By Elliott West
“Illness is neither an indulgence for which we have to pay, nor an offence for which they should be penalised but a misfortune, the cost of which should be shared by the community”.
Aneurin Bevan
Introduction
This year marks the 75th anniversary of the National Health Service, an institution that revolutionised health care in the United Kingdom but unfortunately has over the years become a political football. Before 1948, this country had a very bleak medical landscape where the many were forgotten and the few paid for basic health care. Tuberculosis was rife and seized the souls of much less fortunate in life and you had to pay a midwife to deliver your baby. This landmark moment in history ushered in by the Labour Attlee post-war government was unique because it was the envy of the world, the first universal health system, a service that has an ethos of being free at the point of return.
The Welsh Connection
Aneurin Bevan or Nye as he was fondly referred to, was the youngest member of the Attlee government at 47 years old.. Appointed as the Minister for housing, local authorities and health. If anyone was the right man, in the right job at the right time, it was Bevan. Aneurin was working class through and through. The son of a Welsh coal miner, Bevan was born in Tredegar and worked down the coal mines too. First elected as a Labour MP for Ebbw Vale in 1929, Bevan soon became a rising star in the Labour Party. Bevan was instrumental in leading the campaign for a National Health Service. A service that didn’t distinguish wealth and provided free health care for all.
Aneurin was a powerful figure in politics and was widely respected by politicians of all political persuasions. A straight talker and reformer, Bevan was part of a government that was radical and whose policies were far-reaching, determined to rebuild a Britain that had been deeply scarred by the effects of World War II. Set in the heart of the 1945 Labour Party manifesto was a programme of far-reaching social reforms, collectively known as the Welfare State. Described by The Times as “an outstanding back-bench critic and one of the most brilliant (Labour) members in debate”, Aneurin was actually a shock choice for the position as he had often been at loggerheads with Clement Attlee. Yet the pragmatic and quiet man of politics, Attlee, like Wilson and Blair after him, believed in unity and thought the best way forwards was to stitch the left and right wings of the party together. Bevan was an ideal unity candidate, outspoken but brilliant. He was given a clean sheet to weave his magic. So successful was the Welshman in the role that he kept in post until Labour lost office in 1951.
A Landmark Day
The 5th of July 1948 has gone down in history as a monumental day. On the day, Bevan attended the Park Hospital, Trafford and received the keys to the hospital. Despite strong opposition from the Conservative Party and even members from his own party, Bevan won the argument for welfare reform. A man who was branded by the British Medical Association as a “complete and controlled dictator” and the “Tito of Tonypandy”. Aneurin had to become a peacemaker and offer concessions to those who had opposed the scheme for 18 months and were in danger of derailing this necessary project. A system that they feared would be overrun. This fear partially came true as there were a large number of people using the National Health Service in the early stages. So much so that it went over budget in the first year and Clement Attlee had to make a radio address to the nation to try to stem the flow. The overspend itself would last until the early 1950s.
The Windrush Nurses
Afro-Caribbean nurses arrived in large numbers with the arrival of the HMS Windrush in 1948. They would fill positions as nurses and midwives answering the call from the British government. Yet it wasn’t the welcome they expected with many walking into a hostile environment with racism, isolation and rejection all experienced as they tried to perform their duties. Many found that their qualifications from the Caribbean were not valid in Great Britain and so had to work twice as hard to regain the necessary qualifications required. Unfortunately, there were a number who didn’t meet the requirements. This call for nurses is beautifully summed up in a poem entitled You Called……We Came by Professor Laura Serrant.
You called…and we came.
In ships bigger than anything we had seen,
dwarfing our islands and covering them
in the shadows of smoke and noise.
Crowded, excited voices filled the air,
traveling to the ‘motherland’
– over weeks, over oceans that threatened to engulf us.
Driven by a wish, a call to save, to rebuild
and support efforts to establish ‘health for all’
in the aftermath of war.
You called….and we came.
Women and men of position in our homelands;
nurses with a pride in the excellence of our care.
With experience of management, organisation
and a sense of duty.
We appeared.
Smiling and eager to work on the wards, communities and clinics
of this England.
You called….and we came.
Our big hearts, skilful hands and quick minds
encased in our skins – of a darker hue.
Which had shimmered and glowed
in our sunnier climes..
But now signified our difference
– our un-belonging.
Matrons became assistants
Nurses became like chambermaids.
All the while striving to fulfil our promise
– to succour, to serve, to care.
You called….and we came.
The blue of the sister’s uniform
– seemed as far away from us as the moon.
Unreachable by our dark hands in this cold land.
But we were made of sterner stuff.
The hot sun, which once beat down on our ancestors,
when they too left their lands,
Shone within us.
Forging our hearts and minds
with the resistance of Ebony.
You called….and we came.
Rising like the Phoenix ,
from the heat of rejection.
We cared, we worked and we organised.
Until the quickness of our brains
and the excellence of our care
made it hard for you to contain us.
And slowly, so slowly,
the blue uniforms had dark and lighter bodies beneath them.
The professional care in our touch
was valued despite the strangeness of our speech
and the kinks in our hair.
You called….and we came.
A new millennium – new hopes spread across this land.
New populations, engaging and reflecting
the varied, diverse and vibrant nature of these shores.
Challenging and reflecting on leadership for health.
Moves to melt the ‘snow’ at the peaks of our profession.
Recognising the richness of our kaleidoscope nation.
Where compassion, courage and diversity are reflected
In our presence and our contribution:
Not only the hopes and dreams of our ancestors.
– Human values needed to truly lead change…and add value.
Remember… you called.
Remember… you called
YOU. Called.
Remember, it was us, who came.
75 Years and Beyond
The NHS is undoubtedly one of the best services ever created but it is creaking under the strain it is put through. The cost of running it is astronomical and is certainly not something that can chuck money at and get results. It has a massive backlog of patients on waiting lists, waiting for a range of treatments and operations and a shortage of staff as many doctors and nurses decide to either leave, go private or find higher-paid medical jobs abroad. These problems can’t be solved overnight and there is no magic band to make the problems go away. Essentially much of the infrastructure has been there since the start and it is only the advancement in surgery, technology and medicine that has kept this prized jewel keeping up with the times.
Successive governments have claimed they will reform the NHS but when it comes to it, they just tinker around the edges and we end up going to square one several years later. The problem is there are too many bureaucrats and senior managers in this service, too much red tape and the money that is in the system is often wasted. The NHS works even when under strain but it needs plenty of care, love and attention if it is to shine bright once more.
