Martin Schipton

The 76th anniversary of the NHS was marked with a call for a new historical website recognising those who piloted a national health service 38 years before the creation of the full NHS.

The call comes from Aneira Thomas, the first baby born on the NHS, and Emma Snow, author of a new book describing how the National Health Service emerged in Wales before the Second World War, long before Aneurin Bevan made it a UK-wide institution in 1948.

In her book The First NHS, Snow describes how Wales had a national health service 38 years before England: the Welsh National Memorial Association (WNMA), headquartered in the Temple of Peace and Health in Cardiff.

She tells how the full-scale NHS that Nye Bevan set up was a carbon copy of the model set up in Wales in the early 20th century, largely through the efforts of a kindly Montgomeryshire leader: her great-grandfather John Tomley.

Ms Snow argues that the history of the NHS in Wales is still not on the compulsory curriculum for Wales and does not feature in Welsh school history textbooks. Although the new history textbook for 11-14 year olds mentions health, it does not even mention Nye Bevan or Crimean War nurse Betsi Cadwaladr. Both have NHS health boards named after them, let alone other people and organisations involved, such as the founders of the WNMA.

Hidden Health Heroes

She says more research is needed to uncover these hidden health heroes and include them in the curriculum for all children and young people in Wales. Both Emma Snow and Aneira Thomas have written about the history of the NHS in Wales.

Julie Morgan, MS for Cardiff North and former Deputy Minister for Social Services, met the two women at the Temple of Peace and Health. She said: “Here in Wales we are all very proud of our Welsh connection to the NHS, with Nye Bevan founding it in 1948. It is fascinating to discover the full story of how Wales played an even bigger part in the creation of the NHS than we thought.

“It is vital that children and young people in schools, as well as patients and health and social care staff, can meet and celebrate all of our Welsh NHS health heroes.

I fully support the call for a new website on the history of the NHS in Wales, for the history of the Welsh NHS to be added to the Welsh curriculum and school textbooks, and for more research into the health history of Wales.

“For a start, Aneira and Emma’s books should be in every secondary school library in Wales.”

Welsh National Remembrance Society

In a blog post, Ms Snow wrote: “The UK’s very first national health service pilot was set up in 1910 and covered tuberculosis (TB) services in Wales. It was set up by a group led by three Welsh men: Health Commissioner John Tomley, leading physician David Rocyn-Jones and MP and philanthropist David Davies.

“They called the organisation the Welsh National Memorial Association. Over the years, thousands of staff and tens of thousands of patients passed through its doors.

“The second pilot for a National Health Service was set up during the First World War, when hospitals, which had previously been independent, had to work together to cope with the number of casualties of the war. John Tomley became chairman of the North Wales Hospital Area, which then covered the upper half of Wales. After the war, everyone hoped that a full National Health Service would be set up in the UK, along the lines of the WNMA. However, the government made cuts, so that did not happen.

“During the 1920s and 1930s, TB rates improved in Wales, but not as rapidly as in England. This was surprising, as TB healthcare in Wales was much better thanks to the WNMA, which England did not have. John Tomley began working with the WNMA doctors, collecting TB statistics to try to find the root causes. In the late 1930s, John became the British leader of the Friendly Societies, which at that time provided almost all healthcare for workers, similar to the CEO of the NHS today. He led the campaign for the government to hold a full inquiry, supported by his local MP Clem Davies.

“Eventually their campaign was successful and the Welsh TB Inquiry was set up, led by Clem and a senior doctor. Using John’s TB statistics map and interviewing people across Wales, they discovered what we now call the social determinants of health, which have an even greater effect on people’s health than health services. Wales was particularly hard hit by high unemployment. There was no social housing, so people were forced to pay high rents to private landlords for poor quality housing with poor sanitation. Education was also poor, with schools lacking transport, sanitation, heating and hot meals for children. All of this led to higher rates of disease than in England.

“The Welsh TB study caused outrage in the UK national press and an uproar in Parliament when the final report was released in 1939. However, work had to be halted when the Second World War broke out.

“In 1941 William Beveridge was commissioned to write a report on what should happen to post-war reconstruction. Although no one from the Welsh TB Inquiry had been appointed by the government to its official group, he knew Clem well and worked with him behind the scenes for a year. Clem therefore contributed a great deal of evidence and results from the Welsh TB Inquiry and this formed the basis for the Five Giants of the Beveridge Report, the social determinants of health, against which the NHS and the welfare state would be set up to combat.

“The third pilot for national health care was established during World War II, when hospitals and other medical services were again taken over and worked together for the war effort.

“Eventually, after this war, in 1945 the people voted for a National Health Service and the Welfare State, and Nye Bevan was elected to make our NHS a reality. After much work he established the full NHS in 1948. The WNMA became the transitional authority for Wales, so in effect it became NHS Wales. The first NHS Wales headquarters remained at the WNMA headquarters at the Temple of Peace and Health in Cardiff.”

Emma Snow is Chief Executive of the health and social care charity Community Opportunity. She works in change management for an NHS hospital and is an independent member of Oxfam GB’s Audit & Risk Committee.