1948: Establishment of the NHS

A photograph of a leaflet given to the public, announcing the establishment of the NHS. The text says: “The National Health Service. Your new National Health Service begins on 5th July. What is it? How do you get it? It will provide you with all medical, dental, and nursing care. Everyone – rich or poor, man, woman, or child – can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. but it is not a ‘charity’. You are all paying for it, mainly as taxpayers, and it will relieve your money worries in times of illness."
Leaflet explaining the NHS when introduced in 1948. Image source: National Health Service Western Isles Health Board. Attribution 4.0 International (CC BY 4.0 licence).

With the establishment of the NHS, nearly every voluntary hospital now came under the control of the Ministry of Health. As core hospital provisions would now be funded by the state, the role and scale of charitable fundraising for hospitals changed substantially.

In 1948, the British Hospitals Association suggested new roles of charity in the health sector, primarily limited to donations in support of staff and patient welfare, contributions towards medical research, and volunteering on committees.

Though individuals could still donate to a particular hospital should they so choose, hospitals were no longer reliant on such contributions to provide their services.

Development of the NHS:

  • December 1942: Beveridge Report Published. Published during the Second World War, the report ‘Social Insurance and Allied Services’, was drafted by economist Sir William Beveridge. Mathematician Janet Philip – Beveridge’s wife – was also instrumental in producing and publicising the report. In essence, the report recommended the foundation of a welfare system, including establishment of a free national health service. It was embraced by Clement Atlee and formed the basis of post-war reforms.

  • February 1944: Willink White Paper Published. Conservative Minister for Health, Henry Willink, published the White Paper: A National Health Service. The paper outlined a plan for a national health service in which local authorities would play a significant role.

  • July 1945: Atlee’s Labour Government Elected. Clement Atlee was elected as Prime Minister. He appointed Aneurin (Nye) Bevan as Minister for Health, thus tasking Bevan with responsibility for establishing a comprehensive national health service.

  • 6th November 1946: National Health Service Act Passed. The NHS Act was introduced by Nye Bevan in July 1946, but it wasn’t until November that it was passed by a vote of Parliament. Though the Conservative party had also campaigned in the run up to the 1945 general election with the promise of establishing a national health service, they disagreed with Bevan’s vision which departed from the format outlined in the Willink White Paper.

  • 5th July 1948: National Health Service Act Comes into Effect. With the launching of the NHS, nearly every hospital (whether it had been established as a voluntary hospital, Poor Law infirmary, or local authority-run isolation hospital) now came under the new service. The NHS was centralised, tax-payer funded, universal, and free at the point of use.