The two men took an instant liking to one another. Moran, known as ‘Corkscrew Charlie’ for his supposed deviousness, saw in Bevan not the orator in his parliamentary pulpit, but a charming and persuasive man with whom one could reach an accommodation. Everything now rested on Moran, but he faced a challenge from Lord Horder, physician to kings and queens and a man whose views tallied with those of the BMA. On 26 March 1948, the Royal College of Physicians held its election. One by one its members dropped their silver coins into the bucket. Moran won, by only five votes.
Moran wrote to Bevan, explaining the deeper causes of the BMA’s intransigence. ‘My dear Nye,’ he began. ‘The irrational fears of GPs [are] that one day you will turn them into salaried servants of the state.’ This, Bevan felt, could be addressed. He therefore presented an amendment on 7 April which ensured that GPs would never be civil servants or wage slaves without a new Act of Parliament. What was more, he promised that the GPs could join the new health service while maintaining their private practices, something he had learned from the Tredegar Association. The cynicism was as striking as the magnanimity. ‘I stuffed their mouths with gold,’ Bevan boasted. But the BMA, still confident of final victory, remained unbiddable.
In spite of growing scepticism in the press, on 12 April Bevan insisted that his health service would be launched on time. The government appealed again to the nation, this time via a press campaign. ‘Every forty minutes, a child dies of diphtheria’, it was emphasized. Twenty million people now signed up for the service. Within five weeks, 75 per cent of the adult population had put themselves down for the free healthcare promised.
On 4 May 1948, the BMA turned again to its members for support. Now, however, almost 40 per cent had changed their minds. The swing was by no means complete, but it was enough. And so, on 28 May, the BMA advised all its members to join the NHS. What seemed a remarkable capitulation carried a caveat: they called for a delay. This would have meant final defeat for Bevan, whose riposte was to point out that there would always be more demands and more delays. The reply worked admirably.
But the NHS was still far from ready. Moreover, in two years costs had almost doubled, to £180 million. Most of the 3,000 hospitals were crumbling; age and the Blitz had seen to that. In London, not one hospital was unscathed. Most worrying of all, with five weeks to go, 30,000 new nurses were needed. Another campaign was launched, revealing once again the Labour government’s readiness to adapt to new media, but the press resumed its attacks: ‘Free for All’ and ‘Stop this Bad Bill’ were among the milder headlines.
It was Sunday 4 July 1948 and the NHS was to be open for business on the following day. Yet Bevan chose this day to launch an attack on his political opponents so intemperate as to be self-defeating. All the resentments of the past few years inspired this otherwise generous man to describe the Tory party as ‘lower than vermin … They condemned millions of first-class people to semi-starvation.’ Why did Bevan launch his spectacular assault the day before the birth of the NHS? There was little in the way of calculation at work. In truth, while he spoke like a poet he thought like a child, with an immovable sense of right and wrong.
On the next day, the NHS was inaugurated. The event was signalled by the opening of the Trafford Park Hospital in Manchester. ‘It was like a wedding,’ remembered Mary Bane, a nurse. True to form, Bevan greeted everyone. He proclaimed that ‘we have been the dreamers, we have been the sufferers. Now we are the builders.’ Attlee himself, in a period of illness, refused a side ward, insisting that he should be treated like anyone else. Nurses would find him chatting happily with his fellow patients. A spirit of gratitude, so long dammed up, now gushed forth. Even administrators would be given little presents, as if they had wrought this miracle themselves. There was, of course, a huge backlog of diseases, phlegmatically borne for want of any alternative. Women came to their GPs with their uteruses turned inside out. Men had gone about their affairs with hernias ‘the size of balloons’.
All this came at a cost: 240 million prescriptions were filled out, a fourfold increase in two years. The budgetary caps were soon broken, and an upper limit of £170 million swelled to £352 million in the space of two years. A citizen would soon have to wait half a year to see an optician. Thirty-three million sets of false teeth were made in the first nine months, many of them for children. Bevan and others had imagined a decrease in the numbers of people using the NHS as the nation became healthier, but a different law applied: gas expands to fill the space available. As medicine developed and demand increased, so costs rose. But the effects of the new service could not be denied. Deaths from infectious diseases fell by over 80 per cent. For a while, the opposition remained unconvinced and unrepentant. Lord Horder spoke of ‘this temporary minister’ and predicted that the good old days of private practice would soon return. But the NHS remained, and its GPs remained its motor. The role of the doctor had come full circle: he was again the helper and healer.
Bevan himself resigned in 1951 over Hugh Gaitskell’s introduction of prescription charges for dental care and spectacles. The funds were needed for a project particularly loathsome to a man of Bevan’s sympathies, the Korean War. Attlee felt obliged to speak of Britain’s ‘very serious financial position’; the Americans withdrew their ‘Lend-Lease’ provision, which had provided supplies without Britain having to pay for them, resulting in a disproportionate excess of imports over exports. In eighteen months, a committee was set up on the ‘Socialisation of Industries’ to concentrate on the Bank of England, civil aviation, the coal industry and cable and wireless, but the fatal continuation of union opposition, mismanagement and general incompetence did not respond to optimism. The era that had offered so many sweeping commitments was finding it harder to sustain them. In the Labour manifesto of 1950, the party in government still felt able to recall its New Testament roots:
Socialism is not bread alone. Economic security and freedom from the enslaving material bonds of capitalism are not its final goals. They are means to the greater end – the evolution of a people more kindly, intelligent, free, cooperative, enterprising and rich in culture. They are means to the greater end of the full and free development of every individual person. We … have set out to create a community that relies for its driving power on the release of all the finer constructive powers in man.
Never again was any party able to speak in such utopian terms. Once again the country seemed to be stumbling towards crisis. If it could happen in war, it could happen in peace. The scheme of nationalization had been put in place but many questioned whether it was of any actual benefit. They might have agreed with Churchill, who said it was ‘proving itself every day to be a dangerous and costly fallacy’. Nothing was going as well as it appeared.
An almost hung parliament in 1950 led Attlee to call a second election. Perhaps he had grown complacent, or perhaps he desired vindication. In 1951, after only six years, the Conservatives were returned to office, promising an end to austerity and the beginning of wealth. But austerity, in one form or another, was to last until 1955.
34
An old world
On 6 February 1952, the king died, and, quite by accident, an Elizabethan age was established. Another herald was the establishment of the Conservative government in 1951. Domestic duties were no longer considered as inevitable as they had been, and the status of nursing and teaching rose proportionately. Women were no longer merely duchesses, mistresses, housewives or labourers, but teachers of mathematics and gymnastics. It had taken the carnage of the world wars to illuminate that. There were complaints, as at all times of social change. Surely it was not proper to train women as doctors in a world where cuts in services were continually threatened?