This article is from the January issue of Total Politics. Find other columns in Nik's series on the parliamentary debates that made history here
Mark Twain said history doesn’t repeat itself, but it rhymes. At the outset of a sometimes-tawdry parliamentary debate in February 1948 about the nation’s medical services, Aneurin Bevan, Labour’s minister of health, made a distinction “between the hard-working doctors who have little or no time to give to these matters, and the small body of raucous-voiced people who are alleged to represent the profession as a whole”.
This statement was, alas, founded in brio, not proof. A 1948 survey showed that only 10 per cent of doctors backed the new NHS legislation. The British Medical Association (BMA) described Bevan as a “would-be Führer”; Bevan branded them “politically poisoned people”. Hugh Linstead, a Tory MP and early NHS supporter, bewailed this counterproductive “gladiatorial contest”.
Rab Butler responded for the opposition, paying tribute to Bevan’s “dialectical and debating skill, which is second to none in this House”, but criticised his bellicose speech: “One never thought that the minister of health was possessed of a bedside manner.”
Doctors’ salaries caused a fundamental policy disagreement. The BMA and the Conservatives opposed a basic state salary on the grounds that it would damage the medical profession for doctors to become merely another layer of civil servants. The Liberal chief whip, Frank Byers, slammed “that small clique in the BMA” for grossly misleading the medical profession, and described the Tory position as “utterly puerile”. No Liberal, he said, “wants to see a state-salaried medical service”.
Dr Stephen Taylor, a physician and Labour MP, summed up the central dilemma facing the BMA, which could apply as much to the organisation now as it did then: “The burden of their message ranges from emotional condemnation of the whole Act to admissions that much of the Act is good, except for four or five essential details.” Today’s BMA, having previously said it would consider supporting the Health and Social Care Bill with revisions, has signalled its “opposition to the whole bill”. Curiously, freedom from state direction mobilised the doctors against the government in 1948, but it is that which they seemingly oppose in 2011.
By his own later admission, Aneurin Bevan “stuffed their mouths with gold”, and in the process bound the medical profession so tightly that healthcare in Britain was altered forever. A generous state stipend and the fog of history conceal a once fiercely-cherished independence. It is only one aspect of the changes that occurred, but a no less crucial one.
Aneurin Bevan said in 1948: “We have never been able yet to appoint a minister of health with whom the BMA agreed.” As Andrew Lansley is finding to his extreme discomfort, we still haven’t.