Austerity Britain, 1945–51 (44 page)

Two days later, on 5 July, Attlee replied to his 11 worried backbenchers. ‘I think it would be a great mistake to take the emigration of this Jamaican party to the United Kingdom too seriously,’ he told them. ‘If our policy were to result in a great influx of undesirables, we might, however unwillingly, have to consider modifying it. But I would not be willing to consider that except on really compelling evidence, which I do not think exists at the present time.’
²⁵

12

A Change in the Terms of Struggle

Tuesday, 22 June may have been Windrush Day, but
Woman’s Hour
that afternoon had cricket on its agenda. ‘Yes, I’m one of the awful men you keep switching off,’ the cheery commentator Rex Alston told the listeners. ‘But please give me a chance this time. I won’t keep you more than five minutes – so don’t dash off into the kitchen and see if your cakes are burning. I promise you I won’t talk about silly mid-on and gully and maiden overs and all the other jargon that must perplex you. All the same, don’t tell me that, some time during the week, you won’t be bowled over, completely stumped, or even badly caught out!’ The occasion for this patronising guff was radio’s forthcoming coverage of the England versus Australia Test starting at Lord’s two days later. The outcome of the match itself was predictable. England as usual were captained by a well-meaning amateur (Yorkshire’s Norman Yardley), and Don Bradman’s ‘Invincibles’ won by the crushing margin of 409 runs.

On Tuesday the 29th, about an hour after the match had finished, the regular ‘What’s Your Worry?’ slot on
Woman’s Hour
featured the reassuring voice of Marion Cutler:

It’s hard to believe that next Monday will be the much talked about 5th July when both the Health Service and National Insurance Scheme come into force. So today I’ll try to clear up some of the points from your questions which have been worrying you – and sure I’m not surprised they worry you . . .

Lately many of you have written to say, ‘I’m over age – that’s over 60, and too old to join the National Insurance. Does that mean I won’t be able to get the free medical treatment and advice under the Health Service?’

No, indeed it doesn’t. Let me say once again, joining the National Insurance has nothing to do with what is offered by the Health Service. It doesn’t matter what your age is, whether you’re married or single, whether you’re rich or poor . . .

But I
was
told the other day of one thing that is causing a lot of delay and extra work in getting the Service going.

You know the form E.C.I. which many of you have filled up already and sent in to join the Health Service. In some districts nearly 80 out of every 100 have been returned with the answers to some of the questions left blank. Two spaces in particular – and two important ones – have been left just empty. One is you can’t remember, or haven’t been told to produce, your Identity Card number, and the other one is you’ve completely forgotten the day, month and year of your birth.

Well, we’ve often heard that
not
telling her age has been a woman’s weakness, and most of us hope it will be hidden in a birth certificate, or our marriage lines. But alas it has to go down on paper sometimes, and putting it on this Health Service Form is one of the times.

‘By next Monday,’ Cutler confidently declared, ‘it’s expected there will be over 14,500 doctors working in the Service, and if you want to you ought to be able to get on the list of one in your district before then – be able to enrol and be accepted as a patient.’
^1.

It had been a far from smooth ride to get to this point, with Aneurin Bevan engaged for two years in a fierce war with the British Medical Association (BMA). ‘The Act is part of the nationalization programme which is being steadily pursued by the Government,’ that body’s chairman, Dr Guy Dain, declared in November 1946, the day after the National Health Service Bill had received the Royal Assent. ‘What the Minister appears to have done is to have taken the Bill which we had partly fashioned and to have inserted into it the Socialist principles of State ownership of hospitals, direction of doctors, basic salary for doctors, and abolition of buying and selling of practices.’ In the event it required some concessions at the margins by Bevan, and no less than three plebiscites of GPs, before an adequate number of doctors were willing to enter the scheme.

Feelings undoubtedly ran high – ‘We have not fought and won a war against dictatorship only to submit to it disguised as democracy of the Soviet pattern,’ protested J. S. Laurie, a GP in Fitzwilliam, Yorkshire – but there were many doctors, often practising in poorer areas and not always well represented on the BMA, who positively looked forward to a national health service free at the point of delivery. One was probably Gladys Langford’s GP in Islington. ‘Despite all his trouble on my behalf he utterly refused to accept a fee,’ she gratefully noted in May 1948. Another was Mike Leigh’s father Abe, practising in Salford. ‘He always cursed his private patients and couldn’t wait to get rid of them,’ the film director recalled. ‘When the day came when he had no more private patients, that day was one of celebration as far as he was concerned. He also worked as a visiting factory doctor, mostly around Oldham.’ Even so, the more typical GP at this stage was possibly Dr R. P. Liston of Tunbridge Wells. At a BMA representative meeting barely a week before the NHS came into effect, a Scottish doctor argued that it might be necessary to form a trade union to protect the interests of doctors, given that ‘clearly we must protect ourselves against the forces of tyranny so latent in a state service’. Liston did not deny the point but insisted that a ‘Guild’ would be much preferable. For as he added, pressing every middle-class button in the room, ‘This word trade union sticks in our gullets.’
^2.

During the months leading up to 5 July 1948, there was a torrent of government propaganda – cartoon films, lectures, leaflets and pamphlets, travelling exhibitions, advertisements, broadcasts – explaining and justifying the new welfare arrangements. Press opposition came from predictable quarters, above all Beaverbrook’s
Daily
Express
, which loudly and insistently banged on that the whole exercise was a waste of taxpayer’s money. As for the new dispensation itself (involving a weekly deduction of 4s 11d from the wage-earner, of which only 8½d went to the new health service), there was also a negative note struck by parts of the local press, though more about the insurance than the health aspect. ‘The appointed day!’ declared the
Falkirk Herald
in its last issue before the 5th:

Not the day appointed for the annual exodus to coast or country, but the day on which the new National Insurance scheme comes into operation.

It will give Falkirk folk on holiday at the seaside something to think about, and the whelks and mussels may remind them that they will be called upon to ‘shell’ out some more of their hard-earned cash to purchase the much-vaunted cradle-to-the-grave security.

Among the weeklies, the
New Statesman
’s support was hardly surprising – ‘That we are doing this undismayed by debt and deficit, dubious international relations and an ageing population is a great tribute to the courage and resilience of our people’ – but more telling was the attitude of the tough-minded humorist (and Independent MP for Oxford University, in the last years of that seat), A. P. Herbert. ‘July 5th, 1948! Boys, this is going to be a big day,’ he began his weekly column in
Punch
at the end of June:

This column has, at last, obtained a ‘Family Guide’, with all those delightful Government owls [anthropomorphic drawings, presumably denoting wisdom]: and, being a comparatively elderly column [Herbert was 57], it has suddenly sprung into quite unexpected enthusiasm for the Whole Affair. It had been pretty lukewarm. Indeed, it had been wandering round trying to find out what were the penalties for non-cooperation (there is nothing about
them
in the Family Guide). ‘What,’ it had muttered darkly, ‘would happen if one
declined
to contribute – simply did not stick on the stamps?’ But, now that it has read the Family Guide, all that nonsense is ended. Listen, uncountable readers.

There followed from Herbert a broadly sympathetic examination of the new National Insurance arrangements.

But the real plus for the government, in terms of truly uncountable readers, was the sympathetic treatment given by the women’s magazines, owing something to personal cajolery by Bevan and other ministers. ‘They’re a happy family – 8½d a week isn’t much to pay to keep them healthy’ was
Woman
’s caption on 12 June to a photograph of a smiling quartet (the obligatory father, mother and two small children). And in the accompanying article, Norah Kingswood emphasised that readily available medical treatment under the NHS, free at the point of access, would soon put paid to the grumble she had recently overheard while waiting in the fish queue for her weekend kippers, that ‘We’ll be paying large sums of money each week and getting precious little back.’ At the top end of the market, even
Vogue
was onside. ‘The social conscience of the country has been growing steadily,’ noted its July issue. ‘Progress has been made under Liberal, Conservative and Labour governments. Now we are due to take another stride.’ The magazine’s editor, the Labour-sympathising Audrey Withers, then had words specifically for her well-heeled readers: ‘It has taken a long time to scotch the Class fallacy: to admit that rich and poor are “subject to the same diseases, healed by the same means” – and to ensure that lack of money shall not stand in the way of that healing.’
^3.

One element in society hostile – or at best ambivalent – to the July revolution was the Catholic Church. ‘It will be a sad day for England when charity becomes the affair of the State’ was the underlying view of Cardinal Bernard Griffin, Archbishop of Westminster; seemingly indifferent to larger questions of national welfare, he managed to negotiate the opting-out of Catholic hospitals from the new NHS. Public opinion as a whole was broadly if not overwhelmingly supportive: according to Gallup in March 1948, 61 per cent saw the NHS as a ‘good’ idea and only 13 per cent as ‘bad’. Nevertheless, the apparently mixed feelings of Marian Raynham in Surbiton were probably not unrepresentative. ‘Receive leaflet about National Health Service,’ she recorded in late April: ‘It seems medicine, teeth, glasses, hearing apparatus will all be free when July 5th comes, & after paying the insurance of 4 or 5 shillings. Robin is too young & Daddy too old & I am a housewife, so only Ray pays. What with old age pensions, 7/6 for Robin, free school milk & free hearing for Dad & free teeth for me & any new glasses free it seems a crazy world.’ Vere Hodgson was, perhaps befitting a voluntary welfare worker, still more sceptical. ‘It seems to be all right if we could afford it,’ she reflected on the eve of the NHS’s start. ‘It seems to me just Bankrupt Hospitals being taken over by a Bankrupt Country. You pass on the baby.’ Was there fear at this stage about welfare ‘scroungers’? It does not come through in the mainly middle-class diaries, but at the start of July the
Liverpool
Daily Post
made a front-page attack on ‘coloured’ stowaways on ships from South Africa who were coming to the city to ‘obtain employment, receive dole, a ration book and even free clothing’. And, in a pre-echo of much that lay ahead, the paper demanded that the law be changed, to enable deportation of British subjects and thereby ‘curtail the daily increasing numbers’ of the uninvited.
^4.

There was, by any objective assessment, a huge amount to be done. Earlier in the year, as part of her social-work course, Phyllis Noble spent some time in a Family Welfare Association office in Deptford. She recorded a visit to a poor Irish family living in one of the nearby slums:

To think such squalor can still exist! Surely I can never forget that smoke-filled room, the mouldy cabbage in the corner, the bowl with the dirty water on the bare boards, the toddler wandering about in threadbare shirt and no shoes. Nor the horror I felt when Mr Doyle said in his heavy Irish accent, but so
casually
, ‘There’s another behind you’ – and I turned and saw a pile of rags on the bare springs of the bed, and hidden in the rags a dirty, tiny baby.

Soon afterwards, a national survey was undertaken of more than 5,000 children, across the social classes, who had been born in the first week of March 1946. The findings were unsensational but important. Maternal efficiency was poorest on the part of the wives of unskilled manual workers, not least because they were often in poor health themselves; a two-year-old from such a family was already virtually an inch shorter than his or her counterpart from a professional and salaried family; there was almost double the relative probability of having had frequent colds over the previous winter; and it was only children of the self-employed who were taken less often by their mothers to child welfare centres.

In practice so much would depend upon ease of access – psychological as well as physical – to the new services. In May, following her Deptford experience, Phyllis Noble went as a student almoner to St Thomas’ Hospital. There, at the end of each interview with a patient, she was supposed to ask if the patient could make a donation to hospital funds and, as encouragement, to shake the small tin box that stood on her desk. But at last the much-awaited 5 July beckoned. ‘On the final days before the “Appointed Day” in Casualty we joyfully abandoned the little tin boxes,’ she recalled. ‘It was the symbolic new beginning of a health service that was intended to be free to all.’
^5.