Portraits and Miniatures(12)

His housing performance, for some time at least, bore an uncomfortable resemblance to his 1942 strictures of Churchill. He won debate after debate but was bereft of victories on the building sites. During this period he embellished his replies to House of Commons debates, and largely got away with, a series of remarkable animadversions on the aesthetics of housing policy. He denounced ‘the fretful fronts stretching along the great roads out of London’ of 1930s building and proclaimed that he was not going to have the landscape desecrated by ‘ugly houses poking their stupid noses into the air because they are too high for their width’. Up to the end of 1946 there was not much danger of many new houses poking their noses anywhere, for only 60,000 had been completed in the eighteen months since the end of the war. In the third full year, as is the habit with production programmes, there was a movement into relative spate, and well over 200,000 were completed in 1948. By then he was in trouble with successive Chancellors for commanding too large a timber share of scarce dollar imports and had his programme cut back for several years to come. In the infinitely complicated game of bandying housing statistics he ended up with a defensible record in numbers and a good one for the quality of houses built. Harold Macmillan subsequently upstaged him on numbers although he achieved this partly by reducing the size and quality of the units.

The creation of the National Health Service was a less ephemeral battleground than was provided by the exchange of housing statistics. Bevan of course did not create it out of nothing. Two successive Tory ministers had been working on the issue since 1943, and the late 1940s would have seen the creation of some form of National Health Service whoever had been Minister of Health and even had Labour not won in 1945. Nevertheless, Bevan deserves the credit that belongs to those who are in the right place at the right time and who do not fumble the opportunity with which they are presented. Furthermore, he deployed his forces with great strategic skill, advancing from one to another battle that he could win, and never engaging in those that he could not, except occasionally to fight a drawn diversionary action the noise from which helped his more central purposes. His adversaries were not so much the Conservatives, who were throughout more embarrassed than aggressive, although obligingly voting against both the second and third readings of the bill. They were the doctors, a traditionally noisy profession, who had the advantage of being mostly popular with their patients, but the disadvantage of being fissiparous; and the local authorities, strongly represented in the Cabinet by Morrison, the 1930s leader of the London County Council, the most powerful and efficient of them, which wanted to keep control of their own hospitals.

The doctors, and particularly the grand ones associated with the voluntary teaching hospitals, wished at all costs to be free of the local authorities. However, their great hospitals, while trailing clouds of glory, had little prospect of financing themselves satisfactorily in the post-war world. Bevan, helped by his best officials whom he captivated almost as much as Napoleon did his marshals, saw the gap and drove through it with adventurous skill. He proposed to unify the hospital service (two-thirds local authority with whiffs of the Poor Law about it, and one-third voluntary with whiffs of Lady Bountiful) and run it nominally as a nationalized service, but with a great deal of consultant control.

To do this he had to defeat Morrison in Cabinet, which he did in October 1945, but once he had done so he had the Royal Colleges on his side, particularly as he further sweetened the consultants by allowing them pay beds and the continuation of private practice alongside their public responsibilities. This left the British Medical Association, essentially representing the general practitioners, as an army whose commanders had defected. In compensation Charles Hill, their deputy secretary, widely known as the Radio Doctor and later to be a Conservative MP and minister, put on a great performance as a ranker general, and they also had the advantage, as general practitioners, of being close to the ground. Bevan was accused (by R. A. Butler, for example, who contrasted Bevan’s behaviour with his own mollifying treatment of the teachers in 1944) of handling them truculently. It probably suited him to do so. First, the Lloyd George experience at the beginning of National Insurance in 1912-13 suggested that doctors always capitulated at the end. Second, Bevan needed some ‘noises off’ in order to distract attention from how far away his NHS was from the models which the Socialist Medical Association had previously promulgated. Doctors remained unsalaried, there were no local health centres, preventive medicine was discounted, and the split between the general practitioners and the hospitals became greater than ever before. But he got his bill on the statute book by the end of 1946, and, perhaps more difficult, the NHS in operation by 5 July 1948.