agree: regional organisation is required.  diff. from the system wh. has grown up fortuitously.  And this calls for national basis.
 Big teaching hospitals - successful because given opporties to best men. Can't do this on basis of seniority.  Wd. like to see what is proposed on this before public statement made on hospitals.
 Tremendous outcry is certain.  But believe this is right, none the less.


Vol. hospitals going down hill for some time = & this scheme will finally kill them because so many outside Ldn. rely on vol. contrib.. schemes - which won't go on when a Health Service Contn is payable.
 Diffy. gigantic task, will take years to compete, in face of strong oposn. Protracted talks with l.a.'s.  Vol. hospital will make it as hot as they can for M/H.


Support from Ldn. experience.
a) Govrs. of Ldn eye hospital: gave it up because of govt. cadging by doctors.
b) Since L.C.C. took over, stigma of "infirmary" now removed.  People prefer to go there than eg. to Guy's where the Almoner conducts Means Test.

Taken from C.M. 40(45) - Meeting held on 11 October 1945.