Read Austerity Britain, 1945–51 for Free Online Page B

in an age of austerity. But that would change in an age of affluence with its inflationary implications and, above all, financially onerous concept of relative poverty. Secondly, there was Beveridge’s assumption that married women would – following their wartime experience – return to and stay at home, given that their prime task was to ‘ensure the continuation of the British race’, which at ‘its present rate of reproduction . . . cannot continue’. In administrative terms this meant that a married woman would be subordinate to her husband, with benefits to her coming only as a result of his insurance. Beveridge’s third, equally Victorian assumption, befitting a Liberal who was already in his teens when Gladstone had been Prime Minister in the 1890s, was that in the post-war world enhanced rights would be matched by enhanced responsibilities. Not only did he insist that his social-security system be contribution-based rather than tax-based, but he was also determined that his ultimate safety net of means-tested national assistance would be pitched at such an unattractively minimalist level that it would ‘leave the person assisted with an effective motive to avoid the need for assistance and to rely on earnings or insurance’. And he added sternly that ‘an assistance scheme which makes those assisted unamenable to economic rewards and punishments while treating them as free citizens is inconsistent with the principles of a free community’. 7. Beveridge’s welfare state – a term not yet invented but one that he would come to loathe – was not, in short, to be a soft touch.
     
    Integral to the Beveridge vision of the future was a free and comprehensive national health service. The key propagandist, in terms of preparing the intellectual ground for such a development, was undoubtedly Richard Titmuss – a remarkable person who would become (in Edmund Leach’s words) the ‘high priest of the welfare state’. Titmuss was still a young man, the son of a failed farmer-turned-haulier, when he researched and wrote Poverty and Population (1938), which he somehow managed to do while holding down a full-time job as an insurance actuary. In it he examined the depressed areas of industrial Britain and showed in irrefutable detail the appalling human wastage resulting there from poverty and inequality. Other books followed, including (soon after Beveridge) Birth, Poverty and Wealth (1943), which put infant mortality under the microscope of social class and found that each week almost 2,000 lives were lost unnecessarily. ‘The writings of Titmuss set a new standard,’ the historian of the NHS has written. ‘Their influence was extensive and immediate. His method of demonstrating inequalities found its way into popularisations aimed at various classes of reader.’
     
    In February 1944 the Conservative Minister of Health in Churchill’s coalition government, Henry Willink, issued a White Paper that spoke of ‘the need to bring the country’s full resources to bear upon reducing ill-health and promoting good health in all its citizens’ – in effect making it clear that a post-war Conservative administration would bow to Beveridge’s wishes and introduce a national health service. Nevertheless, ‘there is a certain danger in making personal health the subject of a national service at all,’ the document added. ‘It is the danger of over-organisation.’ One way in which Willink intended to minimise that danger was through combining free, universal access on the one hand with diversity of provision on the other – above all through not nationalising the hospital stock as a whole, maintaining instead a mixture of voluntary and municipally run hospitals.
     
    The attitude of the medical profession to all this was ambivalent. It broadly accepted the case for a free and universal health service, but it was understandably reluctant to abandon its profitable private work, feared political interference