THE NEXT FOUR YEARS, bringing the SMA up to its fortieth birthday should have been triumphant ones for the SMA for the Labour Party was once more in control and the way seemed open for new advances. But progress was to be disappointingly slow and there was to be another General Election before the Labour Party had real strength in the House of Commons; and this was to be followed by an international financial crisis, devaluation of the pound, and at home a threatened ‘strike’ by the medical profession because they were not being paid enough. But the SMA kept firmly to its task of advocating new advances and guarding the health service against inroads.
In answer to the attacks on the health service, the SMA produced A Socialist Charter for Health and this was made the chief subject of the Annual Conference. The President, Dr D. Stark Murray, made this the subject of his Presidential Address at the Annual Conference and tried to move the arguments that were then going on away from more money for GPs to ‘a sense of collective responsibility for health on the part of the medical profession’. Embodied in a resolution which he moved was a demand ‘for a sufficiently large proportion of the gross national income to ensure that the service can and will fulfil the intentions, principles and ideals of the NHS’, and a statement that equally essential was the provision of health centres.
The second subject which occupied the SMA in this year was occupational health and this was the main subject of the resolution which Dr John Dunwoody moved at the Labour Party Conference. The pages of Medicine Today and Tomorrow reflected the growing interest in this subject which was also leading to an increase in the support the SMA was gaining from Trade Unions. The policy advocated by the SMA of an occupational health service as an integral part of the NHS, linked to Health Centres and including safety committees of the workers in every factory, gained ground rapidly and by the end of 1965 could be assumed to be the policy of both wings of the Labour Party, political and trade union.
One death saddened and yet in a way heartened, SMA members, that of Dr Henry Tabbush, MOH for Oldbury, Worcestershire. He had been a very active member in the Birmingham area for nineteen years and had contributed much to the thinking of the SMA on matters of hygiene. His death followed a long illness and what heartened other members was a letter he wrote to them all and which was delivered only after his death. While acknowledging his comradeship with those he was leaving, he still wanted to do his propaganda and asked to be remembered in a campaign advocating ‘elimination of the pay-bed system’.
The President missed the General Election because he went to India for a period of six months having been awarded the first Aneurin Bevan Memorial Fellowship by the Government of India. It is of interest to recall that this had been founded by Nehru just before his death but no appointment had been made until Dr Murray was invited to accept the Fellowship. Nehru and Bevan had been warm friends and the idea was to invite British health workers to visit India and to lecture at medical schools on developments in the health and social services of the United Kingdom.
The SMA launched its usual General Election campaign and had the pleasure of welcoming two new MPs; Dr John Dunwoody and David Owen. They had even greater pleasure, as did these and all SMA members of the two houses of Parliament, when the Labour Government abolished the charges on prescriptions. Yet this was to prove one of the subjects which epitomized the difficulties the Government was to meet. The whole political atmosphere was changing rapidly and many people were moving away from earlier concepts and a whole host of movements toward fundamental changes in society, exemplified by ‘student unrest’, appeared to be gathering force. The SMA could not be exempt from this source of change and the Annual Conference heard an appeal for ‘a campaign for a socialist society, in which health would arise from a new and better way of life’. Part of the discussion was round the title of what was now firmly the official journal of the Association, Medicine Today and Tomorrow and on the part it had to play in the fight for a new society and for a better health service. It was generally felt that the title was no longer valid and was finally agreed that the name should be changed to Socialism and Health.
This was a year of political indecision with the Labour Party losing ground in the country and the health service under constant attack. The SMA was weakened by the retirement of C. R. (Bob) Sweetingham who had been General Secretary since Miss Jupp retired five years previously. He had given very valuable service and increased the number of contacts the SMA had with the trade unions. The Association also lost its Hon Treasurer when Dorothy Keeling died at the age of 88, having been active to the end. She had long been associated with the SMA, first in the Liverpool branch and then nationally, but her work in social services had gone on for nearly seventy years. As first national organizer of Citizens’ Advice Bureaux she had a national reputation but had given much time, energy and devotion to the advocacy of a national health service and then to serving within it. The SMA indebtedness to her was further increased at her death for she left a splendid legacy of £1,000 to the Association.
The year also brought the deaths of Dr Barnet Stross MP, and of Mr Somerville Hastings, the Past President. We have already noted his enormous contribution to the SMA and to the Labour Party. Dr Stross had also given many years of service, as adviser to trade unions in the Potteries, as MP, and as a Vice President of the SMA.
The continued preoccupation with health service problems at home did not prevent the SMA maintaining its interest in the development of health services abroad. Contact was maintained with the Medical Workers’ Union of the USSR and in 1967 this body asked if a delegation from Britain could visit the Soviet Union as part of the celebration of the fiftieth year of the USSR. It was suggested that this should be a joint delegation with the Medical Practitioners Union and the Confederation of Health Service Employees. A full report of the visit was published in Socialism and Health, Sept-Oct 1967, and a number of meetings were arranged to enable the delegates to give to audiences as much information as they could about latest developments in the USSR. Provisional arrangements were made for a return delegation from the Medical Workers’ Union to Britain but the troubles in Czechoslovakia caused this to be postponed until 1969. Meantime in 1968 the Hon Secretary, Dr G. Richman visited East Germany and reported back on the reception he and his wife had had from the Health Workers’ Union there. Writing in Socialism and Health Sept-Oct 1968, on this visit, Dr Richman dealt at considerable length with the question of participation in the administrative structure by all grades of health workers. This problem appears still to be incompletely resolved in the German Democratic Republic and the SMA were intrigued when, early in 1969, they were asked to send a delegate to a conference in the USSR at which this was to be the principal subject for discussion. Dr C. R. Kenchington, who had by then succeeded Dr Richman as Hon Secretary, went to Kiev for this conference and while there opened discussions on the possibility of some Soviet doctors visiting Britain at an early date.
The Labour Party Conference in 1967 again had before it a resolution on health which was a rather omnibus affair composited from many submitted. Dr Herbert E. Bach moved it and was warmly received. In replying, Bessie Braddock MP declared for the National Executive Committee that ‘no Labour Government is going to rebuild the financial barrier between the sick and medical facilities which can make them well again’.
This pledge was broken almost at once and the SMA found itself once more fighting to prevent a prescription charge. A campaign was mounted and there was no doubt of the almost universal condemnation of this tax on the sick which the SMA considered ‘quite irrelevant to the economic position of the country’. Its only effect was to lower still further the prestige of a Government which, it was clear, could not be expected to carry out a socialist policy if it could so far forget the basic principles which socialists had laid down for the health service.
The death of Mr Somerville Hastings on July 7, 1967 at the age of 89 produced many obituary tokens to his work. The SMA held a memorial meeting at the House of Commons, when Dr David Kerr took the chair. The speakers, who all paid tribute to the many sides of Hastings’ political work but above all to his work for health, were Lord Soper, Lady Summerskill, Tom Driberg MP, and D. Stark Murray. All of the speakers felt sure that one man who would have remained steadfast in the cause of socialism was the founder President of the Socialist Medical Association. The history of the Association was in many senses the history of Somerville Hastings for he had taken part in the struggle for a socialist health service for almost sixty years, had seen the near approach to the ideal in 1945 and had fought against every departure from the principles he and others had laid down.
He left the SMA with a firm place in the Labour Party and a job still to do. After twenty years the whole health service needed a re-examination and needed ideas if it was to become truly socialist. Approaching its fortieth birthday the Socialist Medical Association still held its place as guardian of the established service and of pioneer and guide to its future growth and development. The next years of Labour rule were to provide many happenings that justified SMA pride and many that were as frustrating as some that had occurred under Tory Governments. The continual problem arising from lack of sufficient money for all the needs of the service gave the national press the chance to keep up a constant attack on the service. In spite of annual increases in spending, in staff employed, in numbers of patients treated in new hospital building and, at last, in building Health Centres, the newspapers treated every complaint, however trivial, as evidence of ‘crisis’. The impression was created of a service in decline, which was very far from the truth.
Among the complaints were many that stemmed from the unique position of those consultants in health service hospitals who, in order to give much of their time to private practice, gave only part time service to the national health service. The SMA analysed, for example, the question of waiting lists for hospitals admission and found evidence that these were to a large extent a device to keep up the system whereby those who did not want to wait could pay the consultant and jump the queue into a hospital bed. The SMA demanded that private practice should be severed from the national health service and consultants offered the chance to become whole time officers, with undivided loyalty. The Labour Party accepted this at annual conference and Mr Kenneth Robinson, then Minister of Health, proposed a reduction in the number of private beds but would not face up to the medical profession to achieve the abolition of these signs of a two standard service.
During this period the SMA also pressed on with its advocacy of an Occupational Health Service and showed how it could be organized as Health Centres were built. Under Kenneth Robinson the Ministry of Health were able to report a considerable spurt in planning and building but when he left the department there was a slowing down of the programme. Nevertheless enough has been done to prove in practice all the advantages to profession and patients that Health Centres were expected to show.
The political atmosphere, however, was full of speculation on the future administration of the whole of the health services, of the social services and indeed of local government. The Ministry of Health, in 1968, produced a Green Paper on the administration of all health services, a document intended to provoke discussion, which it did but met with so much opposition that when Mr Richard Crossman became Secretary of State for Health and Social Security, it was soon made clear that a new document would be necessary. The SMA put forward its own proposals which found much support in the Labour movement.
These proposals were in fact based on the principles to which the SMA had always adhered, that the form of administration should not only support but make clear, the fundamental need for a truly comprehensive service, available to all without exception and free at the time of use; but emphasized the need for a democratic structure and for the participation of all health workers in the control and development of the service. The hospital service, the SMA said, had demonstrated that health workers, as exemplified by the doctors, can play a big part in the work of all committees running the service; and this privilege must be extended to all grades of health worker. This, it declared, is an essential step to the socialization of the service and must be coupled with the democratic election of the body responsible for the day-to-day running of the service.
This insistence on the participation of the worker and the advocacy of an industrial health service brought the SMA increasing support from, and understanding within, the trade unions. The delegates of unions associated with the SMA were very active in its deliberations and made many valuable contributions to policy discussions. The greatest SMA activity was now in the industrial midlands, whereas it had formerly been in London and a combination of events led to the SMA making a move to that area, an event which concludes this history. The loss of the London office because of building changes coincided with the resignation of Dr Geoffrey Richman, as Honorary Secretary, and prompted consideration of Birmingham as a place for new headquarters. It was felt that the SMA would gain more than it would lose by working in an industrial area. Dr Richard Kenchington, a general practitioner with a long record of local political work was appointed Honorary Secretary and Mrs Joan Soan-Rethel already an Executive member, Honorary Assistant Secretary, and new offices were found.
The move coincided with the 21st Anniversary of the foundation of the National Health Service and to mark both events a conference was held in Birmingham on July 5, 1969. The President, Dr D. Stark Murray took the opportunity to summarize what had been achieved, what remained to be done and what forces had to be fought against. ‘That the NHS had reached its 21st birthday, had withstood constant criticism, grumbles and complaints, had survived years of Tory rule and had expanded continually throughout these years, was a triumph for those who had inaugurated it. That it could be described by an American writer as “one of the greatest achievements of the twentieth century” was indeed a justification for all the work, thought and effort that the SMA and its pioneers had put into its foundation.’
Yet the conference ended on a forward looking note. No one now contemplated any alternative to the National Health Service: rather as international relationships improved and as the need for health services for all people became recognized throughout the world, the principles of the British Health Service were likely to become those of an increasing number of countries. The SMA was, therefore, closing one part of its history only to open another which would prove as exciting and rewarding as the first.
The ordinary work of the SMA was now accelerating. Time was found, however, in the Autumn of 1969 to receive a delegation from Russia led by the President of the Medical Workers’ Union, Dr Nadezhda Grigorieva. This visit is recorded in full in Socialism and Health Jan-Feb 1970, and proved very worthwhile as a means of cementing the tie between the SMA and the Soviet Union. This tie is founded on the firm belief of both the SMA and the Medical Workers’ Union that the delivery of health care must be a governmental duty but that the standards of such a service depend on the mutual trust and the joint efforts of health workers and citizens. On this occasion the Russian visitors were given a chance to make a very full assessment of British medicine visiting Health Centres and meeting individual GPs, seeing hospitals of various kinds in London, Birmingham, Bath, Bristol and Kingston-upon-Thames. They also met British people from many walks of life especially in Birmingham where they were guests at a large Labour Club. On their last evening the London & Home Counties Branch entertained the three Soviet doctors and their international secretary, Mrs Natasha Vorobieva and all were agreed it had been a memorable visit.
The year 1970 opened with intensified discussions on every personal social and medical service. The Government was intent on pushing through, if Parliamentary time permitted, changes in Local Government, in the way in which the social services are run and in the administration of the health service. Everyone concerned with these fields was inundated with reports and memoranda, some of very far reaching significance. For the SMA the most important was the second Green Paper, a more exciting effort than the first had been but very little more acceptable. It confirmed the SMA in its belief that it was essential that there should be a specialist body inside the Labour Party, looking after all aspects of health and endeavouring to see socialist principles more firmly applied and adhered to more strongly. It was the SMA’s fortieth year, but it clearly had as much work to do to maintain the NHS as it had done in seeing it established.