In the Welfare State We’re In, James Bartholomew argues that there wasn’t a need for the NHS to begin with. His basic premise is that the pre-NHS health system work perfectly well and we shouldn’t have changed it.
Healthcare in Britain was very substantial and impressive prior to 1948. Even the Labour Party pamphlet, which recommended a “National Service for Health” in 1943, could find little to criticise. There is mention of only one waiting list, for “rheumatic diseases”. That implies that there were no waiting lists for all the other specialties and no waiting lists to see consultants. There was no mention of any shortage of doctors (which is so chronic now) or, indeed, of nurses. There was no complaint either, about the quality of care.
At the risk of stating the obvious, that was then and this is now. The public expectations of what the NHS can do has driven up demand exponentially. And the fact that there were no waiting lists was because, for the majority of the population, consulting a doctor was the last resort.
He also overlooks the fact that the population has increased. In 1931 the UK population was 46 million, it is now 60 million, a rise of 30 per cent. The life expectancy then for men was about 60, now it is nearer 80 with all the health implications that come with age.
It’s a bit like saying that the railways were reliable and ran on time in the 1930s, so we should never have got rid of steam trains. Or since Hitler and Mussolini made the trains run on time, perhaps we shouldn’t have joined in WWII.