History of the National Health Service facts for kids

The National Health Service (NHS) is the name for the public healthcare services in England, Scotland, and Wales. These services are funded by the government, mainly through taxes. In Northern Ireland, similar services are called 'Health and Social Care' because they combine health and social support.

The NHS was one of the first healthcare systems in the world to offer care to everyone. In June 1948, a leaflet was sent to every home. It explained that the NHS would give people all the medical, dental, and nursing care they needed. It said that everyone, rich or poor, could use it. There were no charges for most things, and you didn't need special insurance. The leaflet also explained that it wasn't a charity. Everyone paid for it through taxes, and it would help people worry less about money when they were sick.

The NHS in Scotland and Northern Ireland started with their own laws in 1948. For the first 20 years, the NHS in Wales was managed from England. But in 1969, Wales got its own special minister to look after its health services.

How the NHS Started

Before the NHS began in 1948, people usually had to pay for their healthcare. Sometimes, free treatment was available from hospitals run by charities. Some local councils also had hospitals for people who paid local taxes.

People often used private health insurance plans, like those from friendly societies. In 1911, a new law called the National Insurance Act 1911 was introduced by David Lloyd George. A small amount of money was taken from weekly wages. Employers and the government also added money. This meant workers could get medical care, though not always free medicines. They would register with a doctor, who was paid based on how many insured patients they had. This system was called 'Lloyd George's Ambulance Wagon'. It only covered workers who paid into it, so most women and children were not included.

In 1910, a doctor named Benjamin Moore was probably the first to use the words 'National Health Service'. He wanted a state-run medical service.

During World War II, a new state-run Emergency Hospital Service was set up. It hired doctors and nurses to care for people injured in the war. This service showed that hospitals could work together under government control. Many voluntary hospitals also needed financial help after the war.

In 1942, a report by William Beveridge suggested that a full healthcare service should be available to everyone. This idea became very important.

Aneurin Bevan helped create the NHS.

A Conservative politician named Henry Willink prepared a plan for the NHS in 1944. This plan included the main ideas of the NHS:

• Services would be free when you used them.
• The service would be paid for by general taxes.
• Everyone living in the country could get care.

After the war, Clement Attlee's Labour government came to power. Aneurin Bevan became the Minister of Health. He decided that local councils were too small to manage hospitals. So, he chose to create a completely new hospital service. This new service would take over both the charity hospitals and the local government hospitals. It would organize them into one big system.

The National Health Service Act 1946 made this new system official for England and Wales. It meant that everyone would register with a local doctor, called a general practitioner (GP). This GP would be their first point of contact for healthcare. Patients would get all the medical, dental, and nursing care they needed without paying at the time of treatment.

Many doctors were against Bevan's plan at first. They worried it would reduce their freedom. But Bevan worked hard to get them to agree before the NHS officially started on 5 July 1948. He knew the NHS couldn't work without doctors. He managed to get the doctors on board by offering good payment plans, especially for specialist doctors called consultants. He famously said he had to "stuff their mouths with gold" to get them to agree.

The NHS Workforce

The NHS became a huge employer right from the start. After taking over hospitals, the new NHS had 360,000 staff in England and Wales, plus 45,000 in Scotland. This included thousands of doctors, nurses, midwives, and many other staff like cleaners, cooks, and administrators.

The number of staff kept growing. By 1961, the NHS was Britain's largest employer. By the late 1970s, it had over 1 million staff. In 2015, it was the world's fifth largest employer with 1.7 million staff. Nurses are the biggest group of qualified staff in the NHS.

Who Works for the NHS?

The NHS has always had a very diverse workforce. People from many different backgrounds, social classes, genders, races, and nationalities work there.

In the early days, most doctors were men from middle and upper-class families. Nurses in general hospitals were usually women from various backgrounds. Men were a smaller group of nurses, often working in mental hospitals.

As more people needed healthcare, the number of staff in the NHS grew steadily. However, NHS wages were often low, and hours could be long. This meant the NHS sometimes struggled to find enough staff, especially in the 1950s and 1960s. One solution was to encourage married nurses to return to work part-time. The NHS was a leader in offering part-time jobs in Britain after the war.

Hospitals also started looking for staff from other countries, especially from Britain's colonies in the 1950s. By 1955, the government was actively recruiting in 16 different colonies. Many nurses came from the Caribbean, and many doctors came from India, Pakistan, Bangladesh, and Sri Lanka.

The NHS also saw a growth in new types of scientific and technical jobs. These included audiologists, biochemists, dietitians, and radiographers. Over time, these roles became more formal, with specific training and university degrees.

In the 1980s, some changes happened. Many cleaning, catering, and laundry jobs were given to private companies. This meant fewer NHS staff did these jobs. For nurses, training changed from hospital-based courses to university degrees. This helped raise the status of nursing. A new role, the healthcare assistant, took on some of the physical tasks previously done by student nurses.

Working Together and Disagreements

From 1948 to 1972, there were not many strikes in the NHS. However, there were some disagreements. When the NHS started, many doctors were worried about losing their independence. They argued for their right to be paid per patient, rather than a fixed salary. This meant that changes to the NHS often needed doctors to agree.

Student nurses also had complaints about low pay and long hours. They often did a lot of the physical work in hospitals.

In the 1970s, more staff groups, like cleaners and nurses, started to speak up about their pay and working conditions. There were some protests and even national strikes by ancillary staff (like cleaners) and nurses. Doctors also took action over their hours and pay.

By the end of the 1970s, there were more conflicts in the NHS. Many health workers took part in protests during the 'Winter of Discontent' in 1978–79. Ambulance drivers and ancillary staff went on strike for better pay, which caused disruption to services.

In the 1980s, the government tried to control pay and use private companies for some services. This led to more disagreements. Nurses eventually got their own independent group to review their pay, which helped improve their wages and status. However, many ancillary jobs were outsourced to private companies, which often meant lower pay and fewer union rights for those workers.

Doctors also became unhappy with the government's changes, especially when more business-like managers were brought in. They started to oppose market-based changes to the NHS, showing how much their views had changed since the NHS began.

In the 2000s, relations generally improved with more government investment in the NHS. However, there were still concerns about using private companies and meeting strict targets.

The NHS in Films and TV

Films and television have played a big part in how people understand the National Health Service. Hospitals and doctor's offices are often shown as places where important life stories happen, like love, birth, and death. The NHS has also been featured in films that give public health advice.

Public Information Films

When the NHS launched in 1948, films were used to share government health messages. During World War II, films were popular for keeping people informed. This continued after the war. The new Central Office of Information made films to introduce the NHS.

Three main films were made in 1948: Charley: You're Very Good Health, Here's Health, and Doctor's Dilemma.

• Charley: You're Very Good Health used a fun story to explain how the NHS would work. It showed how things would be different from before the NHS.
• Here's Health used a dramatic story about a family accident to show how the NHS would change the cost of care.
• Doctor's Dilemma was a short film that encouraged people to register with an NHS doctor before the service officially started.

Popular Films and Television Shows

Soon after the NHS began, popular films started to use it as a setting for stories. Films like White Corridors (1951) and Mandy (1952) showed daily life in an NHS hospital.

The Doctor film series, starring Dirk Bogarde, was a comedy about a young doctor in an NHS hospital. The Carry On comedies, like Carry On Nurse (1959), also made fun of the NHS, its staff, and patients.

From the late 1950s, the NHS became a popular topic for British soap operas. Emergency – Ward 10 (1957-1967) followed the lives of staff and patients at a fictional hospital. Later, General Hospital continued this trend.

In the 1980s, the idea of a hospital soap opera continued to grow. Casualty, set in an A&E (Accident & Emergency) department, started in 1986. It is now the longest-running medical drama in the world. When it began, the creators wanted to show that the "dream" of the NHS was "in tatters" due to problems. The show often showed staff who were unhappy with the changes happening in the NHS.

Television has also used the NHS for reality shows. 24 Hours in A&E and One Born Every Minute are examples. These shows use cameras to follow patients and staff in real hospital departments. They also include interviews to share different viewpoints on the medical cases.

The NHS in Comedy

Comedy films, books, and cartoons have also been made about the NHS. These have helped shape how people think about this important service.

Cartoons

Cartoons have shown the NHS throughout its history. Even before it started, cartoons showed the debates about how it would work. In the 1940s, many doctors were against the idea of becoming state employees. Cartoonists often shared their opinions on this. For example, a cartoon in 1944 showed a doctor examining a leader of the British Medical Association, joking that he didn't have "enlargement of the social conscience."

When the NHS launched, many cartoons showed how people reacted to getting free healthcare. One cartoon from 1951 showed a woman in a doctor's waiting room who had seen many doctors and psychiatrists. She was diagnosed with "deep-seated guilt about getting things free from the National Health Service." Cartoonists also joked about people being excited about getting free wigs on the NHS.

Everyday Humour

Patients and staff have always made jokes about the NHS in their daily lives. It can be hard to find and understand these everyday jokes from the past. However, projects like "The People's History of the NHS" at the University of Warwick collect these memories.

Some researchers believe that humour and laughter might help improve health. The study of laughter is called 'gelotology'. One study in 2011 found that watching comedy videos in a group might help people deal with pain better. Artists have even created "laughter booths" in hospitals, where patients and staff can watch videos of people laughing. This idea is linked to the common saying, "laughter is the best medicine."

See also

• Healthcare in England
• Healthcare in Northern Ireland
• Healthcare in Scotland
• Healthcare in Wales