Never one to avoid controversy, Aneurin Bevan knew from the start that his newly nationalised health service could work only with the full cooperation of the profession. Although a Gallup poll taken early in 1948 confirmed that the overwhelming majority of the public supported it, Bevan was enough of a pragmatist to realise that the doctors were another matter altogether - read Michael Foot's wonderful biography for a thrilling account.1

The merit award system was born of Bevan's recognition that to retain the services of the best, you must expect to pay. “Stuff their mouths with gold” was his simple yet effective prescription, a staggering volte face for an unflinchingly egalitarian Welshman. Effective? Highly, since most would agree that during the NHS's first half century one of its more remarkable features has been that the most outstanding individuals have indeed been attracted to staying within the service, usually working as consultants or University employees at large (generally teaching) hospitals.