For Britain's NHS, another way is possible and essential

In 1952, Queen Elizabeth II ascended to the throne. In that same year, Aneurin Bevan, secretary of state for health and founder of Britain’s National Health Service, published his seminal book In Place of Fear. Bevan wrote: “The essence of a satisfactory health service is that the rich and the poor are treated alike, that poverty is not a disability, and wealth is not advantaged.” 

It was a remarkable period in British history. As with many universal healthcare (UHC) reforms around the world, the NHS was founded in the wake of crises. After World War II, rationing, falling living standards, and high military spending led to the term “austerity” being used for economic policy. 

In spite of significant economic challenges, when the Labour Government came to power in 1945, the “Great Leveller” of war had resulted in an awareness that another way was possible. There was an aspiration for the population to live with safe housing and treatment of ill health regardless of their position in society. 

In place of the fear households had endured that at any moment they could face the catastrophic costs of ill health, a National Health Service emerged, based on clinical need, not ability to pay. The NHS alleviated the financial hardship and fear that had been associated with poor health, and despite the challenges, Britain in the 1950s was thriving. 

Britain's NHS staff are once again on the frontline but this time it's not the global pandemic but the Cost of Living Crisis. As Matthew Weaver of The Guardian reported, the current prolonged cold snap could prompt a sharp increase in excess death this winter as financial worries force vulnerable households to skimp on heating. 

Simon Francis of The End Fuel Poverty Coalition is quoted as saying: “People are now literally choosing between heating and dying. We obviously understand the financial pain that everyone is going through, but you can recover from debt, you can’t recover from dying. If people don’t have their heating on, they will end up at the doors of the NHS or even worse.” 

Following the publication of Everything affects health and Mind the gap: What’s stopping change? the Royal College of Physicians (RCP) has published a new briefing which calls for a cross-government delivery plan on poverty and inequalities for Wales. 

With 74% of people in Wales worried about their ability to stay warm and healthy this winter, the Royal College of Physicians (RCP) is calling for a cross-government delivery plan on poverty and inequalities that sets out milestones, timelines and clear targets detailing what every Welsh government department is doing to tackle poverty, and how ministers are working together to reduce the impact of deprivation. 

The Atlantic Monthly described A.J Cronin’s book The Citadel, as an “honest and moving study of a young doctor.” Based on Cronin’s own experiences as a physician, The Citadel boldly confronts traditional medical ethics, and has been noted as the inspiration for the formation of Britain’s National Health Service. 

A groundbreaking novel of its time and a National Book Award winner. The Citadel follows the life of Andrew Manson, a young and idealistic Scottish doctor, as he navigates the challenges of practicing medicine across interwar Wales and England. 

When the newly qualified doctor takes up his first post in a Welsh mining community, the young Scot brings with him a bagful of idealism and enthusiasm. Both are soon strained as Andrew discovers the reality of performing operations on a kitchen table and washing in a scullery, of unspeakable sanitation, of common infantile cholera and systemic corruption.

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