![]() In addition, 66,000 beds were still administered under Public Assistance, mainly occupied by elderly people who were often not sick in the sense of needing health care. Of the ex-municipal beds, 190,000 were in mental illness and mental deficiency hospitals. On the appointed day, 1,143 voluntary hospitals with some 90,000 beds and 1,545 municipal hospitals with about 390,000 beds were taken over by the NHS in England and Wales. Bevan had worked out the details and the NHS had a command structure, a ‘welfare state’ ideology and was heavily dominated by those providing the services. 3 In 1944, before victory in Europe had been achieved, a committee within the Ministry had considered how the emergency hospital service would be ‘demobilised’. Beveridge, in his report in 1942, had proposed state funding but not how the NHS should work in practice. The ethos and the pattern of the NHS had much in common with the newly nationalised state industries, railways, steel and the utilities. ![]() The planners covered thousands of acres of farmland, but they avoided tower blocks and the devastating results of the simultaneous redevelopment of the centres of older towns. The boundaries were drawn generously, land reclamation figured prominently and the problems of high-rise living were avoided. Alongside post-war rebuilding of existing cities, and the designation of overspill areas, the New Towns Act 1946 led to major new centres of population. The second world war had created a housing crisis. Affairs abroad were as depressing as conditions at home. A steep rise in the prices of foodstuffs and cattle food followed disappointing harvests in many European countries, due to the hard winter and hot dry summer, and in certain crops, notably corn for animal food, in America. Bread had to be rationed for the first time late in 1946 in September 1947, the meat ration was reduced in October the bacon ration was halved and in November potatoes were rationed. So acute was the crisis that restrictions more rigorous than any in the war years became necessary. Immediately after these four months of disastrous weather there followed a period of economic crisis with an ever-increasing dollar crisis. These three months of snow and bitter cold were followed by the heaviest floods for 53 years, which did great damage, killed thousands of sheep and lambs, delayed spring sowing and threatened the prospect of a good harvest which was so urgently needed. Its first three months formed a winter of exceptional severity, which had to be endured by a people who in addition to rationing of food were faced with an unprecedented scarcity of fuel. The eighth year of austerity, 1947, was a testing year. Sir Wilson Jameson described the problems of 1947, the year before the NHS began. It was a tradition going back to the Hippocratic view of its effect on health. Aneurin Bevan 1įor almost a century the government’s Chief Medical Officers (CMOs) had often begun their annual reports with an account of the year’s weather. Let us try to develop that partnership from now on. My job is to give you all the facilities, resources and help I can, and then to leave you alone as professional men and women to use your skill and judgement without hindrance. ![]() But the sooner we start, the sooner we can try together to see to these things and to secure the improvements we all want. Nor will there be overnight any miraculous removal of our more serious shortages of nurses and others and of modern replanned buildings and equipment. It has not had an altogether trouble-free gestation! There have been understandable anxieties, inevitable in so great and novel an undertaking. On 5th July we start together, the new National Health Service.
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