for what became Britain’s welfare state. Beveridge proposed that there should be an all-out attack on the ‘five giants’ of Want, Disease, Ignorance, Squalor and Idleness. As part of the postwar reconstruction, a welfare system would be introduced, paid for out of taxation and national insurance, that would provide for citizens from ‘cradle to grave’. A national health service was fundamental to this vision of a caring society.

Paying for medical care

Before 1948 people in Britain either paid for their health care or went without. People had to pay for doctors, hospitals and medicines. Working men on low incomes could access free health care through insurance schemes that had been introduced in 1911, but these did not cover their wives or families. The very poor could have hospital care for free but they had to undergo a humiliating means test. People avoided calling the doctor, choosing to treat themselves, visit pharmacies or go without treatment.

There were two main kinds of hospitals: voluntary hospitals, including the teaching hospitals, and local authority or municipal hospitals. Voluntary hospitals provided care for acute conditions and were funded through fees, charitable donations and fund-raising events. Local authority hospitals treated the elderly, those with chronic conditions such as infectious diseases and those with mental illness. They were funded

The first NHS patient, Sylvia Diggory, nŽe Beckingham, with Aneurin Bevan at Park Hospital (now Trafford General), 5 July 1948

any means test. It was one of the major social achievements of 20th-century Britain and it changed people’s lives.

There had been plans to create a national health service in Britain for some years. In 1942, at the height of World War Two, the British economist William Beveridge produced a report – known as the Beveridge Report – that laid the basis