Health for All – Introduction

If someone discovered a universal panacea which would guarantee health for everyone throughout their lives he would be hailed as the greatest man on earth. Medical science has advanced to a point where cures for a very large number of diseases exist and where we can anticipate considerable advances in the near future, but as disease has many causes and many manifestations there is nothing in our present knowledge which would suggest that such a panacea will ever be discovered. In its absence all that can be looked for is an organisation of medical science in such a way that scientific advance is made with the greatest possible rapidity, and that any new discovery can be applied at once and made available to the whole population. There is now very general agreement that the advantages of modern medical science can only be placed at the service of every section of the community, and indeed of every nation in the world, by changes in the method of organising medical care.

There is, for example, the declaration of Mr. Ernest Brown as Minister of Health that the British Government has already decided, as part of its post-war policy, to so organise matters that a complete hospital service shall be at the service of every citizen who requires it. Working with a similar aim in view is the Nuffield Provincial Hospital Trust which has already declared as its object the provision of a chain of medical services for all those who require hospital treatment of any kind. Recognising the need of these changes, and faced with the efforts of many different organisations and interests to bring some order into the chaos of British medicine, the British Medical Association has also set up a Medical Planning Commission to which it has assigned the duty of examining the medical services of this country as they exist to-day, and of proposing changes to meet the probable position after the war. This Commission may, or may not, be able to analyse the situation with the clarity it requires, and to put forward suggestions for changes that will be recognised by everyone as just and necessary, because it is a body of considerable complexity and represents exclusively the medical profession itself.

Were it discussing what medical science can do, or might be expected to do in the future, there would be little doubt as to its suitability. What medical science can do is a technical problem and only in a few departments does it require the knowledge and services of those outside the medical world. What medical services may be expected to do is, however, a matter not only for doctors but also for administrators, for legislators and for every individual citizen. No one has attempted to put the case for a fully organised medical service in such a way that all these diverse interests may be reconciled and may be per­suaded to accept the one solution, and while it is too much to expect that one person may present the case so that all will accept it, this book is nevertheless an attempt to summarise what has been proposed and what changes those who have given time to the study of the question believe to be necessary: and to lay down the principles of a socialised medical service and to suggest an immediate, practical scheme.