The Welfare State and the Birth of the NHS

The Welfare State and the Birth of the NHS

The UK has one of the world’s most comprehensive systems of public healthcare and provision for people who are unemployed, collectively referred to as the “Welfare State”. The Welfare State is a kind of “safety net” through which the government supports people in need. Today you will learn how proposals for this system first came about, the arguments in favour of and in opposition to it, and the challenges it has faced over the years.

Britain in the 1940s

Whenever we seek to understand a process in history, it is best to start by considering what was taking place at the time. The National Health Service was founded in 1948, and so historians have understood it, and the broader welfare state, as part of the vision of the UK’s recovery after the Second World War which ended in 1945. In that same year, the Labour prime minister Clement Attlee came to power, and his government is largely credited with the invention of the welfare state, though it has since seen both support and opposition from politicians of all parties.

Using Crowcroft’s summary, identify two positive and two negative aspects of life in 1940s Britain. What problems do you think the country was facing?

Let’s see what you came up with. Click the black bars below to see some of our ideas!

Positive Aspects
  • Britain was becoming more diverse due to immigration from the West Indies, India and Pakistan.
  • Education was improved and became more accessible to everyone.
  • A pension for retired people could now be claimed from age 65, and was opened up to all.
  • Parents received family allowances to help support their children.
Negative Aspects
  • The country was struggling financially following the war.
  • Rationing continued well after the war was over.
  • Prices rose and people struggled to feed their families.
  • Britain was unsure of its identity.

To gain a better understanding of life in this period, we are going to look at some primary sources. A primary source is a first-hand account of a historical experience, from people with direct experience of events. As we will see, primary sources can be anything from newspaper articles to diary entries, cartoons and films. They are distinct from secondary sources, which are accounts of events written after the fact, often by historians, possibly many years later.

Activity: Primary Source Analysis

In this activity you’re a historical detective trying to piece together what life was like in 1940’s Britain! Choose two sources from the National Archives collection and reflect on what they tell us about life in the 1940’s for different groups of people. Not all of the material will be relevant, and you should locate sources which focus on one or more the following topics:

  • Housing
  • Health
  • Employment
  • Family allowances
  • Immigration
  • Education.

You should choose at least two different types of source:

Written: Read the text and imagine yourself in 1946. The war is over, but bread has just begun to be rationed for the first time and you’re struggling to feed and clothe your family. How does the source make you feel about the future of your family and the country?

Stuck? Click here for one of our favourite written sources!

Audible: You can listen to many of the sources being read aloud by a voice actor. Close your eyes and take in the words. Picture the many different people who might have heard this in the 1940s. Imagine you are a working-class mother, a government official or someone arriving in the UK for the first time. Who were these words aimed at? How does who you are change your reaction?

Stuck? Click here for one of our favourite audible sources!

Visual: Even as late as 1960, only about 42% of the British population could read and write, so visual methods were key to communicating ideas. Choose a visual source and think about the design choices and how they impact the message being communicated. Which parts jump out at you and why do you think the original designer wanted these to stand out?

Stuck? Click here for one of our favourite visual sources!

The Beveridge Report

In 1940, the government asked the economist Sir William Beveridge to analyse some of the difficulties facing working people, and to think about ways the government could support them. This led to the publication in 1942 of the Beveridge Report. Whilst it was initially circulated just to government officials, the document proved hugely popular and over 650,000 copies were sold to the general public. Beveridge proposed a system of social security and healthcare which turned into what we now know as the NHS.

Beveridge identified five “giant evils” facing society. You might already have encountered these in one of the primary sources earlier:

  1. Want
  2. Disease
  3. Ignorance
  4. Squalor
  5. Idleness

Watch the video below in which Indy Bhullar from the London School of Economics explores some interesting documents from the archives about William Beveridge, his report, and its public reception. Imagine you are soldier hearing about the report whilst still fighting in the war. How would it make you feel? Would it offer you hope for the future or would it feel like an unwelcome distraction?

Activity: Period Poster Design

Imagine you are a publicist in the 1940’s. It’s your job to help the public to understand Beveridge’s report. Based on the poster Indy showed us in the video (1:18 onwards), design your own poster in a similar style which communicates the five giant evils Beveridge identified in a simple format that is easy to understand visually. Most posters at the time used bold block letters and shapes, and you should try to replicate this style.

We have selected a couple of extra resources to help you remember what information to include in your poster:

Click here to view a summary of the five giants from the time

Click here for an explanation of the five giants from BBC Bitesize

The Reaction to Beveridge and the Birth of the NHS

Not everyone was enthusiastic about Beveridge’s plan, especially when you consider that it was published in 1942, whilst Britain was still at war. The war placed significant burdens not only on soldiers but on people in Britain too who had to ration food, lived under fear of air raids, and saw their families separated.

The Birth of the NHS

The sheer scale of the NHS is perhaps its greatest challenge, and governments have experimented with different ways of managing such a large organisation. One way that this has been achieved is that hospitals and GP surgeries in local areas have formed partnerships which allow them to manage services at a local level in a way that best meets the needs of local communities

Watch the video below in which three healthcare experts identify key challenges for the NHS in the future, covering:

  • Health inequalities
  • A changing population
  • Dual health and social care needs
  • Lifestyle choices
  • Personalised care

We hope you have enjoyed learning about the birth of the National Health Service. If you’d like to have a go at applying what you’ve learnt, why not have a go at this fun challenge?

Challenge: Government Advisor

You have been appointed to advise a new government health minister. Your challenge is to launch a campaign tackling one of the issues facing the NHS today. Your campaign will be your minister’s flagship policy and might include some of the following:

  • Your idea of how the government can address the challenge.
  • A name and/or logo for the campaign.
  • A speech of up to 2 minutes for your minister to launch the campaign.

Select one of the challenges below for your campaign to address:

  • Increased strain on mental health services
  • Health inequality
  • Lifestyle choices
  • An ageing population

Emmet O'Leary
Emmet O’Leary

Emmet O’Leary studied History at St John’s College, Oxford. Whilst studying he spent time as JCR Class Rep, promoting the interests of students from under-represented socioeconomic groups and later as President of the Junior Common Room (JCR). His undergraduate thesis explored the impact of Famine in Ireland, and its demographic shockwaves, on cultural and religious practice in the nineteenth century. He has wide-ranging historical interests including the writings of the Enlightenment and the social upheavals of the European Reformations and is also keenly interested in constitutional law and its connection to current affairs. Emmet is currently Access and Outreach Intern at St John’s.