The National Health Service Crisis, 1951 - Professor Vernon Bogdanor

ladies and gentlemen this is the first of a series of six lectures on post-war political crises and the remaining five lectures will be on the Suez Crisis of 1956 the economic crisis in 1976 which led to borrowing from the International Monetary Fund the Falklands War in 1982 at the exit from the European monetary system in 1992 and of course you might say the Iraq war in 2003 and I shall should add perhaps that I shall be delivering the lecture on the Iraq war whether or not the Chilcott support has appeared by the time of the lecture but today's lecture is on a crisis in the National Health Service in 1951 and the crisis was on what might seem a trivial matter on whether charges should be imposed on false teeth and spectacles so that patients should have to pay a half of the cost and you may well ask why waste time on such a trivial issue but it led to the resignation of two cabinet ministers and began a running battle between left and right in the labour party which probably kept out of office in the 1950s and perhaps continued until the time that Tony Blair became leader of the party in 1994 and perhaps even beyond some would say this battle continues even today so it had huge consequences for the Labor Party and I think it also had huge consequences for the National Health Service and the problems which were raised in 1951 I believe have not yet been resolved now the National Health Service Act was passed in 1946 and the service came into existence in 1948 and here is a short film showing the government's view of the Health Service followed by a disillusioned general practitioner talking about it this leaflet is coming through your letterbox one day soon or maybe you've already had your coffee read it carefully it tells you what the new National Health Service is and how you can use what it offers hospitals and specialist services medicines drugs and appliances care of the teeth care of the eyes maternity services home health services the new scheme starts on July the 5th but there's one thing you should do at once choose your doctor now that's most important study the leaflet then keep it bio you'll need it for reference the new national health service starts providing hospital and specialist services medicines drugs and appliances care of the teeth and eyes maternity services ask your doctor now if you look after you under the new scheme if he can't accept you ask at the post office for the address of the Executive Council will be given the names of other doctors in your area who are taking part in the new service ask the doctor you choose for an application form for each member of your family one form has to be filled in for each member of the family and then handed over to your doctor now then forget choose your doctor now there is a service which will provide the best medical advice and treatment for everyone every man woman and child in this country it will cover any medicines you may need specialist advice and of course hospital treatment whatever the Early's special care for mothers and children and a lot of other things besides in fact every kind of advice and treatment you may need now all the details are set out in this white paper and in a shorter pamphlet and you'll find there are the arrangement the government proposed for the doctors the hospitals the local authorities and so on not that how do you feel about this test me well no feeling and I think the feeling of most general practitioners is one of frustration and disillusionment we just will let down certain promises were made to us when we came in to the National Health Service in 1948 and they simply haven't been kept we are going to help to limit the developments in the way of extra staff extra equipment improving our premises which has been going on steadily since the Health Service began and in addition many of the particularly the younger general practitioners beginning to think about emigrating to other countries and I think this process will continue which is bound to affect the service well you can see that disillusionment with the National Health Service is nothing new it was there very early on now the minister who legislated for the National Health Service was an iron Bevin a man of a left and here about 10 years after the Health Service introduced in the late 50s we can hear him speaking explaining his vision of the National Health Service a vision that remains powerful even today we had to wait a long time for it what I had in mind when we organized a National Health Service in 1946 to 1950 agent remember when we did it you know you you younger ones this is immediately after the end of the Second World War when we were asked the Winston Churchill and said a bankrupt nation but nevertheless we did these things and there's no work in any nation in the world communist or capitalist in the health service to compare them now the National Health Service had two main principles underlining it what that the medical arts science is revealing should be made available to people when they needed them in short I refuse to accept the insurance prison I refuse to accept the principle and the National Health Service you repaid by contributions I first accept I accept it with nonsense if you happy free the main principles as you can see from what he said was that there should be free medical care to the entire population and it was the first such scheme in any Western country and as he said it was not to be based on the insurance principle but to be funded by the taxpayer and from no other source and Bevin as you see from that was very hostile to any contributory principle and the reason for that was as is implied by what he said that the Health Service was in part intended as a redistributive scheme to redistribute benefits from the better off to the less well-off and he said that the redistributed element was as important as the health element he said in debate in the House of Commons in 1958 the redistributed element of the scheme was one which attracted me almost as much as the therapeutical one Conservative MP shouted out more but Bevin said I am more civilized than that so free healthcare for Bevin was a basic right but in his view it also gave rise to duties on the part of those using the service those who benefited from the health service also had duties towards it to use the service responsibly not to abuse proprietary medicines to look after their health not to make extravagant demands on the service or overwhelm it with trivial and artificial complaints so this is also a fundamental part of the system for him that it should be used responsibly now the obvious problem with the health service from the time it was inaugurated with this but if it is free it is very difficult to control costs indeed you may say for something that's free demand is almost infinite but after all there have to be some budgetary constraints the Health Minister couldn't simply claim as much money as he wanted if the National Health Service were to be given a blank check other departments of government would suffer but they also had legitimate claims on the public purse education for example but as soon as the National Health Service came into operation there were problems over health spending because costs escalated more rapidly than expected in the first year there was a supplementary estimate for National Health Service of 59 million pounds which was nearly 30 percent of the original estimate and in March 1949 just a few months after the service began the chancellor of the exchequer systemic crips warned that supplementary must be rare and should only occur when there was a change of policy now Bevin said with some reason I think that the extra costs were a result of catch-up a result of the situation before the Health Service came to existence when many ill people have been unable to afford health care that was proved to be correct because spending on health care did stabilize during the 1950's nevertheless cabinet colleagues were understandably worried that their budgets were being squeezed and health seemed exempt now in March 1950 just our 18 months after the health service began Bevin pressed for a hundred million pounds supplementary estimate 37 percent of the original estimate for health service and that hundred million pounds was around half of the education budget the Public Accounts Committee said the free health service was leading to what it called a serious impairment of a system of parliamentary control and Cripps junior minister hew Gaitskell urged him to put national health spending like other spending under treasury control with a limit that meant economy's in the service or charges to patients but gait skill did not get his way there was a policy compromise because Bevin threatened resignation if there are any incursions in the free health service and the cabinet was not willing to accept the principle of charging the gait skill complained about that and said he thought politically cuts would have done us a lot of good now a compromise was agreed that there should be a ceiling on national health spending but a very generous one and the idea of charges for the health service should be deferred now in his budget of 1950 so Stafford Cripps said there was no excuse for exceeding the estimate in the coming 12 months that further measures of control must be exercised that any expansion in one part of the health service must in future be met by economies or by if necessary by contraction in other parts of the service so there was a ceiling on spending there have been a further move that in the autumn of 1949 Bevin had been forced to agree to legislation giving the government authority to impose charges for prescriptions with pensioners exempted now Bevin argued against fist saying that prescriptions had been free for insured workers since 1911 so those paying national insurance would now pay twice but he did pilot the Enabling build through the Commons and he admitted that there had been some abuse of the health service he's had in the commons I shudder to think of the ceaseless cascades of medicine pouring down British throats and they're not even bringing the bottles back and the charges that were intended to suppress unnecessary demand but with the exemption for pensioners they would actually yield a small sum and in fact the Labour government did not impose the charges they had authority to impose and they were not imposed but they were imposed by the Conservatives after their 1951 general election they imposed them in June 1952 so Bevin could still say there were in fact no charges but of course his opponents could say if you're prepared to accept prescription charges why won't you accept charges for false teeth and spectacles because after all most of those who need false teeth and spectacles by contrast with those who need medicines on prescription were not ill they were not patients they were not sick necessarily but Bevin said that charges were a matter of principle for him and in June 1950 he wrote the following letter to Crips he said I have made it clear to you the Prime Minister and Gaitskell that I consider the imposition of charges on any part of the health service raises issues of such seriousness and fundamental importance that I could never agree to it if it were decided by the government to impose them my resignation would immediately follow despite this spokesmen of the Treasury and you have not hesitated to press this so-called solution upon the government and Bevin had the point that the yields from charges given the administrative costs and exemptions would be very small and the exemptions he will particularly be particularly disliked because they reminded him of the hated means test of the 1930s when you had to prove but your income was below a certain level to get a benefit but still this does raise the question of what do you mean by a free health service in the sense that spectacles and false teeth are not linked to illness now at first it seemed that all this could be contained there was a good relationship between Bevin and Crips because both had been left wingers in the 1930s and Crips was known as the austerity Chancellor he was a teetotaler and vegetarian well suited to the age of rationing Hugh gates Gill in his diary writes about a new year party in 1949 Crips house he said to when there was no drink except sherry and apple juice and the meal was pretty foul and it's possible that there was a tacit bargain between Crips and Bevan that Crips would leave the health service alone if Bevin ensured that the left supported his austerity policies and no evidence of that was possible anyway they were closed from their struggles they were both on the Left in the nineteen thirties old Crips have moved to the right and Bevin hadn't and Herbert Morrison who was the Deputy Prime Minister wrote in his autobiography later on possibly for the sake of past loyalties Crips had been so tolerant of Bevins demands that his reaction was one a weakness especially as he'd been promised in Parliament to put a ceiling on the health expenditure Nye is getting away with murder was the general feeling of my colleagues now Crips junior minister gates Gill kept pressing for the health service we brought under proper control and Bevin had to endure a humiliation in April 1950 when a cabinet committee was set up chaired by the prime minister to control spending and Bevin said with some reason no doubt that the needs of the National Health Service were too great for economies there was gross overcrowding in hospitals particularly in mental hospitals maternity patients were discharged too early there were long waiting lists and congested outpatient departments long waits for appointments and that more money was needed for all these things in fact when the health services finances were investigated by a committees head up by the conservatives in the 1950s it concluded that the cost of the hospital service which was by far the largest share at that time of the NHS far larger than teeth in spectacles was basically stable and wasn't really out of control but that wasn't government's view now gates killed pressed crypts in 1954 something that even Margaret Thatcher dared did not dare to press for at least in public he pressed for there to be charges Hotel charges for hospital patients I says something that even Margaret Thatcher did not dare to propose that incidentally had been supported by beverage in his famous wartime report on the only perhaps characteristic grounds for him that you shouldn't be able to make a profit by being in hospital because in hospital your food was free of course if we were out of hospital he would be paying for your food so that was pressed on crypts by gates skill but unsuccess they even Margaret Thatcher death though that in public and they were supported by Herbert Morrison who thought that the free health service had gone too far he said in seeking to provide a comprehensive health service for all the government had been trying to do too much too quickly now Bevin defeated that and he said they in rather grandiloquent terms the government's abandonment of a free and comprehensive health service for all would be a shock to their supporters in this country and a grave disappointment to socialists opinion throughout the world now it seemed that the problem could be contained in the early 50s because the economy was improving shortages were disappearing and rationing was gradually coming to an end and in 1949 there'd been a famous bonfire of controls where ration books had been burnt by the relevant minister the balance of payments was in surplus and inflation was low due to the success of a voluntary incomes policy which had been agreed with the unions and it's possibly these things had continued and if Crips have stayed at the exchange but 1950 proved to be the year when everything went wrong firstly in February the Labour Party went to the country and its majority which had been a hundred and four 34 in 1945 was reduced to just six now David Cameron has a majority of 10 but he's quite safe because there are large number of parties against him that wasn't the case in 1950 the Conservatives had all the opposition seats except for 9 there were 6 liberals sorry except for 12 a bigger pond except for 12 there were 9 liberals just one woman now and three others so the Conservatives thought that they had the Labour government on the run and in Churchill's famous phrase one more heave would get the Socialists out it was clear that another election could not long be delayed and the Labour government was in effect immobilized in the worst possible position and one of its ministers said if only we'd won 10 more seats we would have had a working majority and could have gone on for five years with 10 fewer there had been a Conservative government on probation but as it was the government was immobilized it was held responsible by the public but could do very little and the Conservatives harried the government in the Commons with snap divisions and obstructions the government was in great danger of being defeated constantly even worse than that the ministers were exhausted there were many elderly men and they most have been in government since 1940 in a wartime coalition and in the second athle government after 1952 senior figures crips and Bevin resigned due to ill health and died shortly afterwards now after the election actly made a typical laconic statement after the first cabinet meeting I tried to get a long film but can't about the election the reports asked him what's happening he gave them the Connick statement we are carrying on that's all but it seemed to some particularly on the left that the Labour Party had lost its way where was it going the main program of nationalization had been carried out the main elements of welfare state were in play where should labour go now perhaps labor some people on the Left thought needed appear in opposition to recover its energies very significantly at the New Year party of crips with the awful drink and the awful food Gaitskell had predicted a low majority in the election and Bevin significantly said that with such a low majority I would rather not be in power at all because labour could make no further advances towards a socialist society better to reformulate socialist ideas from the opposition benches so that was the first problem the very narrow majority of the Labour government the second problem was at in June 1950 the Korean War broke out the North Koreans attacked South Korea we now know at Stalin's instigation and by chance the Soviet Union was boycotting the United Nations at the time so that 40 states accepted the American proposition that this required collected security and armed resistance to aggression and unlike the later Vietnam War Britain after some hesitation sent troops to fight in Korea their motive being in part to show they were not simply another European power but a great power the main ally of the United States and there was great fear of time the United States could revert to isolationism and people in Britain thought we must keep American Europe and of course there were memories of the failure of collective security in the 1930s and of us isolationism in the 1930s and at least said one could not ignore the risk that the u.s. might lose interest in the defense of Europe if her allies in the NATO failed to play their proper part and people very worried that Korea might be a feint for an attack on West Berlin or even on Yugoslavia which had broken away from the Soviet bloc and the West at that time had very few divisions in Europe the Soviet Union had very many now all this meant a crash rearmament program and this was agreed at 3,400 million pounds over three years but raised twice in response to American argument to four thousand seven hundred million pounds and defense was going to rise from eight percent of GNP in 1950 to fourteen percent with an immediate rise of fifty percent now the British hoped for American assistance and the President and Secretary of State said that they would do their best to get it but that's how often I think the British failed to realize that the American government had no automatic majority in Congress and couldn't guarantee that and Congress contrary to what some people in Britain think is not a charitable institution and said we've already given Marshall Aid on which the British welfare state has been built we really can't give any more money and they needed many Americans asked why they should be subsidizing the British welfare state and indeed Marshall age came to an end in December 1950 because of burdens on the Americans arising from their need to rearm and ironically because the British economy seemed to be improving and it's fair to say that Britain was at that time with American connivance discriminating against the dollar in some areas of activity now you might imagine the left would be opposed to all this to the Korean War in rearmament but they weren't because they too remembered what happened in the 1930s and Bevin said was absolutely right and his allies outside Parliament like Michael thought so exactly the same they said we must resist aggression in Korea and we have to accept a rearm program but Bevin thought the program was too ambitious and he wanted his opposition to the specific proposals recorded in the cabinet minutes the cabinet secretary couldn't do that because that would undermine collective solidarity and meant resignation so opposition was replaced by the words grave misgivings it's fair to say that other ministers also had grave misgivings but felt they ought to show the Americans that Britain was pulling its weight and the Labour Party conference in October 1950 accepted the rearmament program by a huge majority by thorn 3/4 million to 800,000 now the Korean War took a turn for the worse which really frightened people in November 1950 when it was discovered that Chinese so-called volunteers were fighting in Korea and there was great fear of a wider war and human President Truman and America was asked about the use of the atom bomb and said in cautiously there has always been active consideration of its use and the British were particularly worried about the American command and the field General MacArthur who seemed to be threatening China that the war might be carried into China and the British Secretary of State for war John Strachey said that war was possible in 1951 and probable in 1952 there was real fear and when he'd heard Truman's press conference Atlee went to visit him in Washington and on that very day there was a clear sign of American isolationism when 24 Republican senators said they did not want to defend Europe and Truman told actly that they thought a British prime minister was never to be trusted but Chiang kai-shek who's the ruler of Taiwan could do no wrong now there was a bargain that actually had to reassure America of British willingness to help and Truman said he would not use the atom bomb without consultation with Britain and that he would restrain general McArthur who was in fact sacked in 1951 ironically at the same time Bevin resigned from the government but in return the government as I've already implied accepted the increased rearmament program up to four thousand seven hundred million pounds in the next three years which imposed a great strain on the economy and the cabinet accepted that completion in and on time is dependent on an adequate supply of materials components and machine tools and Bevin later said these cautionary words have been added as a result of his pressure would the machine tools and the other materials be available at a cost that the country could afford now all this obviously meant pressure on other public services particularly social services and the National Health Service and the left-wing ministers in public like Bevin spoke in public in favor of the rearmament program even though in private they had these doubts and Harold Wilson who was to resign with Bevin said let those who profess to be united with us in their resistance to aggression recognize that this resistance involves high costs and great sacrifices for the people of this country let them recognize the real truth that the high cost of living is the high cost of peace so that was a second thing that went wrong the first thing was the small majority then the Korean War and then the third thing was that in October in 1950 so Stafford Cripps resigned from ill health and was succeeded by Hugh Gekko and this was resented by many of the ministers because Gaitskell was a new figure in the House of Commons who just come in in 1945 he'd been in the cabinet since 1947 Harold Wilson who was younger than gates Gill had nevertheless been in the cabinet from the beginning from 1945 Bevin had been in the caffeine in Parliament since 1929 he had much more parliamentary experience and gait skill although people thought highly of him in the inner circle of the cabinet had little support in the party and was relatively unknown to the wider public and Bevin protested in a letter to Ackley that Gaitskell had no roots in the labour movement and he wrote him saying I am bound to tell you that for my part I think the appointment of gates killed to be a great mistake I should have thought myself that it was essential to find out whether the holder of this great office would commend himself to the main elements and currents of opinion in the party now Bevin thought that the government was now dominated by elderly men who were completely exhausted and had nothing new to offer and ruthless men like Gaitskell with no commitment to socialism and Bevin I think felt that Crips have a right wing his policies might seem was basically a socialist but the gait skill was not and the gait skills on the right of the party and indeed it said that mr. Khrushchev and the Soviet leader later said about gait skill but he would be the first to be shot outside the houses of parliament as a traitor to the working class and of course there was also jealousy on the part of Bevin one can't discount that now Bevin had been at health for five years perhaps too long and he wanted promotion his demands of quite moderate actually he wanted the Colonial Office but athlete ought he was racially prejudiced and what he meant by that he was too Pro black and to anti white and will be unsympathetic to the whites in South Africa and Rhodesia so he didn't get that so Bevin was already annoyed at what happened and Harold Wilson was also annoyed because he liked Gaitskell was a professional economist and as I said he was younger than gates could but senior to him in government now gates Gill unlike Crips was committed to health charges in principle and indeed on the first day of his appointment unknown to Bevin he wrote to Ackley raising the questions of charges he was in favor of charges on principle and Bevin was against charges on principle so here you have a clash of principle and you may argue that they both lacked a sense of proportion but of course a power struggle was involved now when Bevin was eventually moved in January in 1951 he was moved to the Ministry of Labour and it's important to note that when the crisis overspending arose Bevin was no longer Minister of Health his replacement hillary Marquand was outside the cabinet and therefore in a weaker position to defend a health service and Bevin also was put in a rather difficult position of the Ministry of Labour because the main quality needed was to be a patient negotiator prepared to keep out of the limelight which wasn't really Bevin and the post was also very sensitive because it meant holding down wage claims and preventing strikes when living standards were constrained to pay for real mental now Bevin claimed that he only moved when athlete promised him there'd be no cats in the health service so there's no confirmation of that claim now in March 1951 there was a further change in the government when Ernest Bevin the Foreign Secretary resigned he died soon afterwards and replaced by Herbert Morrison so the two top positions in the government outside the Premiership were now taken by rivals of Bevin from the right of the party and I think at lead it'd not handle Bevin well he certainly deserved promotion after the great of the military success of getting the health service off the ground and Bevin at one point told active that he actually wanted the foreign office and a clear applied foreign office never led to the Premiership that wasn't quite true it did in the case of the Lord Rosebery but when he said the foreign office has never led to the Premiership Bevin said in that case give it to Herbert Morrison but there's no doubt that Bevin was resentful now to add to the problems in March and April when this crisis arose athle was ill with a duodenal ulcer and in hospital for some time and the key cabinet meetings were chaired by Herbert Morrison who was much more a figure on the right and a clue I think was rather better at holding a disparate group of individuals together but there had to be regular excursions into the hospital to get Atlas view of the crisis and he wasn't well now in February 1951 the new health secretary Hillary Marquand agreed to a ceiling of 393 million pounds on the Health Service this was raised the next month to compromise with Bevin to four hundred million pounds and that avoided the need for prescription charges now our gates kill said in his budget he wanted to increase old-age pensions but he couldn't increase the total social services budget that just wasn't the money he said and he said that meant charges he said the only alternative to charges was a cut in the hospital building program which no sensible Minister would have taken and Hillary Markland a new Health Minister agreed to that so Bevin was in a difficult position because the health secretary accepted the charges and Marquand said he didn't think the charges did infringe the principle of a free health service because those who required them were normally at work in a good state of general health it's a different matter to impose charges on people who are sick so false teeth and spectacles he said well ancillary serves is not crucial to the concept of a free NHS they've made it difficult for Bevin now gates gills secured cabinet support for his proposals a Bevin reserving his position and Harold Wilson also reserved it efficient Bevin said he was opposed to many things in the government he was opposed to rearmament he was opposed to the ceiling but prepared to accept them on the basis of cabinet responsibility to accept collective solidarity but charges were a resigning matter he said the charges were not to pay for pensions or hospital building but for a rearmament program which could not be carried out he was not opposed to rearmament in principle and he accepted the scale was a matter of political judgment that other people could take a different view so that wasn't resigning matter but charges were a matter of principle now in a speech to a rowdy audience of because he was Minister of Labour and he was being attacked from the fact that wage claims were being resisted at Bermondsey in 3rd of April he spoke I think in unplanned an emotional outburst he said I will never be a member of a government which makes charges on the National Health Service for patient seemingly categorical that left a loophole would part payment for charges on teeth and spectacles be a charge on the patient were people who needed false teeth and spectacle to really patients now Bevin suggested various compromises to delay the introduction of charges for 6 months by which time it would be clear well the program was realistic or to keep the ceiling of 400 million but see whether it could be achieved without charges gates Gill said this would give no assurance so necessary savings would be achieved and other ministers said the Cabinet Committee had considered already all practical alternatives and found the 400 million could not be achieved without charges now Ashley and Bevin then went to see Ashley in hospital and the doctors who were treating Atlee said he should be spared worry it was difficult to imagine anything less like he despair him worried from the visit by Bevin and Wilson in hospital but at least said there must be given taking budgets no one can say any particular estimate sacrosanct unusual for a minister to resign on a budget only one he could remember when Randolph Churchill in 1886 his political career never recovered he said must think of the movement not yourself Christ at this moment sheer start following electoral conditions party divided smashed voters would say we can't govern Tories in for 10 years Bevin would have done it we must stand by trumps of the Exchequer as cabinet decided with p.m. in the chair now Ashley then told Morrison who visited in hospital there was a danger of split after such a debarked of the Conservatives might remain in office for a long period he said 10 years he underestimated that by 3 years 30 gates can had another supporter when he spoke to the king about his budget Windsor Castle he was invited to stay as I gather Prime Minister's Chancellor's are appalled about you discuss it with the king in Georgia six and stay overnight and the King first asked whether his his budget would really be true too awful and gates cuz wife said I don't think so he was very right-wing you know which the king found surprising he actually the king actually rather got on well with an Irene Bevan because both had surmounted it as a difficult stammer he rather liked and are in Bevin but on this issue he said two gates kill he must be mad to resign over a thing like that I really don't see why people should have false teeth free anymore than they have shoes free waving his feet at me as he said it and Gaitskell had another support have perhaps more surprising it was Tony Benn now Tony Benn had been returned as a new MP at a by-election in Bristol in nineteen fifty and he wrote in his diary on the question of principle of a free health service it is nonsense this is not a matter of principle but on the contrary it is a practical matter there is only one test we can apply and it is an overall one with what we have and can get by way of revenue how can we lay it the best advantage of those who need it most so he support engaged now engaged skill announced his budget he first announced an increase in in in pensions but that was almost the only good news because he said he had to make drastic changes because of the rearmament program and he said half the cost would come from economies and half from increased taxation indeed the main theme of the budget was increased taxation but redistributed in profits tax purchased tax on a huge range of goods petrol tax income tax up six months and the charges which he said would raise 30 million for the rest of the financial year and 23 million in Apulia he said children be exempt also expectant to nursing mothers and a sick and those in hardship would be reimbursed from national assistance Gates go rather added fuel to the flames by saying even if he had the 23 million he would use it not for the health service but for family allowances and old-age pensions and when Ashley heard all this he said to gates go well we should not get many votes out of this The Times commented who may think rolla typically mr. gates Gill seems to have resisted most of the temptations which beset a socialist Chancellor of the Exchequer but it's fair to say that Gaitskell did resist drastic cuts in Social Services which some conservative were calling for and the main fiscal burden of rearmament would fall on the better off his budget speech with well argued and popular and one great plaudits and one conservative newspaper said he rose a comparative tyro and sat down an acknowledged star now our bevin resigned and in his resignation letter he said the budget in my view is wrongly conceived in that it fails to apportion fairly the burdens of expenditure as between different social classes it is wrong because it is based on a scale of military expenditure in the coming year which is physically unattainable without grave extravagance in its spending it is wrong because it is the beginning of the destruction of the social services in which labour has taken a special pride in which were giving Britain the moral leadership of the world and he made a resignation statement in Parliament it was preceded ironically by a question from a Welsh parliamentary question where Welsh and Labour MP later to become Speaker George Thomas about the dangers of straying sheep in South Wales now most of the resignation statement was concerned with defense spending in which he said the economy couldn't sustain so rapid an expansion of defense spending because the raw materials machine tools and components would not be available so the assumptions in the budget were mistaken but he said even if it was possible and this was his second point it was undesirable because it was a threat to the social services and particularly the Health Service and it was unnecessary to do that and he said by undermining these services the West would actually be weakened in the Cold War and not strengthened so it was a protest against the budget as a whole not just national health charges we have allowed ourselves to be dragged too far he said behind the wheels of American diplomacy and he said once you abandon the principle of free health service and what is to be squeezed out next year where do you stop the health service will be like lavinia for lips cut off and eventually her tongue cut out - that was a reference to Shakespeare's play Titus Andronicus Bevin very well read Shakespeare and I suspect most Tory MPs didn't get the illusion but it was an allusion to Shakespeare and he also Bevin rather discredited himself in the resignation statement by making a personal attack on Gaitskell and that was thought to be bad form because you cannot reply to a personal statement in the Commons of resignation statement and it was a poor and misjudged speech which lost him sympathy and ill-tempered and brought out personal resentment of gait skill and things were much worse when he spoke later to a parliamentary Labour Party meeting when he spoke endlessly of my health service and Tony Benn wrote in his diary he shook with rage and screamed shaking and pointing and pivoting his body back and forth on his heels his hair came down his eyes blazed and I thought he would either hit someone or collapse with a fit the megalomania and neuroses and hatred and jealousy astound us all and to to heed the Home Secretary said it reminded him of Mosley now it's fair to say probably the main reason for the resignation well that Bevin was getting out of sympathy with colleagues labour with its narrow majority thought could no longer advance socialism it had nothing to gain by remaining in office and perhaps opposition would be better and he himself certainly felt he could serve the cause better out of office to advocate social solutions he said in cabinet the cabinets had taken many decisions which you had not wholly approved but when it became clear that these represents love preponderantly you in the cabinet he had been prepared to take his share of responsibility for them but lately he had come to feel that he could bring more influence to bear on government policy from outside the cabinet than he could ever hope to exercise within it and when a minister reached that position it was time for him to go now Harold Wilson made a much more successful speech which gained him much lauded he said the rearmament program was not practical it would disrupt the economy and threaten the social services he said that gave skill had erected a technical detail into a point of principle nevertheless the majority in the Labour Party favored the charges however as it happened Bevin and Wilson were proved right the rearmament program could not be carried out the necessary raw materials and machine tools they said were not available and the costs of those that were available was so high that Britain rammed the balance of payments difficulties the program was scaled down by the Conservative government after 1951 down from four thousand seven hundred million to four thousand to 79 million and only three thousand 378 million of that was actually spent and Churchill said perhaps rather churlish Lee about Bevin that he happened to be right and he said I was giving the right honourable gentleman an honorable mention for having it appears by accident perhaps not for the best of motives happen to be right now against guilt argument was that even if the program can't be carried out and he was perfectly well aware my you might not be able to carry it out Britain had to be seen to make the effort to tell the Americans we were pulling our weight but difficulty with this argument was that a phantom program meant real sacrifices in public spending which the Left opposed now the committee which the Conservatives set out which reported on the health service in 1955 said the charges brought in so little money they weren't worth it it said that any charge that there is widespread extravagance in the health service whether in respect of the spending of money or the use of manpower is not borne out by our evidence they said there was little room for reducing spending in the Health Service but on some matters like Hospital capital spending more he'll be spent it said on charges no convincing case has been made out for the imposition of new charges and they're on existing charges high priority should be given to modifying them as soon as other conditions permit so to remove the deterrent effect in cases of real need and they said that the country would not be in a position to provide a fully comprehensive health service in the foreseeable future whether it was provided free or otherwise unless much more was spent on it now of course all this was bound up with the leadership question and some argued that Gaitskell was deliberately trying to ruin a leadership rival he knew that charges were a resigning matter and if Gates Co could defeat Bevin he would be in a strong position to become leader of Labour Party as indeed he did when Ackley retired in 1955 now there are partisans on both sides of the debate and actly rather blame Morrison as a right-wing decorative prime minister for losing him to ministers but my own view for what it is worth is that actly himself was largely to blame firstly he did not promote Bevin which Bevin was entitled to and secondly he should have told gates good as an early stage but whatever the pros and cons of charges they could not be introduced by a government with the majority of just six and he should have told gates killed not to be silly this is a new young chancellor who wasn't going to resigned and a matter raising such an issue of principle should not be raised with the government with the majority of six instead athle allow both sides to take up in 20 positions from which they would not move and I think actly who was for a long time underestimated as perhaps now overestimated first he was not a good chooser of ministers they did not handle Bevin well and he left him Restless and under occupied while concerning the general sense of a government of old men staggering on without initiative or imagination was Bevin was by far the best debater in the Commons and his seniority and abilities deserve promotion and I think a CLE failed to give a lead to avoid the crisis he waited until people have taken up in trendy now I want to conclude by talking about the consequences first for the Labour Party and second for the health service now for the first time since the war after Bevins resignation the left had someone who could plausibly seem be seen as a leader Bevin and Atlee wrote to his brother we are in for a good deal of bother with Nye Bevin too much ego in his cosmos and there was this great self belief and tremendous emotional outburst which Bevin appreciated that he appreciate he was volatile at a young socialist conference shortly afterwards a young socialist speaker was reduced to tears because the loudspeaker failed he couldn't be heard and Bevin reassured him and said I would say to my young friend do not worry that the loudspeaker failed if it had only failed more often when I was speaking I would not be in the difficulties I am in now the government limped on until October 1951 when Ashley went to the country and labor did much better than expected people at assume the Tories would win a large majority they didn't at the time of the resignations the Conservatives were 12% ahead in the opinion polls now they've actually gained more votes from the Conservatives but they lost the election the Conservatives had an overall majority of 17 just enough to go on for five years and the concern is then benefited from the economic boom in the 1950s to win two more elections in 1955 and 59 and this raises the interesting question had Bevin not resigned exposing divisions in the party might not labour have won Tony Benn thought that he said without gait skills budget and the resignation I doubt we would have lost the general election of that year now if Labour had won or if they could have held on to a better economic conditions of 1952 they almost certainly would have won and had labour won they would have been the beneficiaries of a long boom of the 1950s and they would have been added able to establish what Devon wanted a social democratic state perhaps like that of the Scandinavian countries as it was the crisis seemed to show that labour was the party of economic crisis and muddle and because the economy improved under the Conservatives they gained a reputation for economic competence which may not have been wholly deserved then the effect on personalities the conflict made Hugh Gates kill the Evening Standard said the Chancellor made a speech so pleasing and so must Lee it is clear he's a new force in politics he became leader in 1955 who was the only Labour leader before Jeremy Corbyn to be elected with an overall majority on the first ballot at that time I should say only MPs voted and gates Gil got 157 votes Bevin got 70 and Herbert Morrison who was a spent force by now just 40 now at Lee and ironically also gates Gill had predicted that Bevin would be the leader indeed in the late 1940s at least said he actually favoured Bevin as successor which makes all the more inexplicable his failure to promote him but Bevin threw leaves away with what seemed volatile and self-centered behavior after his resignation ironically after gates kills death his widow said you know I never really believed that Hugh was the natural leader of the Labour Party the really natural leader was Nye he ought to have been leader not Hugh but neither aways chance it wasn't Hugh who sort of who should have led the party it was nigh but neither gate skill nor Bevin were ever to hold office again and both died prematurely Bevin in 1960 and gates killed in 1963 Labour Party I think could ill afford to lose either to lose both was a major tragedy for the country was a major tragedy for the party certainly and arguably for the country as well and perhaps one of them would have been the great peacetime leader that Britain was seeking in the post-war years arguably they had complementary qualities and the party in the country needed both instead the country got neither the real beneficiary turned out to be Harold Wilson who had no popular constituency before his resignation he was almost unknown in the country now he appeared a man of a left and the left became his Praetorian Guard and he was elected Labour leader on gates killed death in 1963 became prime minister in 1964 and again in 1974 now the Gaitskell know Wilson were thought of as leaders before 1951 our Bevins resignation began a civil war which lasted throughout the 1950s gates kill said it is really a fight for the soul of a Labour Party he said I am afraid that if Bevin winds will be out of power for years and years and the party was in fact out of power though Bevin didn't win and almost certainly one of the reasons why it lost the elections of 1955 and 59 with the infighting but labour wasted its time then as they have often since fighting with each other rather than the concern and it reflected something wrong with a Labour Party where was it going at least seem to offer no vision or inspiration only a few ad hoc proposals labour needs a new philosophy gait skill no doubt was a good economist that wasn't something more needed a program of radical reform for a party of the left inspiration and vision could that be supplied by Bevin or was his particular socialist vision now outdated this was a problem that has bedeviled labor for many years perhaps until Tony Blair's new labour perhaps still not resolved so these large consequences of the Labour Party followed from the seemingly trivial argued about 14 and spectacle now the problem for the health service shown up in 1951 an unlimited demand but limited funding mask to some extending the immediate post-war period because the person on average income paid much less income tax from now so there was less resistance to higher taxation perhaps also there was a stronger collective feeling feeding of collective solidarity and now Bevin said the rich ought to be very grateful to be asked to contribute to the health service to help those less well-off than themselves which isn't something I think politicians would say now now a recent report by the Commonwealth Fund has said that the health National Health Service is the world's best health system if you use the criteria of equity safety and access but it's less good in terms of outcomes for patients its second bottom on the systems have studied or mortality and mean able to healthcare that is keeping people alive and today by contrast with 1951 when Gaitskell raised direct taxation the major parties believe the voters will not support higher direct taxation and labour has believed this since 1992 when it was defeated after proposing higher taxes to pay for the health service now Bevin said the service must be funded from taxation from no other source neither insurance nor privately part of his socialist philosophy and his rather idealistic view was that socialism would create a new sense of moral obligation and society to replace the obligation of acquisitiveness which characterized capitalist society and in a lecture to the Fabian Society in 1950 he shocked people by calling for a new kind of authoritarian society and after the gasps he said a society in which the authority of moral purpose is freely undertaken now in the late 1950s Bev and I think realizes was not happening the lure of consumer goods an immediate satisfaction was too strong he called the affluent society a meritorious Society and said said of the working class to a friend in 1959 history gave them their chance and they didn't take it now it is probably too late if you think he had a false view of human nature but too idealistic perhaps is a conception of the health service based on that view still viable or did he to turn a principle into a dogma a religion even Nigel Lawson the conservative Chancellor said in his memoirs written in 1993 the health service is the closest thing the English have to a religion with those who practice in it regarding themselves as a priesthood this made it quite extraordinary difficult to reform because so higher proportion comes from the state it is very difficult to reform and the financial times an Iranian Singh article last Friday said when the Health Service was founded the largest expenditure came from single episodes of infectious disease now its problems of a an aging population and long-term illnesses caused by poor lifestyles diabetes now consumes 10% of the health service annual budget of 116 billion pounds Bevins hope the public would feel a sense of obligation to keep their health in order is not fully realized many people do not clearly take enough care of their health obesity alcoholism so on and it's been said the health services faced a funding gap of 30 billion pounds a year by 2020 where is it to get the money now some would say that Bevins idea of a free health service based solely on taxation has actually restricted spending on the health service by making illegitimate to seek other source of revenue when people will not pay higher taxation but gates Gill was also mistaken that user charges have been shown to be counterproductive that they raise compared to original revenue since they did tear people from seeking care early on so perhaps and may not say much money and may worsen health outcomes some argue the social health insurance systems of Netherlands Germany and Switzerland system of private insurance but the compulsory insurance system and on the continent a continuation in some ways of a lloyd-george system in Britain of 1911 there there are it's fair to say indications that Lloyd George thought his system was better preliminary to the Bevin system of pre health care which I think he would have favored Social Insurance some people say replaces political direction and a centralized service with greater choice for patients but present only the rich had that choice they can opt out of the national health service with social insurance public become purchasers of health care so providers become more responsive to patients they mean end to the nationalized provision which are now in Bevin favored but defenders of the system say it's actually adapted very well we've been able to cope with new medicines antibiotics ultrasound hip and knee replacement treatment for HIV radical new treatments for heart disease and various cancers defenders say we can continue to afford the system of free health care developed by Bevin and that is the right answer so this is a live debate on what you as members of the audience will have different views but I hope you'll agree that this debate began in 1951 and is still resonant today this debate which began on what seemed of trivial issue or whether one could charge users for half the cost of false teeth and spectacles thank you

Channel: Gresham College

Views: 23,273

Keywords: gresham, gresham lecture, gresham talk, gresham visiting professor, gresham college, gresham college lecture, gresham college talk, Professor, visiting professor, history, modern history, british history, european history, political history, politics, modern politics, party politics, parliamentary politics, parliament, labour, conservatives, gaitskell, bevan. wilson, NHS, health service, Health, doctors, junior doctors, hospitals, political crisis, post war

Id: DVwpzJw1vwo

Length: 64min 38sec (3878 seconds)

Published: Fri Sep 25 2015