Heritage: NHS in crisis - Upminster GP blames patients in 1950

The creation of the National Health Service in 1948 was not universally welcomed, as Prof Ged Martin discovered

Britain’s National Health Service was born in July 1948. Everybody had the right to free health care.

But, two years later, Upminster GP Doctor Ernest Anthony called the NHS “a vote-catching piece of political propaganda”.

In a long letter to the British Medical Journal, he voiced the anger of many doctors.

“Our status in the social scale is going down week by week,” he grumbled. Ordinary people “can march into our surgeries” and demand free services. “The patients have little respect for us. Gone are the days when the doctor was lawyer, philosopher, and friend.”

He raged that patients possessed “the unqualified right to ring up the doctor at any hour of the day or night and demand the doctor’s presence”.

A woman had phoned in the early hours claiming her little girl had meningitis. He got up, dressed and drove seven miles – for a false alarm. The child had asked for a glass of water and complained of a headache. Her mother had panicked.

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Meningitis is a deadly illness, and needs to be tackled as soon as symptoms appear. The mother was right to worry.

But Dr Anthony scornfully asked: “Are we never to sleep while there is a patient awake?”

Doctors had become “general errand boys for every neurotic in the district.” GPs needed running shoes, not medical equipment.

If “vote-sensitive politicians” refused to “discipline” demanding patients, doctors should be allowed to impose call-out fees.

At first, the NHS was completely free: charging (for false teeth and spectacles, and later for prescriptions) began in 1951, to pay for the Korean War.

Dr Anthony believed free treatment encouraged freeloaders.

He argued that “only one item be allowed free on a prescription”. GPs could then “penalize the patient out for all he can get by adding an item for which he would have to pay.”

Just imagine any government proposing that!

He also attacked the “new army” of NHS bureaucrats, who saw administration as “an end in itself”.

Dr Anthony accepted that many patients came to see him “because of genuine need”. Indeed, he worried about “those who do not come and who ought to come but who feel they are being a nuisance”.

But his abusive labelling of patient types hardly welcomed people. He sneered at “the moaning neurotic” and “the over-anxious mother”, worried by “every trivial and often imaginary complaint”.

In his fury, he contradicted himself. If doctors were not given “the whip hand”, the NHS would “ruin the nation financially”.

But more resources were needed. It was difficult to locate beds for sick patients: each hospital group should operate an admissions bureau to allocate services efficiently.

He cited the case of a seriously ill elderly woman. She arrived at a local hospital at 12.15, “was kept on a chair until 3.45”, and then transferred to another hospital, where there was no bed either. Sounds familiar?

Dr Anthony bemoaned his impossible workload. “I see no prospect of living to retiring age and collecting my pension.”

He ran his practice alone, complaining that NHS funding models stopped him from taking a partner. If a second doctor arrived, his own income would simply be halved – and he had teenage children to put through university.

In time, his son John finished medical school, and did join the practice. To avoid surname confusion, they agreed to become Dr Ernest and Dr John.

Over the years, other medics have renewed the team – now called Upminster Family Doctors – but the tradition of patient-friendly use of first names continues.

They’re still in Little Gaynes Lane, where Dr Ernest Anthony had his base. In 2007 a second surgery was opened, in Ingrebourne Gardens, to serve residents of Cranham.

Dr Anthony should have thought twice about publicly abusing his patients.

But, almost 70 years later, nobody has solved the resources issue in Britain’s NHS.