Ideology and Process in the Creation of the British National Health Service

Journal of Policy History

Volumn 14, Issue 2, 2002, Pages 113-134

  Stewart, John ^a  

^a OXFORD BROOKES UNIVERSITY   (United Kingdom)

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[No Author keywords available]

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EID: 85012214074     PISSN: 08980306     EISSN: 15284190     Source Type: Journal    
DOI: 10.1353/jph.2002.0013     Document Type: Article

References (89)

1. There is a huge body of scholarly literature on the creation of the NHS. Among the works cited in this article are Daniel Fox, Health Policies, Health Politics: The British and American Experience, 1911—1965 (Princeton, 1986)
2. Rudolf Klein, The New Politics of the NHS, 3d ed. (London, 1995)
3. Charles Webster, The Health Services Since the War, volume 1: Problems of Health Care (London, 1988)
4. Charles Webster, The National Health Service: A Political History (Oxford, 1998).
5. Rodney Lowe, The Welfare State in Britain Since 1945, 2d ed. (London, 1999), 167, 183;
6. Klein, The New Politics of the NHS, vii.
7. Aneurin Bevan, In Place of Fear (London, 1952), 81;
8. Martin Francis, Ideas and Policies Under Labour, 1945—1951 (Manchester, 1997), 102.
9. For recent British health policy, see Julian Le Grand and Polly Vizard, The National Health Service: Crisis, Change, or Continuity, in Howard Glennerster and John Hills, eds. The State of Welfare: The Economics of Social Spending, 2d ed. (Oxford, 1998).
10. On postwar “consensus,” see John Stewart, The Twentieth Century: An Overview, in Robert Page and Richard Silburn, eds. British Social Welfare in the Twentieth Century (London, 1999).
11. On Liberal ideology in the first half of the twentieth century, and its policy implications, see Michael Freeden, The New Liberalism: An Ideology of Social Reform (Oxford, 1978) and
12. Liberalism Divided: A Study in British Political Thought, 1914—1939 (Oxford, 1986)
13. Ira Katznelson, Knowledge About What? Policy Intellectuals and the New Liberalism, in Dietrich Rueschmeyer and Theda Skocpol, eds. States, Social Knowledge, and the Origins of Modern Social Policies (Princeton, 1996).
14. Fox, Health Policies, Health Politics, 132;
15. Francis, Ideas and Policies Under Labour;
16. Charles Webster, Labour and the Origins of the National Health Service, in Nicolaas Rupke, ed. Science, Politics, and the Public Good (London, 1988)
17. Charles Webster, “Conflict and Consensus: Explaining the British Health Service,” Twentieth-Century British History 1, 2 (1990)
18. Stephen Brooke, Labour's War: The Labour Party During the Second World War (Oxford, 1992), 330.
19. Martin Powell, Evaluating the National Health Service (Buckingham, 1997), 168, 172.
20. On Hastings, see John Stewart, “Socialist Proposals for Health Care Reform in Inter-War Britain: The Case of Somerville Hastings,” Medical History 39 (July 1995)
21. on Murray, see John Stewart, “The ‘Back-Room Boys of State Medicine’: David Stark Murray and Bevan's National Health Service,” Journal of Medical Biography (November 1996).
22. See John Stewart, “‘For a Healthy London’: The Socialist Medical Association and the London County Council in the 1930s,” Medical History 41 (October 1997).
23. The Papers of the Medical Planning Commission are held in the British Medical Association Archive, BMA House, London. Its “Draft Interim Report” was published in British Medical Journal, vol. 1 (1942): 743—53.
24. Important SMA publications included: SMA, A Socialised Medical Service (London, 1933)
25. SMA, A Socialised Health Service (London, 1944)
26. the organization's journal Medicine Today and Tomorrow. The “Penguin Specials” were Aleck Bourne, Health of the Future (Harmondsworth, 1942), and
27. David Stark Murray, The Future of Medicine (Harmondsworth, 1942).
28. The records of the Public Health Advisory Committee are located in the Labour Party Archives, Manchester, England. The Party's preelection statement, National Service for Health (London, 1943), was drafted by David Stark Murray.
29. DSM (2) 4, cutting from the Scottish Co-Operator (13 April 1946). 1 4.
30. Labour Party, Report of the Thirty-Second Annual Conference (London, 1932), 269.
31. Peter Baldwin, The Politics of Social Solidarity (Cambridge, 1990), 134;
32. Somerville Hastings, “The People's Health in Sweden,” Socialist Doctor 2, no. 2 (November 1933): 2–3.
33. SMA, SMA Leaflet no. 1: The Beveridge Report and the Health Services (London, n.d. but 1943) and
34. SMA Leaflet no. 2: Assumption B or the “Panel” (London, n.d. but probably 1943).
35. David Stark Murray, “Should Medicine Be Just a Trade?” Reynolds Illustrated News (26 December 1937)
36. cutting in DSM (2) 4.
37. On which, see John Stewart, “‘Science Fights Death’: David Stark Murray, Science, and Socialism in Interwar Britain,” Annals of Science (April 2000).
38. This perception of general practitioners as medically backward was more widely shared and probably accurate. See the discussion of the 1944 Goodenough Report in Anne Digby, The Evolution of British General Practice, 1850—1948 (Oxford, 1999), 59ff.
39. On surveillance and its authoritarian overtones, see David Armstrong, “The Rise of Surveillance Medicine,” Sociology of Health and Illness 17, no. 3 (1995).
40. SMA Bulletin 109 (June—July 1949), 3;
41. Powell, Evaluating the National Health Service, 191.
42. On the post-1945 Labour administrations, see Kenneth Morgan, Labour in Power, 1945-1951 (Oxford, 1984).
43. On the tensions in Labour thought, see W. H. Greenleaf, The British Political Tradition, volume 2: The Ideological Heritage (London, 1983), pt. 4
44. the insightful contemporary commentary by Robert A. Dahl, “Worker's Control of Industry and the British Labor Party,” American Political Science Review 41, no. 5 (1947). I am grateful to one of this article's anonymous referees for the latter reference.
45. SMA, Child Health: A Survey and Proposals (London, n.d. but probably 1948), 6;
46. SMA, A Socialist Health Service (London, 1949), 2—3.
47. Quoted in Nicholas Timmins, The Five Giants: A Biography of the Welfare State (London, 1995), 101;
48. Dahl, “Worker's Control of Industry,” 878;
49. Arthur Marwick, “Middle Opinion in the Thirties: Planning, Progress, and Political Agreement,” English Historical Review 79 (1964).
50. Much has been written about the Fabians: see, for example, Dietrich Rueschmeyer and Ronan Van Rosen, The Verein fur Sozialpolitik and the Fabian Society: A Study in the Sociology of Policy-Relevant Knowledge, in Rueschmeyer and Skocpol, eds. Douglas E. Ashford, The Emergence of the Welfare States (Oxford, 1986), 121ff.
51. For the Cabinet Debates, see Morgan, Labour in Power, 151–63.
52. Stephen Brooke, Labour and the “Nation,” in Jon Lawrence and Miles Taylor, eds. Party, State, and Society: Electoral Behaviour in Britain Since 1820 (Aldershot, England, 1997), 161, 163.
53. Gosta Esping-Andersen, “Citizenship and Socialism: De-Commodification and Solidarity in the Welfare State,” in Martin Rein, Gosta Esping-Andersen, and Lee Rainwater, eds. Stagnation and Renewal in Social Policy (Armonk, N.Y. 1987), 83, 90;
54. Baldwin, Politics of Social Solidarity, 8ff. and passim.
55. Brooke, Labour and the “Nation,” 162.
56. The Second Commons Reading can be found in Parliamentary Debates, 5th Series, vol. 422. On the BMA, see Peter Bartrip, Themselves Writ Large: The British Medical Association, 1832-1966 (London, 1996).
57. British Library of Political and Economic Science (BLPES), London, Piercy Papers, 8/20, memorandum from E. F. M. Durbin to Clement Attlee, 30 September 1943, citing a letter from Dr. Horace Joules.
58. Desmond King, In the Name of Liberalism: Illiberal Social Policy in the United States and Britain (Oxford, 1999), 32. I am grateful to one of this article's anonymous referees from clarifying an earlier version of this point.
59. See, for example, Public Record Office, Kew, London, MH 80/27, Ministry of Health memorandum, February 1944, “Negotiations Outside the Office.” This was but one explicit recognition by civil servants of the BMA's central role in negotiations over a future health service;
60. Webster, “Conflict and Consensus,” 143–47.
61. A detailed analysis of the negotiations can be found in Webster, The Health Services Since the War, vol. 1, chap. 4;
62. R. A. W. Rhodes, Understanding Governance: Policy Networks, Governance, Reflexivity, and Accountability (Buckingham, 1997).
63. Morgan, Labour in Power, 16.
64. BLPES, Fabian Society Papers, K10/5, “Principles of a Comprehensive Health Service” (n.d. but probably 1943).
65. On the TUC and health care, see Ray Earwicker, “A Study of the BMA- TUC Joint Committee on Medical Questions, 1935—1939,” Journal of Social Policy 8 (1979)
66. and on pensions, see John Macnicol, The Politics of Retirement in Britain, 1878-1948 (Cambridge, 1998).
67. For the broader context of organized labor and the Labour Party, see Brooke, Labour's War, passim.
68. See Bevan's riposte to an SMA resolution in 1947 that it was he, and not party conference, who decided NHS administrative issues: Labour Party, Report of the Forty Sixth Annual Conference (London, 1947), 197.
69. Stewart, “Battle for Health,” 217ff.
70. Brooke, Labour's War, 167.
71. For contrasting views of Bevan, see John Campbell, Nye Bevan (London, 1987), and
72. Charles Webster, ed. Aneurin Bevan on the National Health Service (Oxford, 1991).
73. On Bevan's welfare philosophy, see Abigail Beach, “The Labour Party and the Idea of Citizenship, c. 1931-1951” (Ph.D. thesis, University of London, 1996), 241-42.
74. Murray in Medicine Today and Tomorrow 8, no. 1 (Spring 1951): 1.
75. For a brief summary, see King, In the Name of Liberalism.
76. Stephen Taylor, A Natural History of Everyday Life (London, 1988), 296.
77. Jennie Lee, My Life with Nye (London, 1980), 177. Lee was Bevan's wife.
78. Quoted in Ray Earwicker, “The Labour Movement and the Creation of the National Health Service, 1906-1948,” Ph.D. thesis (University of Birmingham, England, 1982), 350.
79. Dahl, “Workers’ Control of Industry,” 898 and passim.
80. Rodney Barker, Education and Politics: A Study of the Labour Party (Oxford, 1972), chaps. 4 and 5; Brooke, Labour's War, 114-25, 198-200, 336-37.
81. On organized labor and social security, see Baldwin, The Politics of Social Solidarity, chap. 2;
82. Fox, Health Policies, Health Politics, 136, makes the point about the TUC and a national hospital system.
83. Brooke, Labour's War, 337.
84. Ashford, The Emergence of the Welfare States, 281.
85. Webster, The National Health Service: A Political History.
86. On what might constitute “equity,” see Powell, Evaluating the National Health Service.
87. Charles Webster, National Health Service Reorganisation: Learning from History (London, 1998).
88. Health Care Analysis 5, no. 3 (1997)
89. Calum Paton, New Labour's Health Policy, in Martin Powell, ed. New Labour, New Welfare State? (Bristol, 1999).