Care was ‘luxury’ until Bevan plan
IT’S hard for many to imagine today but even the most basic healthcare in Britain was once a luxury not everyone could afford.
Before 1948, when Nye Bevan founded the NHS, patients faced an unequal healthcare system, where only the most affluent could access quality care. And hospitals, although free, were seen as places for the very poorest and carried the stigma of the workhouse.
In the late 19th century, women called “lady almoners” would assess the backgrounds of patients coming to voluntary and municipal hospitals, to decide if they could receive their treatment for free.
Some had to make a financial contribution, others, found to be too welloff, were told to find private treatment.
But with private doctors charging exorbitant fees, those who couldn’t afford to pay often lingered on long waiting lists.
Only the wealthiest had their own GP, while women frequently died during childbirth and every year thousands died of infectious diseases such as pneumonia, meningitis, tuberculosis, diphtheria and polio.
Many others would die awaiting treatment as waiting lists grew longer in the 1920s and 1930s.
In 1929, for instance, there were 2,800 women on the waiting list for gynaecology in Edinburgh alone.
Life expectancy for men was just 48 and even in the 1940s infant mortality – the number of children who died before their first birthday – was one in 20.
RAF veteran Harry Leslie Smith, who died in 2018, gave a revealing account of life before the welfare state.
His 10-year-old sister Marion died of tuberculosis in 1926 as their family couldn’t afford a doctor.
He said: “Affordable healthcare was out of reach for much of the population. A doctor’s visit could cost the equivalent of half a week’s wages, so most people relied on good fortune rather than medical advice to see them safely through an illness.
“Healthcare depended on your social status. The rich received timely treatment, the rest got the drippings.
“Because my parents could neither afford to see a consultant nor send my sister to a sanatorium, Marion’s TB spread and infected her spine, leaving her an invalid.” They eventually sent her to a workhouse, where she died a long and painful death.
Although chancellor Lloyd George introduced the National Health Insurance system in 1911, only those who paid into the scheme were covered, not family members.
By 1946, 21 million had access to a GP through National Insurance but this was only 40% of the population.
Other schemes began to be introduced such as community-owned mutual aid funds and medical clubs.
The less well-off could pay into these while times were good to receive access to a doctor and medicines but millions slipped through the net and social status still determined quality of care.
But the NHS changed all that and, for the first time, decent healthcare was made available for all – whatever their background or bank balance.
The rich received timely treatment, the rest got drippings
HARRY SMITH WHOSE SISTER DIED FROM TB