2026-09-23T05:16:06Zhttps://api.repository.cam.ac.uk/server/oai/requestoai:www.repository.cam.ac.uk:1810/2447292025-04-09T12:06:05Zcom_1810_276com_1810_256063com_1810_221680com_1810_194745col_1810_218415col_1810_221693
The State and medical care in Britain: political processes and the structuring of the National Health Service
10.17863/CAM.16478
Lowe, Keith William
The creation of the National Health Service is treated,
analytically and historically, as a planning process involving major
changes in the social organisation of health as a part of the larger set
of social and economic reconstruction policies undertaken by the wartime
Coalition and postwar Labour governments. Definitions of 'health' are
considered as relative both to social expectations and ideology, and to
theoretical models of the organisation of health services. These models
are identified with certain socio-political agents or interests in the
providing and consuming of health services: professional groups, public
and private authorities, non-professional workers, and the public. The
models of the health service advocates and of the medical profession are
considered as reference points.
A framework is presented for the analysis of the representation of
these interests, by the state, in the planning and operation of the NHS,
and as beneficiaries of its services. Through a detailed historical
consideration of internal health service planning documents of the major
interests, including the medical profession, the health service
advocates representing the Labour party and trade unions, and recently
released documents of the Ministry of Health and the Coalition and
Labour Cabinets, the interaction of the interests with the two
governments and with each other is traced, and the reconciliation by the
state of the health service models proposed by them is analysed.
It is argued that the changes wrought in the social organisation of
health in Britain can be described according to certain principles of
the organisation of pre- and post-NHS health services: principles of
public access, structure of services, structure of administrative
control and structure of planning representation. Tne major interests
were represented differentially by the state with respect to each of
these criteria; similarities and differences between the approaches of
the two governments to the representation of interests are examined, and
it is concluded that, although the health service advocates and the
public benefited from a free and universal scheme, the public and
non-professional health workers enjoyed considerably less representation
than the medical profession in the particular services provided by the
NHS and in its planning and administration.
University of Cambridge
1981-12-04
Thesis
Doctoral
Doctor of Philosophy (PhD)
eng
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National Health Service
Social organisation of health
Differential representation of interests
Beveridge Report
Sir William Beveridge
Socialist Medical Association
Medical Practitioners’ Union
Dr David Stark Murray
British Medical Association
British Hospitals Association
King Edward’s Hospital Fund for London
Political and Economic Planning (PEP)
Labour Party
Trades Union Congress
Aneurin Bevan
Clement Attlee
Coalition Government
Community health centres, health centres
Industrial health services
National Health Insurance