In writing To Provide All People – a film-poem to mark the 70th anniversary of the NHS – I wanted to create a lyrical bridge between the birth of the most radical and beautiful idea we’ve ever realised and the people who embody that idea today: the staff and patients of our NHS.
Moving between the story of its coming into being in 1948 and contemporary personal experiences, my intention was to paint a philosophical and emotional map of the NHS, rather than a journalistic or political survey. I wanted to excavate what the idea of healthcare free at the point of delivery means; what are the societal and psychological resonances of such a national act of compassion; and how the ethos of the NHS has shaped us, as individuals and as a country.
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Researching the personal experiences of the NHS today was moving, fascinating and often inspirational. This research consisted of over 70 hours of interviews, mostly with staff and patients at my local District General Hospital, Nevill Hall in Abergavenny. I chose Nevill Hall because it’s a direct descendant of the miners’ welfare hospitals of Tredegar and Blaina that so inspired Aneurin Bevan as a young man. The minister of health who oversaw the creation of the NHS was born in the South Wales valleys, and these hospitals showed him the practical potential for individual emancipation through communal action.
Nevill Hall, for me, also epitomises the deeply personal relationships all of us have with the NHS. One of my very first memories is being examined in A&E after I fell out of a window at the age of two. In the years since, the hospital has continued to care for me across a remarkable spectrum of needs, from being patched up after rugby injuries to offering me speech therapy as a child. It’s also where both my grandmothers died, my mother had her knee replacements, where my second daughter, born two months premature, received life-saving care in the Special Care Baby Unit and where our eldest daughter has regular visits to the Ophthalmology Clinic.
Researching the creation of the service was equally inspirational. It’s an extraordinary story of vision and action. In the wake of the Second World War, Bevan, the youngest member of a new Labour government, created – in the space of just two years and against considerable opposition from the Conservatives, his own cabinet, the medical profession and the press – an organisation that totally altered the nation’s cultural position in relation to health.
On 4 July 1948, an individual’s healthcare was largely their financial responsibility. Health and wealth were intricately linked. At one minute past midnight on 5 July, however, an individual’s health became a communal concern, a legal right, and financial worry was removed from the consulting room. The best of medicine would be available to everyone. It’s hard to imagine what an equivalent cultural shift would look like today. A one-tier education service created overnight, perhaps? The very best of education available to all children regardless of their background, social position or wealth?
As Bevan said in 1946, speaking of his hopes for the service: “I believe it will lift the shadow from millions of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering. It will produce higher standards for the medical profession. It will be a great contribution towards the wellbeing of the common people of Great Britain.”
And he was right. It did exactly all of that and more. When was the last time you heard a politician speak with such vision and, two years later, put that vision into practice?
It should be acknowledged that whoever had won the 1946 election would have made an attempt to create a national service of some form. Pressure had been growing for a comprehensive system since the end of the First World War and Bevan’s predecessor, the Conservative minister for health, Henry Willink, had already written a white paper titled A National Health Service. No one, however, had envisioned the extent to which Bevan, fuelled by his formative years in the socialist hotbed of the South Wales valleys, would drive the concept, hence the outcry when he revealed his plans for nationalising the nation’s hospitals.
Bevan’s hinterland was fertile soil for such a bold and visionary policy. Had the minister of health at that time come from a different background, it’s highly possible our contemporary NHS wouldn’t exist in the form we know it today. In 1946 it appeared impossibly radical. Former prime minister Winston Churchill, brought up at the other end of the social spectrum, strongly opposed the idea, while Willink prophesised “the plan would destroy so much in this country that we value”.
Seventy years later and the opposite is true. The NHS has become a symbol of what we value and a vital thread in the worn fabric of British national identity. It is, despite negative press stories to the contrary, still a point of pride on the international stage; a world-leading entity of massive scale capable of the most personal treatment that enables us, as a society, to discover and witness our humanity on a daily basis.
It’s also, it can’t be denied, after years of underfunding, cuts to social care, misguided reforms, catastrophic experiments with private companies and the damaging consequences of Brexit, a system under considerable strain. The idea of it, though, 70 years after its founding, is still good – the best, as a nation, we’ve ever had. But for that idea to flourish in the 21st century, for it to survive as the service adapts to our contemporary needs, the ethos at its heart must be never forgotten and always be protected.
I hope To Provide All People conveys this while celebrating the extraordinary, at-once intimate and communal nature of the service; a national expression of empathy made manifest every minute of every hour through thousands of acts of quiet, often unseen, care and compassion.
To Provide All People by Owen Sheers is published by Faber & Faber and available in hardback now
The NHS: to Provide All People airs on Saturday 30th June on BBC2 at 8pm