The biggest challenge was to establish something as complex and expensive as the NHS at a time when finances, and available staff, had become severely depleted
On doctor’s orders: Barrie Mahoney celebrates a family role in the creation of the NHS
‘The fact that it ever came into being was an incredible achievement.’
This month marks the seventy-fifth anniversary of the foundation of the National Health Service, set up by the Labour government in 1948. This has brought back many poignant memories for me, since both my parents were involved in the establishment of a hospital in rural Lincolnshire.
The NHS, despite its current difficulties with funding and the retention of staff, is one of the very few things that unites most of the country. It is often described as our national religion, and is supported by most people. In 2023, there are problems with accessing treatment, long waiting lists, and a lack of follow-up care. But surveys indicate that the founding principles of the NHS, which was to be universal, equitable, comprehensive, high quality, free at the point of delivery, and centrally funded, are still supported by the majority. It was the first health system in any western society to offer free medical care to the entire population. It was also the first system to be based not on the insurance principle, with entitlement following contributions, but on the national provision of services available to everyone. Presenting his National Health Service Bill to parliament in 1946, health minister Aneurin Bevan said ‘not only is it available to the whole population freely, but it is intended … to generalise the best health advice and treatment.’ Its anniversary is something to celebrate.
For me personally, the celebrations remind me of the small part played by my father and mother. They helped establish a cottage hospital within the NHS, in 1948. I was born in this hospital, just three years after the NHS was established.
For seventeen years, I grew up in the house in the grounds of Holbeach Hospital, where my father, Ronald John Mahoney, was hospital secretary – or ‘hospital administrator’ as the job title was renamed. My mother, Phyllis Mahoney, was the hospital matron during its early years. She left the post in the 1940s to bring up my two elder brothers and myself.
Before its incorporation into the NHS, Holbeach Hospital had an interesting history, and much may be attributed to my father. He opened the building as ‘casual wards’ when he was appointed in 1937. It was then transformed into an emergency hospital during the second world war, before becoming a fully-fledged NHS hospital. Holbeach offered general care and access to local doctors, as well as facilities for visiting specialist surgeons. I remember it as always being very busy – it was spoken of highly by the local community.
Although workhouses were intended for local people who were poverty stricken and had no other means of support, casual wards were for those with no fixed abode. These people were often called ‘vagrants seeking temporary public relief’, and they stayed in casual wards for brief periods before moving on, potentially to find employment. This was the building’s initial purpose.
The story of Holbeach Hospital began in 1937, when a building and a house were constructed on a large plot of land just outside Holbeach. The two buildings were alone within a landscape of largely-barren fields, and very few trees. To the visitor in winter, it must have appeared to be a very alien environment – that is until the beginning of the growing season, when fields of vegetables would appear. It was in this environment that my father was appointed as ‘master’ of the new Holbeach Casual Wards, and my mother as matron. In addition, my parents were responsible for the running of the local children’s home, which was situated in another part of town.
Many years ago, I saw plans of the two buildings and was surprised to see that there was no infrastructure surrounding them. Roadway access from the lane, as well as pathways and the other necessary buildings, were completed under the direction of my father after he was appointed. I guess it was a daunting task, but one that I could imagine my father relishing; he always enjoyed and rose to a challenge.
In the years following my father’s retirement, Holbeach Hospital came under threat of closure. In 1988, with support from the local community and GPs, the hospital was taken over by Holbeach and East Elloe Hospital Trust, which now runs it as a care home, as well as providing beds for use by local GPs. It is to the credit of the community that this valuable resource was recognised, and supported in a way that continues to be of benefit to the local community. I am sure that my parents would have been pleased that the hospital continues to be used to support the community in this way.
The NHS currently faces some of the biggest challenges in its history, but my mind goes back to its biggest challenge of all. This was to establish something as complex and expensive as the NHS at a time when the horrors of wartime had seen finances – and available staff – become severely depleted. The fact that it ever came into being was an incredible achievement.
I often hear politicians make the trite comment that the NHS offers the best healthcare in the world. Clearly, it does not. Data shows that most western European countries achieve far better results than the UK in the treatment and care of a range of serious illnesses and disease, including cancer and heart-related issues. Where the UK does well is in providing the widest range of cover for all its people at the lowest cost; in other words, the NHS is largely funded by the goodwill of its staff. I personally benefitted for many years from the care of the Spanish Health Service when I lived in the country; high quality care is not unique to the UK.
I hope and believe that the NHS will continue to develop and thrive over the next seventy-five years. But for that to happen politicians must take action to ensure that the service is adequately staffed and funded. It is important that staff are valued and rewarded sufficiently. Their professionalism and contribution to society needs to be recognised. To fail at this will mean opening ourselves to the horrors of a US-style privatised service, which only the wealthy can afford, and will be a loss to everyone.
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