Health before the NHS. The Road to Recovery.

Robert Winston narrates the story of health in Britain before the National Health Service (NHS). Using footage from archives including the Wellcome Library, this programme explores how Britain coped with a ramshackle system as they struggled to deal with sickness and disease in pre-WWII Britain. At the beginning of 20th century health care was a paid for service in Britain with doctors being a luxury few could afford. As slum clearing and improved sanitation had helped control epidemics of infectious diseases emphasis switched to the health of the individual. Government Committees were set up to look into problem of ‘National Degeneration’ and Dr Steven Thompson argues attention was shifted to infant wellbeing to ensure Britain produced an internationally competitive industrial nation With high risk at childbirth focus was shifted to midwives and Dr Tania McIntosh discusses changes in the field of midwifery at the turn of the 20th century. Midwives were still self-employed and often found other ways to supplement earnings and Ilfra Goldberg recalls how her community midwife doubled up as a chimney sweep. By the 1930s reforms had turned midwifery in to a profession and Penny Lowe describes her mother’s midwifery training. With wide scale unemployment and poor working conditions contributing to poor health, Janet Dunn talks about her parents’ struggle. The risk of childbirth was just as high for the rich; Margaret Smart discusses her privileged upbringing. Dr Martin Gorsky suggests doctors chose their location based on availability of custom and as such parts of Britain were heavily unsupported. Mary Phillips describes her father’s duties as a doctor in Barnstable, North Devon. Since the 19th century friendly societies and trade unions had set up health insurance schemes to help those who couldn’t afford health care and the state followed suit in 1911 with the National Health Insurance scheme. Those excluded from the schemes were forced to find other ways to manage and Goldberg talks about formal arrangements with doctors that circumnavigated these schemes. Brenda Watkinson tells how her father volunteered for a ‘PMS’ local health care saving scheme. Local Historian, John Morgan, describes the novel approach to health service in the South Wales town of Tredegar during the 1920s. Using a ‘poundage system’ Tredegar had the most comprehensive medical aid scheme in the country. Tredegar was the birthplace of Aneurin Bevan, and the town would be a major influence in shaping his vision of a NHS. Infectious diseases were still an enormous threat throughout the 1930s and Betty Giltinan reveals how diphtheria affected her family. Dr Sally Sheard attributes the failure of diphtheria immunization to the dislocation between local and central health responsibilities. The approach was a legacy of 19th century public health system, founded on the belief that local organisation were better placed to deal with health problems in their community than a central authority would be. Meanwhile the School Medical Inspection Service monitored the health of the country’s poorest children and provided free treatment. Peter Jarvis describes the work his father undertook for this service. Malnutrition gave raise to rickets, a disase many health practitioners were determined to cure. Edward Mellanby discovered the link between Vitamin D and rickets and there is footage of Mellanby promoting the importance of a healthy diet and advocating free cod liver oil to children. Dr Gorsky identifies advancement in the science of nutrition and with concrete conclusions about the minimum income necessary to purchase a diet for healthy living there was a public critique on government policy. Dr George McGonagall features; he produced case studies which proved the relationship between health and income. His approach to welfare helped generate new approaches to preventative medicine. For example; the Peckham Experiment set out to explore factors that influenced health such as the family as a social unit. Over footage of Peckham, Pam Elven and Doreen Head discuss their families’ involvement while Professor David Armstrong explains the way the Peckham Experiment was set out. The outbreak of World War Two triggered discussion about health reform on a grand scale and a vision of the future came from Aneurin Bevan, whose experience of comprehensive health care showed how a national system could work. The establishment of the NHS in 1948 brought order to chaos, recognizing access to health care should not be dependent on individual circumstances.