Last weekend, I attended the Welsh Conservative Party Conference in Cardiff. Seeing the many friends I made during my campaign there two years ago was a real pleasure. In 2005, I had the honour of representing the Conservative Party as its candidate for Blaenau Gwent in that year’s General Election. The constituency had been previously represented by that undeniably talented Labour politician, Aneurin Bevan. The area was rightly proud of a local man who shaped the health service for the country, and celebrated his connections at a monument erected beside the road between Ebbw Vale and Tredegar (picture above).
My latest visit to South Wales got me to thinking abour Bevan’s legacy. In the light of recent NHS woes, the MMC controversy being just the latest, should we still celebrate the service that Bevan bequeathed to us? Or, should we consign it to the past, and start developing a health service fit for the 21st century?
On July 5th 1948, having overcome political opposition from both the Conservative Party and from within his own party, and persuaded the medical profession by “stuffing their mouths with gold”, Nye Bevan’s National Health Service Act of 1946 came into force. It had taken eighteen months of heated discussions between the Ministry of Health and the British Medical Association, to win over the support of the vast majority of the medical profession. Some 2,688 voluntary and municipal hospitals in England and Wales were nationalised and came under Bevan’s supervisory control as Health Minister. Socialised healthcare had arrived in Britain.
To understand why the NHS is structured the way it is, one has to remember what Britain was like at the time of the service’s inception. An appalling World War was fresh in the minds of the public. Much sacrifice in blood and money had created a strong desire to want security for family and friends. That security did not just include protection from foreign foes, it also involved personal security at home. And because the suffering had been felt by all, the health service should be ‘free’ for all, irrespective of personal means.
Bevan, a passionate Socialist, created a nationalised service that has grown inexorably over the years into a vast, unwieldy organisation. Each year of its existence, spending on healthcare has increased, so that today it continues to outstrip our taxable resources. The selfless service of the staff, an admirable quality that once ran through the fabric of the NHS, is increasingly becoming thin on the ground. Doctors are becoming disillusioned, so much so that they are leaving the service, their country and in some cases, the profession itself. If there is not a change in policy direction, I fear that we are witnessing the slow death of the health service. Despite what you might of read about the importance of all “healthcare professionals”, the reality is that doctors make the NHS tick. Nothing happens clinically without a decision being made by a doctor. So, if the medical profession is contemplating abandoning ship, the political classes need to take note.
It is an article of faith in the Labour Party that nothing of Bevan’s legacy should be touched. This is nonsense, and the great majority of the public know it. Rather unfortunately, therefore, it falls to the Conservative Party to “get its hands dirty”. I believe that the answer rests with increasing personal responsibility for health. The NHS is crying out for a new source of money and it is best raised by encouraging people to share the burden of escalating health costs. As a country, we have to realise that the bill for healthcare increases the more irresponsibly we choose to behave. And for those of you who cling to the outdated political view that there are no Conservative votes in addressing this issue, I would strongly argue that for us not to address this domestic challenge would make us look weak. The Conservative Party has a recent track record of taking tough decisions on domestic policy which are initially unpopular. In time though, the British public have come to accept many of them. No one likes change, least of all to health services. People are at their most vulnerable when sick, particularly those of modest means. However, for politicians to continue blindly pursuing Bevan-like policies is criminal. As WF Deedes wrote recently,
Yes, people will resent any charge on what has once been free for all. But unless we can swallow our political prejudices and move on, we shall assuredly destroy a wonderful medical service.
