Today marks the 70th anniversary since the creation of the NHS. It is an institution which has become part of the social fabric of British society.
When celebrations of the NHS occur, Aneurin Bevan is inevitably mentioned. As Minister of Health in Attlee’s post-war government, he was given responsibility for its creation.
As I mentioned in a piece for the Western Mail last week, when Bevan is invoked by politicians, there is often mention of his principles and the need to defend them.
It might be clear what those principles are in relation to the NHS (universal access, free at the point of use), but what are Bevan’s principles more broadly? And most importantly, what is the legacy and relevance of these principles in Wales today?
Poverty, property and democracy
Bevan’s political thought derived from his experiences in Tredegar and centred on the importance of achieving power for the working-class. He classified society as being made up of three social forces – poverty, property and democracy – arguing that in a capitalist society “either poverty will use democracy to win the struggle against property, or property, in fear of poverty, will destroy democracy”.
The conflict between these three social forces, as Bevan described them, would appear differently in different situations. “Different flags will be waved in the battle in different countries and at different times”, but “poverty, great wealth and democracy are ultimately incompatible elements in any society”.
We will come on to discuss democracy in a moment, but firstly, if we look at Wales today, that difference between the haves and the have-nots is arguably still as great today as it was in Bevan’s time. We may be living in a more affluent society, but as Guto Ifan has pointed out there exists in the UK as a whole, and to a lesser extent in Wales, large inequalities in taxpayer incomes.
Some criticised Bevan’s politics – during the 1950s and in assessments since – for being old fashioned and a restatement of worn-out Marxist theories. But even today, the relevance of his politics is still plain to see. Poverty and the lack of economic power is still a major issue in Wales.
According to a report by the Joseph Rowntree Foundation, Wales has a higher rate of poverty than the other nations of the UK, as nearly one in four people in Wales live in poverty. This has been blamed on “rising living and housing costs, cuts to working-age benefits and poor-quality jobs”.
Bevan’s focus on poverty and increasing the living standards of society seems more relevant today than ever.
Parliament and political power
Bevan believed that it was through the Labour Party acting in Parliament that the working-class could have their voices heard. He argued that parliament was “a sword pointed at the heart of property-power”.
Bevan began In Place of Fear asking “where does power lie in this particular State of Great Britain”, a question still being asked today. As Brexit negotiations are ongoing, there are loud calls for parliament to have a say over Brexit negotiations and for the sovereignty of parliament to be recognised.
Bevan was actually against British membership of the Common Market. In 1957 he argued that sovereignty would be taken away from parliament if Britain was to join, much the same argument as Brexiteers make today. Bevan described the Common Market as “an escapist conception in which the play of market forces will take the place of political responsibility”.
Of course Britain is now in a much different political situation, and whilst not wanting to try and suppose what Bevan would think now, it is difficult to envision Bevan supporting the positions of the likes of Boris Johnson and Jacob Rees Mogg.
But the question of where power lies is still important. One of the major differences between now and during Bevan’s lifetime is the existence of the three devolved governments in the UK. Brexit has exacerbated problems in the relationships between these and the Westminster government.
Brexit has led to fundamental disagreements over where powers are to lie after Britain’s exit from the EU. The disagreements over the EU Withdrawal Bill concern 24 areas where policy is devolved. The UK Government wants to retain power over these areas after Brexit in order to “help ensure an orderly departure from EU law” and establish common frameworks throughout the UK. The Scottish Government has described the Bill as a ‘power-grab’ whilst the Welsh Government reached an agreement with the UK Government over the issue.
Issues over power and sovereignty are set to become more pronounced both during and after Brexit negotiations, as politicians disagree over the same question Bevan asked concerning where power lies.
Empowerment of society
Ultimately, Bevan wanted to empower society and build shared values based on collective striving. He believed in creating a vibrant society where everyone could live free from poverty and suffering. Power was not just a weapon possessed and wielded by politicians in parliament, but a weapon possessed by the people. Bevan believed that Labour should seize the power of parliament in order to create institutions which would empower society. As he was quoted as saying: “the purpose of getting power is to be able to give it away”.
As I discussed in the Western Mail piece, creating a healthy and vibrant society should be the aim of policy-makers. The NHS is facing huge pressures and policy-makers need to think of innovative ways to protect the core principles of the service. As I suggested, Bevan’s goal of empowerment and creating a vibrant society could be met by shifting the focus of health policy to illness prevention, and creating a healthier society through encouraging more exercise and healthy eating. We cannot rely on invoking the founding principles of the NHS without developing radical policies to make sure those principles are protected.
The economic, political and social landscape of Wales looks very different from Bevan’s lifetime. However, important issues remain. People are still suffering in poverty in Wales and this needs to be addressed, whilst the question of where power lies still looms large, both in terms of political power and the empowerment of society. Bevan’s political thought remains as relevant as ever but it should not be taken as dogma. As we talk about Aneurin Bevan and commemorate 70 years of the NHS, we need to think seriously about how we take his legacy forward to create a better Wales.