Aneurin Bevan: A Life in Five Chapters

Chapter 1 · Tredegar

The pit at thirteen, and the Medical Aid Society

1897 – 1919 · Tredegar · Monmouthshire

Aneurin Bevan was born in Tredegar in Monmouthshire in 1897, one of ten children of a miner, of whom several did not survive childhood. He had a severe stammer as a boy, was treated as slow at school and left at thirteen to work underground.

He read constantly and largely without guidance, in the Tredegar Workmen's Library — one of hundreds of institutions built and funded by miners out of their own wages — and he set out to defeat the stammer deliberately, by finding synonyms for words he could not begin and by practising. The result was a speaker whose sentences arrived in an unusual order because he was always a word ahead, choosing.

The institution that shaped his politics was the Tredegar Medical Aid Society. Miners paid a few pence a week from their wages, and the society employed doctors, a dentist, a chemist and nurses who treated members and their families without a charge at the point of use. It was not charity and it was not insurance sold for profit; it was a community buying its own medical care collectively.

He said afterwards, more than once, that all he had done in 1948 was Tredegarise the country. The National Health Service is a mining valley's arrangement, extended to fifty million people.

Why this matters

The NHS's model existed in one Welsh town before Bevan was old enough to vote, and he said so himself.

A library, a stammer and a medical aid society. What would you ask him?

Ask Bevan

• “How did the Tredegar Medical Aid Society actually work?”
• “How did you get rid of the stammer?”
• “What did the Workmen's Library give you?”
• “What was it like going underground at thirteen?”
• “Did you mean it when you said you had Tredegarised the country?”

Chapter 2 · The Making of a Speaker

Blacklisted, unemployed, and elected at thirty-two

1919 – 1939 · Tredegar · London · Ebbw Vale

Bevan won a scholarship from his union to the Central Labour College in London for two years, and came back to a coalfield in decline. He was blacklisted by the colliery company for union activity and was unemployed for a long period, living on his sister's earnings and his father's compensation — a period he referred to for the rest of his life when discussing what unemployment does to a person.

He was elected to the Tredegar Urban District Council, then the county council, and in 1929 to Parliament for Ebbw Vale, a seat he held until his death. He was thirty-two.

In the 1930s he was on the left of the Labour Party and frequently at odds with its leadership. He campaigned for a Popular Front with the Communists and others against fascism, and was expelled from the party in 1939 for it; he was readmitted later that year after accepting the party whip.

During the war he was one of the very few sustained critics of Churchill in the Commons, attacking the conduct of operations and the treatment of the coal industry at a time when criticism was widely regarded as disloyal. Churchill called him a squalid nuisance. He was, by common consent, one of the two or three best speakers in the House, and he never used a written text.

Why this matters

Bevan was unemployed, blacklisted and expelled from his own party before he held any office, and the experience of unemployment is the argument underneath everything he did.

Blacklisted, unemployed and expelled. What would you ask him?

Ask Bevan

• “What does long-term unemployment do to a person?”
• “Why campaign for a Popular Front when it cost you the whip?”
• “Why criticise Churchill during the war?”
• “Why never use a written speech?”
• “What did the Central Labour College teach you?”

Chapter 3 · The Act

One service, free at the point of use, out of taxation

1945 – 1946 · Whitehall · Westminster

Labour won the 1945 election and Attlee made Bevan Minister of Health, which then also covered housing. He was forty-seven and had never held office.

What existed before was a patchwork. The 1911 National Insurance scheme covered insured workers for a panel doctor, and generally not their wives and children. Hospitals were voluntary charities or local authority institutions, of very uneven quality, many of them close to insolvent. Whether you were treated depended on where you lived, what you earned and what you were insured for.

Bevan's National Health Service Act of 1946 made three choices, and the third was the contested one. The service would be comprehensive, covering general practice, hospitals, specialists, dentistry, ophthalmics and pharmacy. It would be free at the point of use, funded from general taxation rather than from insurance contributions. And the hospitals would be nationalised — taken from the voluntary bodies and the local authorities into a single national service.

That third decision was opposed inside the Labour Party as well as outside it, notably by Herbert Morrison, who wanted the hospitals left with local government. Bevan's argument was that local authority hospitals would perpetuate exactly the inequality between rich and poor areas that the service existed to remove.

The service opened on 5 July 1948.

Why this matters

Nationalising the hospitals was the contested choice, and Bevan won it inside his own party before he won it against the doctors.

Three choices, and the third argued inside his own party. What would you ask him?

Ask Bevan

• “Why fund it from taxation rather than insurance?”
• “Why nationalise the hospitals rather than leave them local?”
• “What was wrong with the 1911 scheme?”
• “Why include dentistry and spectacles at all?”
• “Was housing or health the harder half of your department?”

Chapter 4 · The Doctors

A profession that balloted against it, twice

1946 – 1948 · Westminster · BMA House

The British Medical Association opposed the Act. Its objections were partly professional — doctors feared becoming salaried state employees, losing clinical independence, and being directed where to practise — and partly financial, since general practitioners owned their practices as businesses and the value of those practices was at stake. The Association balloted its members twice and got large majorities against cooperating.

Bevan's public language was not conciliatory. In a speech at Manchester on 4 July 1948, the day before the service opened, he described the Conservative Party as lower than vermin, referring to the means test and the interwar years. It caused an enormous row, was quoted against Labour for a decade, and Attlee reprimanded him for it.

His negotiating position was more subtle than his speeches. He conceded the things that would let doctors accept the service without changing what it was: general practitioners would remain self-employed contractors rather than salaried employees, and consultants would be permitted to keep private patients and to use private beds in NHS hospitals. The private practice concession is what secured the consultants, and it is the origin of a feature of the NHS that has been argued about ever since. He is widely reported to have described the tactic in terms of having filled the consultants' mouths with gold; the phrase is not securely attested in a contemporary source, though the strategy it describes is.

On 5 July 1948 the service opened and the great majority of doctors joined it. Within a few weeks nearly the whole population had registered.

Why this matters

The NHS was created by conceding private practice to consultants and self-employment to GPs, and both concessions are still in the service.

A profession that balloted against it and joined it anyway. What would you ask him?

Ask Bevan

• “What were the doctors actually afraid of?”
• “Why let consultants keep private patients?”
• “Did the vermin speech make the negotiation harder?”
• “Why keep GPs as independent contractors?”
• “What would you have done if the doctors had refused?”

Chapter 5 · The Resignation

A shilling on a prescription, and a principle

1951 – 1960 · Westminster · Ebbw Vale

In 1951 the Attlee government, financing rearmament for the Korean War, introduced charges for spectacles and dentures in the NHS. The sums were small.

Bevan resigned from the government, and Harold Wilson and John Freeman resigned with him. His argument was that the principle of a service free at the point of use was the whole point of it, that once a charge existed it could be raised and extended without limit, and that a health service was being reduced to pay for weapons that would not be built in time to matter.

The resignation split the Labour Party for a decade into Bevanites and Gaitskellites, and the party lost the 1951 election and the two after it. Whether the split contributed to the defeats or merely accompanied them is argued.

He also moved on the party's other great question. At the 1957 conference he opposed unilateral nuclear disarmament, which his own supporters expected him to back, telling them that it would send a British Foreign Secretary naked into the conference chamber. Many of them never forgave him, and the speech is the clearest evidence that he was a politician rather than a symbol.

He became deputy leader of the party in 1959 and died of cancer in July 1960, at sixty-two.

He had held office for six years in a career of thirty-one, and in those six years he built the National Health Service and about a million homes.

Why this matters

Bevan resigned over a charge for spectacles because he judged that the principle of free treatment could not survive its first exception.

A shilling on a prescription and a resignation. What would you ask him?

Ask Bevan

• “Was resigning over such small charges proportionate?”
• “Were you right that a charge once made would grow?”
• “Why oppose unilateral disarmament in 1957?”
• “Did the Bevanite split cost Labour the 1950s?”
• “Six years in office out of thirty-one — was it enough?”

What Bevan changed

Bevan created the National Health Service: comprehensive, free at the point of use, funded from taxation, with the hospitals nationalised into a single service. He did it against the organised opposition of the medical profession, by conceding self-employment to general practitioners and private practice to consultants — concessions still in the service today. He also built around a million homes, and resigned four years later over charges for spectacles and dentures because he judged the principle could not survive its first exception.

A debate that continues

Were the concessions to the consultants the price of the NHS's existence or the source of its later problems? Both arguments have been made continuously since 1948.

Keep exploring — ask Bevan

• “Can a service be free at the point of use and unlimited in what it offers?”
• “Was it right to buy the doctors' cooperation with private practice?”
• “Does a principle survive its first exception?”

Related lives

• Edwin Chadwick — Wrong Theory, Right Drains
• Howard Florey — Define 'Responsible For' Before You Answer
• Florence Nightingale — The Lady with the Lamp

Related themes

The National Health Service · The welfare state · Medicine and the state