Britain's National Health Service *

On January 1, 1947, it was just one hundred years since the first medical officer of health was appointed in Britain,Dr. Duncan of Liverpool. Much public health history has been made during these years and the century is punctuated with dates of special significance. None is likely to be of greater significance than that in which the National Health Service Bill became an Act of Parliament. Many and varied have been the happenings that have gone into the making of this comprehensive measure, directly or indirectly; the creation of a democratic system of local government and a programme of sanitary reform in the nineteenth century, the development of personal health and social services in the early years of the twentieth, vast housing and slum clearance schemes and educational reform in the years b'etween the two world wars, and finally World War II with the heavy involvement of the civil population and all the emergency medical arrangements made necessary by a state of total war. A health service for the nation is no new idea in Britain. Existing services have been under criticism for many years and plans for reform and extension have been advocated by many authoritative bodies during the past twenty-five years. The last war stimulated these discussions and made possible the issue of the Beveridge Report and the Report of the Medical Planning Commission in 1942, the report of the Goodenough Committee on Medical Schools and Teaching Hospitals in 1944, and the reports of the hospital surveyors covering England, Wales, and Scotland at a slightly later date. The war had hastened matters and made people feel that the time for talk was running out and the time for doing something was at hand. This feeling was further stimulated by the obvious advantage of many of the war-time medical arrangements: the central and regional coordination of hospitals, the better distribution of specialists, the establishment of special teams in various centres for the treatment of certain special conditions, and the provision of national public health laboratory and blood transfusion services.