Medicine And Books

The Health Services since the War: Volume II. Government and Health Care: British National Health Service 1958-1979

BMJ 1997; 314 doi: (Published 12 April 1997) Cite this as: BMJ 1997;314:1136
  1. Gordon Macpherson
  1. former deputy editor of the BMJ

    Charles Webster / Stationery Office, £85, pp 988 / ISBN 0 11 630963 6

    Maldistribution of resources, capital investment an urgent priority, poor administrative integration, and discontents about pay. Just another year in the life of the National Health Service. Not, however, 1997 but 1958, the year at which Charles Webster starts the second volume of his official history of the NHS.

    The author takes readers to 1979, a landmark year that saw widespread turbulence among NHS and other public sector staff, a disappointing royal commission review of the NHS, and the launch of the Thatcherite political revolution. Among the vast catalogue of complex events he covers are the first dramatic change in the service's structure–the 1974 reorganisation–as well as the root and branch reform of the social services and four royal commissions: on doctors' and dentists' pay, mental illness, medical education, and the NHS itself.

    Though 1979 proved to be the start of a long march to a market driven NHS, in that year the service was still recognisable as the one launched by Aneurin Bevan 31 years earlier. As Webster rightly observes, with direct taxation still the prime funding source and patients still benefiting from care free at the point of delivery, the health service remained unarguably a national one. But it still had deep seated organisational weaknesses, rooted in its mixed local government, voluntary hospital, …

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