Why a National Health Service? Chapter 6 1951-1964

THE NEXT PERIOD of the Socialist Medical Association history need not be given in so much detail since it deals with alteration in elements of a service which was now clearly being run on the principles laid down; and the chief effort of the Association became the protection of the National Health Service from the Tory administration that was now in charge of it. Toward the end of this period when Labour came back to power it found itself facing problems which could have been dealt with during that period but which had been neglected. The greatest of these was the failure to carry out a real programme of hospital building so that by 1960 it could still be said that Britain had no example of a large modern district hospital. Between inflation and the natural escalation of hospital costs more and more money had to be found, and was found, to maintain the health service but the capital programme was neglected.

The first sign of this, it must be conceded, began while Labour was in office. Aneurin Bevan left the Ministry of Health and was replaced by Hilary Marquand. Medicine Today and Tomorrow saw the significance of this change which, it said, was being hailed by opponents of the national health service, as a sign that ‘the revolutionary force of Aneurin Bevan appeared to have expended itself in the great effort of placing the National Health Service Act on the statute book’. What had been happening was that Bevan and his Ministry had been so busy with day-to-day administrative problems that no decisions on policy had been made in the previous year. The new Minister had therefore to recover the revolutionary spirit and make some big decisions for ‘if the service does not develop it will deteriorate’-and development to MTT meant that ‘either more money must be found or better ways of spending the health Service funds must be found’.

However, the SMA was to find itself more concerned with preserving the actual basis of the service, that it should be free at the time of use, than with getting more money than before. First the Labour Government, faced with a mounting financial crisis, imposed certain charges and ‘while it is clear that constituency Labour Parties will vote against this aspect of Government policy’ and while ‘so delicately poised is the financial stability of the average worker that even the price of dentures essential to health or spectacles essential to industrial efficiency may be more than can be afforded’, reactionaries would demand still further impositions. Indeed that was to happen within the year for Labour lost the General Election and a Tory Minister of Health brought in a charge on prescriptions which was to rouse the SMA to one of its greatest efforts.

Meantime there had been one very important change in the SMA itself. Stability among the officers had been difficult to achieve. The Honorary Secretaryship was held in turn by Dr Ian Gilliland, Mr T. C. Thomas and Dr Ida Fisher, while the position of General Secretary suffered many changes. Dr L. Ison succeeded Mr Harry Barst, who took up an appointment in the Sudan, as Honorary Treasurer. The Bulletin had many changes of Editor, Dr Gordon Signy holding the post for two years but it appeared spasmodically until, at the end of 1951, it was restored as part of MTT where it remained until at a later date that journal once again became the official journal and bulletin of the SMA.

The great change was the retirement of the President, Mr Somerville Hastings, MS, FRCS, MP. This was the 21st year of the SMA and therefore the 21st year for which he had been President and he considered the time had come to make way for someone else. No one in the Association agreed with him for he appeared as vigorous, courteous, attentive and knowledgeable as he had always done; but he was also MP for Barking, and at the age of 73 was finding all his public duties an increasing drain on his energy. The Association held a dinner in his honour in May 1951 and tried to express what he had meant to that body, to those who had known him personally, but above all what he had meant to the development of the national health service. Paying sufficient honour to such a man would be difficult in any circumstances but his own self effacing attitude, his remarkable identification of himself with any cause for which he fought, made it almost impossible to pay adequate tributes. He accepted them as he had done everything that had come his way in life, the sorrows and pleasures, as something a man had to do, for failure to do which he might be criticized, but for doing which he expected nothing.

His had been to that moment, and continued until his death in 1967, a remarkable life. His official obituaries detail his rise to consultant status as ear, nose and throat surgeon, at the Middlesex Hospital from his qualification in 1902 until his senior appointment. He was president of the Section of Otology of the Royal Society of Medicine, 1928-29 and continued at the Middlesex until his retirement in 1945. His political work is usually dated from 1923 when he won the parliamentary seat at Reading for the Labour Party but as we have seen, his work for a national health service had begun at least ten years before that. It was unfortunate that he lost Reading in 1924, for a continuous career in the House of Commons would greatly have increased his influence. As it was he had to wait till 1929 to be re-elected, lost Reading again in 1931 and did not return to Parliament until he won Barking in 1945 with the overwhelming majority of 18,911. He held that seat until he voluntarily gave it up in 1959. He was thus in the House of Commons to see the triumph of his life work when the National Health Service Act became law in 1946. At that moment, however, his proudest thought was that he was backed up by a team, inside and outside Parliament, who in their own unity of thought epitomized for him the team work he believed would change the whole course of medicine, as indeed it has.

That team was largely his own creation. He would himself have said that they would have come together somehow and had the same effect sometime without him but no one who was active in the Socialist Medical Association over that period would agree. He was remarkably sensitive to atmosphere and could himself make the right response at the right moment. He had always studied his brief, knew his agenda in every detail and was ready to guide the discussion, to reach whatever compromise promised progress, to undertake new responsibilities, to ‘skate over the thin ice’ if the political argument was tense, or to dig his toes in if a Minister, Labour or Tory, had to be opposed. He combined that ability to be master and servant which is the hallmark of the first class chairman. But, above all, he could put his ideas on paper in a logical and coherent way – and was ready to scrap the lot or change word by word as his committee desired. His treatment of memoranda prepared by others was exactly the same. They were examined in the most minute detail and if needing amendment were pencilled over with suggested alterations before he came to the meeting. It must be recalled that at the same time as he was paying this meticulous attention to SMA documents he was on the London County Council, on Labour Party committees, on a great variety of other bodies, and all of them had the benefit of the same careful attention to detail. When the health service came into being he was at once ready to serve on his Regional Hospital Board, Boards of Governors and other bodies and to see in practice so much that he had visualized in theory.

To the SMA, Somerville Hastings was, of course, more than a President. He was not only a founder member but provided the young association with its first meeting place, his own home in Devonshire Street, London, and provided hospitality to innumerable and interminable committees. His wife, Bessie, played the hostess with superb simplicity serving coffee to any size of gathering, knowing everyone and what was going on but seldom offering her own opinion. No one ever had any doubt as to the support Somerville had from her in every way.

Like all busy men working for great ideas Somerville Hastings had time for many different occupations and varied interests. His greatest was in botany, particularly the botany of the garden and above all of alpine plants. He wrote many books on these subjects as he did on medical and social matters throughout his long life. His firm basic belief in the need for a national health service kept him speculating on all the different ways in which such a service could be run and it was from his speculations that others took ideas and developed them. His own words supplied much that is now part of the health service: and stimulated others to develop and put theirs into practice.

The Association now appointed Dr David Stark Murray as President and he was at once confronted with many new problems both in the SMA and in the political arena. Dr Murray was son of a former Labour MP and had been engaged in political activity all his life, and as a medical student had already become interested in the need for a state medical service. By 1951 he also had, like Hastings, the experience of seeing some of his own ideas embodied in the health service. His two war time books, The Future of Medicine (Penguin) and Health for All (Gollancz) had set out proposals similar to those propounded by the SMA. But Murray had been the first person to suggest Group Laboratories and was now in control of one of the largest and best developed, serving the hospital groups in the area of Kingston-upon- Thames. He had been one of the first pathologists to set up an ‘open-access’ system (1937) which made all laboratory services available to the general practitioners; and had been able to push this along under the Emergency Hospital Service and to see it incorporated in the national health service. He had a firm belief in the GP and in the need for his close contact with specialist services and provided in the laboratory regular educational meetings for all the doctors in the area. Out of these came the Kingston Medical Centre, one of the first of the modern types of educational and social centres for the combined hospital medical staff and general practitioners now an accepted part of a district hospital.

The SMA at this point took up strongly the subject of Health Centres. The Summer 1951 issue of MTT carried an article by Dr Peter Roe discussing the need for the rapid development of health centres especially as the profession was now experimenting in group practice and was clearly becoming better prepared for health centre practice. The Autumn 1951 issue declared, ‘The NHS will fail – no matter how much money is spent on it – if Health Centres are not provided.’ This was an introduction to Get the Health Centres Going Now, a restatement by the SMA of the arguments for the immediate planning of permanent centres; but also suggesting how temporary buildings could be used and adapted. It was, however, to be many years before such a health centre programme was really to begin to provide an opportunity for ‘team work’ in a ‘cheerful and pleasant atmosphere’. The Association was soon involved in another General Election in which the SMA Members of Parliament all had stern battles.

In previous General Elections the SMA had not only supported its own members but had provided speakers and workers in many constituencies. The main activity was in issuing leaflets for free distribution at meetings and in the 1951 election 174,000 copies of the General Election Manifesto were issued. In later elections even greater efforts were made and since then the Association has maintained a General Election fund so as to have some money ready for this purpose. The SMA contingent in the House of Commons had been reduced to six but they were still able to make their mark in any debate on health matters.

With the beginning of 1952 it was decided that although Medicine Today and Tomorrow should remain semi independent it should in future contain the SMA Bulletin, and should be published every two months, and should be of twenty pages, thus giving space for much more news of SMA work. Many meetings were organized. At one, Drs Joules, Creak and Gilliland reported on a visit they had paid to the USSR and Dr Ida Fisher delivered fraternal greetings from health workers in Rumania which she had visited. A weekend school was held at Pasture Wood on a wide programme, including international affairs. Conferences on the Chronic Sick and on Health Centres were well attended. In June a National Conference was called by the SMA Tuberculosis Campaign Committee for this disease and indeed all chest diseases, was a subject on which SMA members felt very strongly and on which, since many were Tuberculosis Officers, they could speak with great authority. They were responsible, especially in South Wales, for enlightening the miners on the subject of pneumoconiosis, with subsequent improvement in the recognition of and compensation for that disease.

At this time the SMA lost one of its pioneers, Lord Addison, who had been in large measure responsible for seeing the National Health Service Bill through the House of Lords. Christopher Addison qualified in medicine in 1891 but after a few years became more and more interested in political questions and so was elected in 1910 as a Liberal MP. During the 1914-18 war he was Minister of Munitions: and when it was decided to form a Ministry of Health in 1919 he became the first Minister. It was he who set up the Dawson Committee but before he could implement its report, lost his seat in 1922. By now he was convinced that only the Labour Party would carry out the reforms he wanted and so he stood, and was elected, as a Labour MP. In 1937 he was elevated to the peerage and so was able to assist in the passage of the bill which in some way fulfilled his determination to see the condition of life and health placed on a sound foundation.

By March 1952 the SMA had a new and gigantic campaign in hand, a Petition against the Health Service charges introduced as soon as the Tories were returned to power. This was a campaign by meetings, advertisements and circularization which involved hundreds of volunteers. Nearly 90,000 petition forms were sent out and the whole country was roused. Local Labour Parties, Cooperative Political Parties, Trade Unions and SMA branches organized the collection of signatures and additional staff had to be employed to handle the petition forms. Dr Elizabeth Bunbury and the President’s wife Mrs Jean Murray, undertook the office organization while Dr Barnet Stross advised on parliamentary procedures and involved as many Labour MPs as possible in this activity. Protest meetings were held all over the country. To give the Petition the greatest possible impact it was decided to make the campaign a short one, only three months, and then the Petition forms were presented to Parliament. Drs Stark Murray, L. T. Hilliard, Elizabeth Bunbury and others took the bundles of forms with 211,577 signatures to the House of Commons where they were accepted by SMA Members of Parliament, Mr Somerville Hastings, Dr A. Broughton, Dr Barnet Stross and Mr Arthur Blenkinsop. Thousands more signatures were received after that date and nearly £1,500 was received in donations to pay for the campaign. The Petition was important; but of even greater importance was the enormous response which the SMA had been able to provoke from the whole working class movement.

The SMA was thus as active as it have ever been and recruited many new members. Dr Ida Fisher and Mr T. C. Thomas were sharing the secretarial duties, Dr Gordon Signy undertook to edit the Bulletin and Dr Donald Degenhardt acted as secretary to a reconstituted Policy Committee. Many subjects were noted on which policy had yet to be decided. The Editor of Medicine Today and Tomorrow took a pessimistic view of the immediate future. ‘It is clear,’ he wrote, ‘that Health Centres, an Industrial Health Service, proper arrangements for the aged and chronic sick, a prompt attack on tuberculosis and other advances depend on the early defeat of this present Conservative Government.’

His justified pessimism arose from remarks made by the then Minister of Health, Mr lain Macleod, at the opening of the first Health Centre, Woodbury Down, Stoke Newington. This was ‘a Comprehensive Health Centre at last’, and opened officially on October 14, 1952, by Mr Somerville Hastings MP, than whom ‘no man in Britain could have been considered more suitable for the job’. But the Minister of Health ‘tried to lessen the importance of the occasion’ which was natural in a bitter opponent of the health service who suddenly found himself in charge of a socialist idea. He was not satisfied ‘that the healing professions are quite sure in what sort of centre they want to work; nor do the public know in what sort of centre they would like to come to with all their different sorts of ailments’. MTT thought that ‘implicit in his speech was the prophecy that there are going to be very few health centres under this or any other Tory Government’, but the Editor cannot then have thought that the whole Health Centre programme would be held up for more than twelve years.

For the moment the SMA had to give most of its attention to the way in which Tory Governments were harming the health service, chiefly by financial restrictions. A new pamphlet, Hands off the Health Service was issued and conferences and weekend schools all took up that theme. Efforts were intensified to ensure that the Labour Party understood what was happening and what would have to be done when Labour returned to power. At the Annual Dinner in May 1954 the Rt Hon. Clement Attlee MP was the guest of honour and in his speech said he was aware ‘of the many faults and weaknesses in the present NHS but at least it was a beginning’. The Labour Party had to regard most of what it had done as only a first stage in reconstruction and ‘intended to press forward on this framework under the next Labour Government’.

At the Labour Party Annual Conference in the autumn this was emphasized by Miss Margaret Herbison who said ‘a new Government would undertake to bring about better integration of the Service and secure fairer representation on the various administrative bodies’. She also gave a firm pledge ‘that Labour on its return to power would abolish the pay-bed system’ .

The SMA had some difficulty at this time in finding honorary officers who could give enough time to get all the secretarial work done with the aid of the very hardworking secretaries who were being employed. So it was decided to appoint a General Secretary who could lighten the work of the Honorary Secretary, and Miss Audrey Jupp was chosen. At the annual conference Dr Sydney Gottlieb became Honorary Secretary. By that time the country was facing another General Election and the SMA threw itself into the campaign. A leaflet Forward or Retreat? was issued and a quarter of a million made available to local Labour Parties. When the Conservative Party won the election MTT voiced the SMA fear that reactionary policies would mean ‘medicine will be back on the market place and doctors will be back on two standard practice, in which the biggest purse will certainly get the quickest service even if it does not necessarily get the best’.

During this period the SMA held many meetings on various aspects of chest disease and had a very important influence, particularly as its specialist committees on the subject had members who were recognized authorities like Dr Richard Doll, Dr Horace Joules and Dr Francis Jarman. The dramatic incident of the killing London fog of December 1952 had given the whole subject enormous publicity. The ‘Clean Air and Healthy Lungs’ Committee issued a most valuable report which helped to build up public interest in clean air. As the evidence of the connection with cigarette smoking and lung cancer increased the SMA led the propaganda on the subject. At the same time pressure was kept up on the subject of occupational health services but little progress was made on a programme that would be accepted by both the Labour Party and the TUC.

During 1957 the SMA Honorary Secretaryship changed again when Dr Sydney Gottlieb had to resign. His place was taken by Dr David Kerr, another general practitioner, who gave the SMA five years service before becoming an MP. Activity throughout the country was intense and a weekend school at Oxford had a better attendance than the Association had known previously, the subject of ‘The Family Health Service’ being of wide appeal. At the Labour Party Annual Conference the SMA meeting was crowded and two excellent policy statements on ‘A New Deal for the Mentally Disordered’ were made by Dr S. Sharman and Mr Arthur Blenkinsop, MP. Mental Health now became one of the Association’s chief propaganda subjects, leading to important changes when next Labour was in power.

It will be readily understood that throughout its life the SMA had taken a close interest in health service developments in many countries but especially in the Soviet Union. Now there came an invitation from the Medical Workers Union of the USSR to send a delegation of SMA members both to meet the officials of that Union and to see something of the Soviet health services. Medicine Today and Tomorrow over the years had carried reports of visits by Dr Bunbury, Dr Len Crome and by Drs Joules, Gilliland and Signy, but this was the first suggestion of an official visit. As a result a five man delegation left for Moscow at the end of April 1958 and were back in time to report to the SMA Annual Conference. Dr D. Stark Murray led the team of Dr David Kerr, Mr T. C. Thomas, Mr H. Daile and Mr F. T. Ballard. They were received in a very friendly and generous manner and were able to give a very comprehensive report on medical care in the USSR. Above all they were able to demonstrate that medicine could cross frontiers that were still partly closed to other subjects.

The July 1957 issue (Vol 11, No 10) of Medicine Today and Tomorrow was a special one for it celebrated the first ten years of the NHS and 21 years of publication. A long editorial article covered much of the history we have given in these pages. Dr D. Stark Murray described the visit to Russia which was also the subject of a report by Dr David Kerr to the Annual Conference. A little later in the year Mrs Aileen Kerr and Dr John Atkins visited Rumania as guests of the Health Workers Union and reported back on the services they had seen. A year later, in May 1959, the Soviet Medical Workers Union sent a delegation to Britain and the SMA organized a programme for them. These two delegations established contact which, with occasional difficult moments, was to remain unbroken.

Once again the country faced a General Election and the SMA redoubled its efforts in favour of its members and issued nearly 300,000 of its special election leaflet. But the SMA candidates were not very successful, and Mr Somerville Hastings did not stand, so the SMA strength in the House of Commons was slightly reduced. However, the Association very quickly made its point of view clear in a resolution that the SMA adhered to ‘its belief in a fully socialized Health Service unimpaired by the election results’, but the fight ahead was still to be very difficult.

It was in the middle of 1960 that politics in Britain lost one of its great figures, Aneurin Bevan MP, former Minister of Health. The September issue of Medicine Today and Tomorrow (Vol 12, No 11) carried an appreciation of his work for health. He had, of course, made his mark in the widest of political fields but of all memorials to him, ‘the greatest and most lasting will be that he saw to it that the foundations of the NHS were so well constructed as to ensure that succeeding Governments, even if they had the will, could not destroy it’. Bevan was undoubtedly a great figure for ‘to have achieved greatness although a socialist and of humble origin’ was not only exceptional but comprehensible only to those who shared his attitudes. He knew he was not the architect of the health service for all the sketch plans and drawings had been done over the years by many people. Bevan’s greatness was that he was not the ‘man to be bound by the sketch plans of any architect’. ‘He had to get the building up and working not only in the shortest time but against the sabotage of vested interests.’ The SMA often disagreed with him ‘but never did they doubt his mastery of the subject, his determination to get the service going and his ability to make and stick by his decisions’. His biggest decision was undoubtedly his acceptance of the SMA view that ‘we must have one hospital system for the whole country’. Bevan’s view was, of course, coloured by his experience of the efforts of the Welsh miners to set up their own medical services. His second big decision was the abolition of the buying and selling of practices but he missed the chance to complete that part of taking medicine out of the market place by making all doctors whole time salaried officers. He could have done it, for the country was behind him, but the opposition persuaded him otherwise.

Of course, ‘Nye’ was accepted and admired by the working class movement for his extraordinary personal qualities. The SMA as a body had many opportunities to see him in action and to admire his knowledge of health matters in full detail and his masterly way of presenting or reporting a case. ‘Everyone lost arguments with Aneurin Bevan and sometimes lost them when time has shown they would have been the better won. But no one ever felt he lost to a man who was arguing ignorantly or idly.’ The Editor of MTT thought that one of the greatest bits of writing Bevan ever did was Clause I of the NHS Act, ‘the first completely socialist definition of any service ever to be passed by the Houses of Parliament’ .

Later he discussed this definition in his book In Place of Fear and gave two further versions, both typical of his own personal way of using the English language. ‘A free Health Service is a triumphant example,’ he said, ‘of collective action and public initiative applied to a segment of society where commercial principles are seen at their worst.’ He gave as examples of the triumphant collective action the supply of spectacles and hearing aids to great numbers of people who had never had a chance to see or hear properly. In the end he summarized the whole ethical, moral and socialist ideal in a memorable sentence. ‘The essence of a satisfactory health service is that the rich and the poor are treated alike, that poverty is not a disability and wealth is not advantaged.’

The year 1961 must have seemed likely to be a dull one in matters of health although the new Minister of Health, Mr Enoch Powell, was trying to make encouraging noises, and the Editor of MTT tried to liven it up with articles for and against boxing from two labour MPs, Mrs Bessie Braddock and Dr Edith Summerskill. This was a battle which went on for a long time without either side ever having a clear cut victory.

Early in the year, to everyone’s astonishment, Mr Enoch Powell not only came out in favour of developing the health service but proposed a capital programme for the rebuilding of hospitals which looked as if things might begin to move. Mr Enoch Powell was not to be in office long enough to get the programme really started but it created an atmosphere in favour of spending more money on buildings which at a later date gave Labour a good starting off point for what actually became a much bigger and better hospital building effort than Britain had ever had. The SMA, however, saw all this as no more than a facade and went on with its programme to force the NHS onwards to ever better standards. A campaign with the slogan ‘Defend and Extend the NHS’ was initiated, a pamphlet Hands off the Health Service was issued and large numbers were sold of a commemorative brochure Aneurin Bevan.

This new campaign made the Annual Conference of this year a very lively one. One subject that was in the forefront of discussion was the nationalization of the drug industry which the conference felt would be a better way of dealing with the high cost of drugs than by a charge on prescriptions. The Conference also passed two resolutions condemning cigarette smoking, a particularly telling speech being made by Miss Dorothy Keeling. These two subjects led to the setting up of a special committee (with Dr Horace Joules as Chairman and Mr T. C. Thomas as Secretary) to prepare evidence for the Pilkington Committee on Broadcasting. The SMA felt very strongly that advertising of tobacco and patent medicines by radio or television should be prohibited.

The SMA as we have noted had always taken a leading part in discussions about the dangers of bombing (in war time) of civilians, in the first place when high explosives and incendiaries were the weapons and then when atom bombs were used. Now it protested to both the USA and the USSR embassies about the testing of bombs which produced radio active fall-out. The SMA expressed surprise that the USSR tested such bombs within its own boundaries and appeared to ignore any hazard to its own population. The SMA, however was objecting to any and every test and demanded that the health of the world should be protected.

The Labour Party Annual Conference had not debated health questions for a year or two and probably for that reason health was given quite some time at the October 1961 conference. Dr David Kerr was the SMA delegate who moved a composite resolution on the abolition of charges in the health services and the taking into public ownership of all pharmaceutical, surgical and hospital industries. A second resolution calling for the abolition of pay-beds was also moved and many people spoke including the future Minister of Health, Mr Kenneth Robinson, MP. The SMA composite was carried unanimously but the second was very narrowly defeated on the plea of Mrs Bessie Braddock MP, that the hands of future Labour Governments should not be tied in this way.

The next two years were relatively quiet years politically for the Tory Government had lost all dynamism and the country was increasingly ready for change. The SMA felt that the Labour Party was not itself generating nearly enough energy for new policies and at both the National Conference of Labour Women in May 1962 and the Labour Party Conference, resolutions were put up, designed to reassert the basic principles of the health service. These gave two of the SMA’s younger members an opportunity to put the Association’s case and to indicate that the SMA was a force to be reckoned with in British politics. Dr Shirley Summerskill made her first major appearance for the SMA supporting a resolution calling for an extension of the NHS and stressed to the women’s conference the need for Health Centres and for an Occupational Health Service. Later in the year Dr John Dunwoody got unanimous support from the Labour Party Annual Conference at Brighton for a resolution mainly concerned with hospitals and indeed deploring ‘the inadequacy of the Tory Government’s ten year Hospital Plan’ and asking for increased capital spending to replace and improve decaying hospitals.

During the year the SMA suffered two more losses. The first, by resignation, was the loss of the General Secretary, Miss Audrey Jupp who had given eight years to the organization and had consolidated its work especially with associated organizations and Trade Unions. The second loss, by death, was a founder member Frederick Ballard. He had been the SMA guide in matters of dental care from the moment of its foundation and one of the most active and zestful members the Association ever had. His leadership was particularly valuable for it was based on the recognition by his own dental colleagues of his skill, integrity and knowledge. He had been a life long socialist and when he died in his eightieth year was still actively studying and advocating new ideas in dentistry.

The first weeks of 1963 were marred by the death of a younger but no less active and important member, Dr Sam Leff. Aged only 53 he was a man of such vigour, as MOH for Willesden, as a writer, as a lecturer on technical and political matters, that his death was a more than double blow. The SMA lost both a worker and an innovator who had contributed to everything the association undertook and the gap he left has never been adequately filled.

As in the previous year the SMA also had a grievous loss by resignation when Dr David Kerr ceased to be Honorary Secretary in order to devote more time to the constituency he was to fight and win in the next General Election. He had initiated many new ideas, both politically and in organization within the SMA but just because he gave so much time and energy to it he now found it was too much to be also a prospective parliamentary candidate. Dr J. Powell-Evans, a founder member took over the Honorary Secretary’s post and Dr Geoffrey Richman became a very active Assistant Honorary Secretary.

At the Labour Party Conference the atmosphere reflected the rising tide of support for a change of government and Dr John Dunwoody put a resolution to the meeting which it is worth reprinting as it restated the SMA case for extending the NHS. It read:

This Conference reaffirms its adherence to the principles upon which the National Health Service was based. No development during the past fifteen years has threatened their validity. Modern medical care of the highest standard can be provided only through a service freely available at the time of need to all citizens. The defects and deficiencies of the present National Health Service arise from the failure to realize the original plan in full and the deliberate policies of the Conservative Government to refuse the money necessary to bring all services up to modern standards.

Conference calls upon the next Labour Government to bring about the full Socialist development of the service; and in particular to :

  1. remove all existing charges to the patient and return to the principle of central exchequer responsibility for the cost of the service;
  2. encourage every improvement in the status, standards and conditions of work of the family doctor, especially by the rapid establishment of health centres and the provision of open access services where they do not already exist;
  3. increase immediately the money available for the maintenance of our hospitals, giving regional boards and management committees more freedom to improve their service within global allocations;
  4. publish and implement urgently a revised ten year plan for renewal and expansion of the hospital service, providing enough beds to meet existing needs and for hospitals large enough to provide economic units especially at the level of the district general hospital;
  5. accelerate the establishment of community care services for the mentally and physically handicapped and the elderly by facilitating capital expenditure on these projects by local health authorities and by expanding rapidly the training facilities for essential non medical staff in this field;
  6. reverse the growing application of essential resources of manpower and facilities to private ‘market place’ medicine and abolish pay-beds from National Health Service hospitals;
  7. establish within the National Health Service at an early date a system of occupational health care;
  8. give greater attention to all measures for the prevention of ill health;
  9. devote adequate sums to research;
  10. give urgent consideration to the integration of the different sections of the National Health Service,
  11. inspire the profession with the ideals of the National Health Service as a great social achievement still incompletely fulfilled.

There was a vigorous debate and John Dunwoody later reported that ‘concern about the extent of private practice today, the importance of improving the family doctor service and dissatisfaction with the administration of the NHS were recurrent themes in the speeches’. The National Executive Committee of the Labour Party accepted all of the resolution except paragraph (f) and Mr Anthony Greenwood said that NEC ‘did not believe pay-beds could be abolished ‘overnight but were determined to stop queue jumping’. They did, however, intend to see that empty pay-beds would be fully used by NHS patients and that whenever possible amenity beds would be substituted for pay-beds. For long term planning he promised that new hospitals would have more single rooms, available for all who needed them.

The year 1964 was given over very largely to General Election matters. Medicine Today and Tomorrow announced that nine SMA members, of whom only three were already MPs would be fighting when the election bid came: and published messages about the part the SMA and the NHS would play in such an election, from twenty members and prominent politicians. When the election did come, four leaflets were prepared and 600,000 were distributed, a colossal effort. When the election results were announced three new SMA Members of Parliament were elected, Dr David Kerr, Dr Maurice Miller and Dr Shirley Summerskill. But the SMA had much greater support in the House of Commons for altogether 26 of its members, associate members and Honorary Vice Presidents were returned.

So it was a successful year for the SMA but marred again by resignations and, unfortunately, by deaths. Dr L. Ison, who had been Hon Treasurer for eleven years asked to be relieved and his place was taken by Miss Dorothy Keeling. The Council lost two members by death. Dr K. G. Pendse who had been for long a leader in South Wales died suddenly at a relatively early age. He was born in Baroda, India, but had been mainly educated in this country and had been from his date of qualification a GP in South Wales, much respected and a very ardent worker. Death also claimed Mr Herbert Luckett who also was one of the first and certainly the strongest of trade unionists who supported the SMA. He represented the agricultural workers and on health matters connected with the land was a very knowledgeable and helpful member: but was in every way a warm advocate of everything he thought would improve the health of the people and a firm believer in the need for cooperation between health workers and the people.

The return of a Labour Government after thirteen years of Conservative rule made this moment seem a portentous one: but with a small majority the Party had to prepare itself for fresh struggles. The SMA was now 34 years old and it too had to face internal problems and at the same time prepare policies to meet the changing political situation.