Cradle to Grave – Is the N.H.S. going backwards?

By John Coppinger:

I was born in 1949, one year after the N.H.S. was ‘born’. I was the only survivor of the three children that my mother gave birth to.  Was it because I was born just after the N.H.S. had started? I will never know the answer to that question.

It may seem to you that this is a sad tale but unfortunately, it is a tale that would be told in many a household prior to 1948.

Perhaps there are some younger people reading this article who may not know the relevance of July 5th1948. 1948 was a major step forward in the civilisation of our country. It was a time when government woke up to the fact that their citizens were extremely poor financially and more so medically.

In 1911, Lloyd George, established a system of National Health Insurance. This offered benefits to the contributor below a certain level of income, and did not include dependants.

History reveals it was not uncommon for factories to contribute to local hospitals in exchange for what might now be called sponsored beds. This allowed beds to be reserved for their workers, however, if the beds were not needed, with the permission of the benefactor, they could be used for other patients. It was also common for benefactors to subscribe to hospitals and many a local hospital was built from the subscriptions from local residents. If you are keen to know a little more, you may find the link below helpful.

Further reading: The National Archives

Good quality food is essential for health. In the 1940’s post war austerity was taking its toll, food was rationed and depending on how many ration coupons you had available, you may have eaten for dinner: two sausages which tasted like wet bread with sage added, mashed potato made from powder, half a tomato, one cube of cheese, and one slice of bread and butter. Rationing continued until June1954

A manual worker would earn on average, £4.12 shilling a week and if you did not work you did not get paid. If you were feeling unwell and in need of medical care, a discussion would take place within the household about priorities.  There are children who needed feeding and perhaps their shoes required replacement.

If you went to see a local doctor in the years leading up to 1948, you would be charged you for the ‘privilege’ of receiving a consultation, if you required treatment there may be another charge and so on it went.

The United Kingdom was the first country to provide medical care to the entire population, free at the point of delivery, being paid for out of taxation. Health care was not based on an ability to pay. Note, social care managed by local councils in  much the same way as it is today.

Further reading:

The new service was totally free until 1951, when charges were imposed for prescriptions, dental care and spectacles and it has remained like this up to 2017.

Today if you are ill, you make an appointment with a doctor, who will make a diagnosis, explain the options to you, write a prescription for medicines and if necessary, refer you to a hospital specialist. The only charge you will receive is for the prescription for medicines; even this may not be a chargeable event if your circumstances are such that it would cause you hardship.

It does not take much imagination to draw parallels between now and the 1940’s.  Britain is currently caught in a tidal wave of austerity. There are food banks in every town and city, supermarkets have an area where food can be donated to feed the poor. Housing is so expensive children remain at home because they cannot afford to leave. The most disturbing fact of all is the increasing number of people sleeping rough on the streets, for whom adequate food is not available and their health is in decline.

To add to this misery in what seems to be another return to the 1940’s, the U.K. is dismantling the N.H.S.

There are plans afoot to ration health care, surgical procedures are to be limited, waiting lists are going to be allowed to rise. There are also plans to implement a restriction of medications and a scaling down of the number of pharmacies that will be available. Further reading:

A new process known as Accountable Care Partnerships, is being introduced to England. Already this initiative has changed from Accountable Care Organisations to the A.C.Ps., presumably because partnership sounds less threatening than organisation. However, their modus operandi will remain the same, to filter G.P’s referrals to hospital. They will be given the task of reducing the number of referrals to hospitals, and they may well replace the current Care Commissioning Groups.

The A.C.P.s are being peddled as a streamlined structure for healthcare delivery. It must also be said that they will be expected to deliver their objectives within a strict budget,

The link below will take you to Healthier Northwest London published document on their take on how such a service can be delivered. I will leave it for the reader to decide if this change is more or less streamlined than the current system.

For those who have missed a well-reported outcome from budget led referrals, please read the link below.

We all have our views on the N.H.S. and will undoubtedly draw our own conclusions about what is desirable and what is actually happening. However, for me, it is clear that the U.K. is on a collision course to part privatisation.

I hope you find something of interest in this short article, at least enough to form a view on where you see the N.H.S. heading in the next year or so. I have listed below my comparative summary of the plans for our N.H.S.


1948 2017
N.H.S Born N.H.S Dies
Health care delivered free Health care to become part payment
Patient put first Budget put first
New procedures introduced Procedures to be withdrawn
More hospitals built Hospitals closing down
Healthcare funding for N.H.S Healthcare funding for N.H.S to be shared with Social care
Budget used for medical care only Budget used to boost company share value


I will leave you one more piece of information. We hear that the United Kingdom cannot afford the current N.H.S. expenditure. I have written another article on this website, highlighting the U.K. as being the 5th richest nation on Earth; yet we hold 12th position in term of our G.D.P. expenditure on healthcare.

If I do not take time to get this message out to as many people as possible!

Then tell me, how can I explain to my grandchildren how I let the most important legacy given to the British people die?



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Comments (3)

  1. Linda Skipper


    Excellent article John I too am fearful for NHS future. We would be bankrupt if we had needed to pay for my breast cancer treatment, complex revisions of hip & knee replacements, hysterectomy, other gynae procedures & hand surgery. My husband’s investigation & treatment of femoral artery embolism & subsequent below knee amputation. I will fight for NHS until my last breath. We need to get rid of the Tories & get a Labour Government.

    • John Coppinger


      Thank you Linda, I did not realise you had been through so much. I sincerely hope things are improving for you both. An excellent example of what the NHS does. I believe that the general public do not recognise what a valuable legacy the NHS is and do not take much notic of it until they need it. The way things are headed, they will wake up one day it will be gone, to be replaced by profit hungry businesses, one fine example being Richard Branson who has spat his dummy out because he was not awarded a contract. He is calling foul and allegedly is wanting to take this matter to the courts.

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