Hello, my name’s Laura Robson-Mainwaring and I’m the Principal Records Specialist for modern health records in the modern domestic team. So I specialise in records related to health and welfare in the 20th century.
Today we going to look at the Beveridge Report, which is a document we can find within our Prime Minister’s Office document collection, denoted by the departmental code PREM, or P-R-E-M. It falls within the series PREM 4, which contains papers originally marked as confidential that were kept at 10 Downing Street in the interwar and Second World War period under the premierships of Stanley Baldwin Neville Chamberlain and Winston Churchill. Prime Minister’s Office material usually contains lots of letters, draft reports, and memorandum about a range of subject matters covering anything that the government might have to make big decisions on both the domestic and the overseas front. Many of the files even contain small comments written into the margins by the Prime Minister revealing how they reacted to important policy matters.
Today we are going to look at the file reference PREM 4/89/2. So this is a unique file reference that relates to material about the Beveridge Report and it covers the dates November 1942 to April 1943. So what is the Beveridge Report? So here we have the frontispiece of the Beveridge Report, which is officially titled ‘Social Insurance and Allied Services’. So on the surface, this is a 300 page report made up of fairly dry language. It was written on the request of government by a social economist and civil servant named Sir William Beveridge and it’s not unlike hundreds of other commissioned reports that can be found in the state archives.
So what makes this seemingly unremarkable report so remarkable? In essence, the Beveridge Report is now recognised as the blueprint for the modern British welfare state, including most notably the NHS. The report contained a summary of principles deemed necessary to banish poverty and want from Britain, namely through the proposal of a comprehensive system of social security that would be operated by the state. We can see on the some of the opening pages of the report that Beveridge’s vision was to battle against what he called the five giants. So these were idleness, ignorance, disease, squalor and want. He proposed a social programme that would care for the population from the cradle to the grave, which included family allowances – so what we would term child benefit today – as well as new housing schemes changes to unemployment and sickness benefits, old age pensions and the introduction of free universal healthcare.
To understand the report, we need to understand the context in which it was written. So it was published in December 1942 during the Second World War, and to some extent the war changed people’s attitudes towards state interference. An emergency medical service was created during the war, which essentially created a temporary national system of hospitals throughout the country. Hospital culture was traditionally independent, but this centrally controlled system paved the way for the creation of the NHS. Interference from the state could also be shown to have positive impact on citizens’ welfare. For example, government ministers noticed that, as a result of rationing, the health of the poor had actually improved. Various wartime welfare reforms, such as supplementary pay for old age pensioners and the subsidy of milk from school meals, again paved the way for long-term changes the unique conditions of wartime also meant that the time was right for revolutionary upheaval. Whilst many in the government felt that existing systems just needed updating, in the report Beveridge said ‘a revolutionary moment in the world’s history is a time for revolutions, not for patching’. The war also further highlighted the problem of poverty within society. In many places the situation was dire. Records held in The National Archives from the likes of the Unemployment Assistance Board show how severe experiences of poverty were and how a man’s weekly budget would not cover his essential needs. Material from this department appears in our catalogue under the reference AST.
So what were the reactions to the report? So Winston Churchill received his copy of the report on the 11th of November 1942; so, this very copy right here. We can see here from this memorandum that the report was described as ‘lengthy’ and we can see Churchill asked for a brief report to be made of the key points. We can see from the briefings of the report that some of Churchill’s advisers were worried about the ambitious and expensive scope of the proposals and there was concern about what publicity it would receive. Cabinet resolved that Beveridge should not speak publicly about his ideas until after it was presented to Parliament, citing the Secrets Act, and we can also see in another part of the file some reactions from Churchill. So you can see his note is made here in the margins that he remarked, ‘once it is out he can bark to his heart’s content’.
However, before the report was even published, the press were reporting on its historic nature, stating that it would be the big issue in home politics for a long time. Whilst those in government were sceptical, the public reacted positively. By February 1944, over 600,000 copies of the report had sold. You can see again here that we have a survey that was taken out by the British Institute of Public Opinion and it shows that 95% of the British public had heard about the report and many were particularly drawn to the idea of a universal state health service. The report was also seen as something to aim for after the war had finished as part of reconstruction.
Some aspects of the beverage report were implemented quicker than others and not entirely in line with the proposals in the report. The Family Allowances Act was passed in 1945 under the coalition government, giving each family five shillings a week for each child other than the first one, slightly under the proposed eight shillings as set out by Beveridge. These posters and leaflets about the new family allowances are found within our Central Office of Information collection, a government information department that provided publicity and public information. In the 1945 election, Clement Attlee’s Labour government came to power, with many in the electorate seeing them as the party who would deliver the Beveridge Report the most closely. Following the election of the Labour government, the National Insurance Act and the National Health Service Act was passed in 1946.
The creation of a National Health Service was arguably the most significant aspect of Beveridge’s proposals. Healthcare in Britain before the NHS had been founded on charity or on insurance-based schemes, as most people could not afford to pay for medical treatment. The NHS changed this and medical care became free and based on need rather than on ability to pay. It was 100% financed from taxation, which meant that the rich contributed more than the poor. Everyone was eligible for treatment and treatment could be given at any NHS institution anywhere in the country. However, before the NHS opened its doors to the public, there was great opposition to many aspects of the proposals, particularly from the likes of the British Medical Association, a body that represents doctors. They campaigned against some of the terms of the proposed new health service, which would see doctors become employees of the state on set salaries as opposed to being self-employed and independent. However, without them the NHS could not operate and the government was forced to make a number of compromises. GP surgeries remained private businesses that could be bought and sold and consultants in hospitals were allowed to continue an element of private treatment. You can find more records relating to the creation of the NHS within our Ministry of Health Collection.
The National Health Service Act was eventually passed in November 1946 and the NHS opened its doors to the nation on the 5th of July 1948. By the end of the year, around 90% of the population had signed up for the service and, significantly for its success, 85% of doctors also joined the service by the end of this first year and the NHS would become one of the most enduring and significant aspects of Beveridge’s proposals in his report.