The History of the NHS

The NHS has been a godsend to the British people since its introduction in 1948 – with the free healthcare it has provided ensuring hundreds of millions of people have been able to live longer and healthier lives.

Such is the impact of the scheme, a tribute was paid to it during the opening ceremony for the 2012 London Olympic Games – an honour reserved for only the most impactful and important moments in a host nation’s history through the ages.

But where did it all start and how far has it really come? Here is your quick guide to the history of the NHS.

NHS History Timeline

1948-1959

While the earliest calls for a “National Health Service” were made as far back as 1919, it wasn’t until July 5, 1948, that the system was introduced for the first time in earnest.

Aneurin Bevan, health secretary for the UK at the time, would drive through the first true free health system – having received royal assent for his new scheme in 1946.

Bevan faced a two-year battle with the BMA (British Medical Association), before finally getting them on board just a month prior to the date the NHS was scheduled to come into existence.

Initially, the service consisted of:

  • 14 regional hospital boards
  • 400 hospital management committees
  • GPs who were independent contractors
  • Maternity and child welfare clinics
  • Ambulance services

While prescription costs of a shilling were introduced in 1952 (initially scrapped in 1965, but then brought back from 1968 until present day – at a different rate), it was an affordable charge even for the poorest people in the country.

This new, free system could not have been better timed, with the 1950s bringing medical advances which would help humanity to better understand health as a concept.

  • 1953 – the discovery of DNA as the basis for all genetic structure. This would help people better understand diseases caused by defective genes
  • 1954 – smoking and cancer is linked for the first ever time
  • 1958 – Polio and Diphtheria vaccines launched

As medical knowledge advanced, the emergence of a free healthcare system for all would mean an entire nation suddenly found themselves able to afford to stay healthy under better professional care.

1960-69

With the 50s bringing a more thorough understanding of the genetic and biological structure of the human body, the 60s would see incredible medical advancements from a more practical sense.

Surgery had always been temperamental in the past, but with the knowledge of the human body primed, several ground-breaking procedures were successfully carried out:

  • 1960 – The first successful kidney transplant is carried out between two identical twins
  • 1961 – The contraceptive pill is introduced (initially just for married women, but eventually everyone in 1967)
  • 1962 – First full hip-replacement carried out successfully
  • 1967 – Abortion act is introduced to make the practice legal up to 28 weeks into a pregnancy
  • 1968 – Britain sees its first ever heart transplant

As well as these steps forward, new plans of action would be introduced to try and ensure the continued development of the NHS system itself.

1962 would initially see Enoch Powell introduce a three-part hospital separation (splitting it into hospitals, general practices and local health authorities).

While this provided nurses and doctors with a better future, it also massively underestimated the costs which walked hand-in-hand with its introduction.

The 1968 Salmon Report would highlight measures to not only ensure nurses were better trained, but make the three-part separation viable.

1970-79

The 1970s didn’t drastically change in the NHS’s core system, but did see the three-part system reduced down to two, with the amalgamation of hospitals and local authorities in 1974.

This era would also beckon the realisation the NHS wasn’t going to glide along without any monetary concerns as had been previously expected.

Frugal usage of money suddenly became the call of the day, with efficiency championed ahead of the gross expenditure of funds.

Medical advancements would naturally continue, with several first-time events continuing to occur:

  • 1972 – CT scans change the way doctors view and assess the human body
  • 1975 – endorphins discovered, which are able to control pain and pleasure in the brain
  • 1978 – Louise Brown, the first ever test tube baby, is born on July 25
  • 1979 – first ever bone marrow transplant of a child takes place

Ultimately, this decade would see the continued growth of the service, with minor changes set up to ensure the financial future of free healthcare in the UK.

1980-89

If there was ever a period where the NHS faced a genuine risk, it was the 80s. Margaret Thatcher championed the privatisation of most services in the country when she rose to power – and it was feared the national health service would fall under the same remit.

However, in 1982 Thatcher would state the NHS was “safe in our hands”, with the Conservative government deciding this was one public sector which needn’t be touched, owing to its continued success.

While success would continue on this front, the discovery of AIDS would pose a new hurdle for the medical world to tackle. The disease was deadly and had spread quickly owing to a lack of basic knowledge.

The Black Report also highlighted a significant disproportion between the average age of death for poor people, when compared to the wealthy. The 1987 Whitehead Report would also draw the same conclusion.

Medical advancements included:

  • 1981 – improved health and survival rates for babies since vaccinations had been introduced
  • 1985 – Britain’s youngest liver transplant patient at age two
  • 1987 – the first heart, liver and lung transplant on the same patient
  • 1988 – the introduction of routine breast scans (mammograms) to battle cancer

Keyhole surgery was also be brought in for the first time – delicate procedures carried out through tiny gaps in the skin, using telescopic rods fitted with fibre-optic cables.

1990-1999

Administrational changes aplenty would strike in the 1990s, with several new reforms changing the face of the NHS forever:

  • Community Care Act (1990) – health authorities were given the power to manage their own budgets – becoming NHS trusts
  • 57 NHS trusts established (1991) – these are set up for the first time
  • Organ Donor Register introduced (1994) – a new system is put in place, allowing the organs of people who have died (and registered to this scheme) to be used again for transplants
  • NHS Direct launched (1998) – an electronic service where trained nurses were able to supply people with 24/7 medical support and advice

The dawning of a new technological boom would go a long way to aiding the introduction of NHS Direct – a service which would run until 2014, when it was replaced by the slightly more upgraded NHS 111 system.

With budget management splintering off at the start of the decade, individual services would be able to focus attention on areas which needed it – as opposed to worrying about being forced to spend certain funding in precise areas.

2000-2009

A bumper decade would follow in the noughties, with more new reforms and systems introduced than ever before.

The first, and debatably most important, came in 2000 with the introduction of walk-in clinics. These allowed people to receive medical attention immediately – even without an appointment.

Later that same year, the NHS Plan was introduced – a scheme with the intention to increase funding and reform the system in such a way service standards were increased across the board.

Other impactful changes in this 10-year period included:

  • Primary care trusts (2002) – Intended to liaise with the private medical sector and understand better the needs of a local community. Abolished in 2013
  • Pilot scheme for free choice (2002) – Patients facing a wait longer than 6 months given choice of going to an alternative provider
  • National Programme for IT (2002) – A developed IT system launched to bring the NHS into the modern age
  • Foundation trusts created (2004) – Handing local people the power to govern themselves and cut ties to the government
  • NHS health choice information website launched (2007) – Intended to make people more aware of health issues from their homes, without needing to call a practice or centre
  • Patients handed free choice (2008) – Patients allowed to choose from any hospital or clinic that meets NHS standards for their services
  • NHS Constitution (2009) – For the first time people are able to see what the NHS actually pledge to do, as well as what people can do to help the service
  • Care Quality Commission (2009) – Set up to regulate mental health and adult social care in the UK
  • NHS Health Checks (2009) – Everyone aged between 40 and 74 given an assessment to diagnose potential future conditions

Elsewhere, on a medical front, more advancements were made:

  • 2002 – Successful gene therapy to cure an 18-month-old of “bubble boy” disease
  • 2006 – Bowel cancer screening programme launched
  • 2006 – Babies vaccinated against pneumococcal meningitis
  • 2007 – Robotic arm makes conducting heart surgery much easier
  • 2009 – Act F.A.S.T. campaign introduced to battle strokes

As the new century dawned, the NHS continued to move in the right direction – but further changes would occur in the last six years which would take it along a completely new path.

2010-2016

The primary advancement to the core system of the NHS in this decade has come in the form of a 2013 reform known as “the new NHS”.

This saw NHS England – an independent body – strive to improve health outcomes for people in the country. The cause sees them using resources to provide the best possible standard of care for individuals, communities and general society, both now and in the future.

Councils began to promote public health, while clinical commissioning groups (made up of doctors, nurses and health professionals) buy services for patients to use.

An updated NHS Constitution would also be published, with improvements made in:

  • Patient involvement
  • Feedback
  • Duty of candour
  • End of life care
  • Integrated care
  • Complaints
  • Patient information
  • Staff rights, responsibilities and commitments
  • Dignity, respect and compassion

Artificial organs would also prove themselves a viable alternative, with both a pancreas and heart created using plastic – and successfully administered in 2011.

2013 was the first time a liver was taken from a body, kept alive, and then transported into another working body.

The Future?

As we’ve continued to grow and evolve as a society, the NHS has always kept up with us. That trend will no doubt continue into the future; as modern medicine looks to perform ‘miracles’.

With the advancements already being made, it wouldn’t be beyond the realms of fantasy to suggest cures for genetic conditions such as blindness may be around the corner.

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