History of the
NHS
The NHS was born out of a long-held ideal that good
healthcare should be available to all, regardless of wealth. Use this
interactive timeline to find out what‘s happened since Aneurin
Bevan officially started the National Health Service on July 5 1948. Click the
arrows, or drag the cursor to move through the timeline.
1948
NHS established
The NHS is born on July 5 1948 out of a long-held
ideal that good healthcare should be available to all, regardless of wealth.
When health secretary Aneurin
Bevan opens Park Hospital in Manchester it is the climax of a hugely ambitious
plan to bring good healthcare to all. For the first time hospitals, doctors,
nurses, pharmacists, opticians and dentists are brought together under one
umbrella organisation that is free for all at the
point of delivery. The central principles are clear: the health service will be
available to all and financed entirely from taxation, which means that people
pay into it according to their means.
1952
Prescription charges introduced
Charges of one shilling are introduced for
prescriptions.
Prescription charges of one shilling (5p) are
introduced and a flat rate of a pound for ordinary dental treatment is also
brought in on June 1 1952. Prescription charges are abolished in 1965, and
prescriptions remain free until June 1968 when the charges are reintroduced.
1953
DNA structure revealed
Crick and Watson, two Cambridge scientists, reveal the
structure of DNA in Nature Magazine.
On April 25 James D Watson and Francis Crick, two
Cambridge University scientists, describe the structure of a chemical called
deoxyribonucleic acid in Nature magazine. DNA is the material that makes up
genes which pass hereditary characteristics from parent to child. Crick and
Watson begin their article: "We wish to suggest a structure for the salt
of deoxyribonucleic acid (DNA). This structure has novel features which are of
considerable biological interest." DNA allowed the study of disease
caused by defective genes.
1954
Smoking-cancer link established
Sir Richard Doll establishes a clear link between
smoking and lung cancer.
In the 1940s, British scientist Doll begins research
into lung cancer after incidences of the disease rise alarmingly. He studies
lung cancer patients in 20 London hospitals, and he expects to reveal that the
cause is fumes from coal fires, car fumes or Tarmac. His findings surprise him
and he publishes a study in the British Medical Journal, co-written with Sir
Austin Bradford Hill, warning that smokers are far more likely than non-smokers
to die of lung cancer. Doll gives up smoking two-thirds of the way through his
study and lives to be 92.
1954
Children get daily visits
Daily visits gradually introduced for children who
until now had been allowed to see parents only at the weekend.
Until now children in hospital are often only allowed
to see their parents for an hour on Saturdays and Sundays and are frequently
placed in adult wards, with little attempt to explain to them why they are
there or what is going to happen. Paediatricians Sir
James Spence in Newcastle and Alan Moncriff at Great
Ormond Street are making considerable steps to change this, demonstrating that
such separation is traumatic for children. As a result, daily visiting is
introduced gradually.
1958
Polio and diphtheria vaccinations
A programme to vaccinate
everyone under the age of 15 against polio and diphtheria is launched.
One of the primary aims of the NHS is to promote good
health, not simply to treat illness, and the introduction of the polio and
diphtheria vaccine is a key part of the NHS’s plans. Before this programme, cases of polio could climb as high as 8,000 in
epidemic years, with cases of diphtheria as high as 70,000, leading to 5,000
deaths. This programme sees everyone under the age of
15 vaccinated and will lead to an immediate and dramatic reduction in cases of
both diseases.
1960
First kidney transplant
An Edinburgh doctor, Michael Woodruff, performs the
first UK transplant involving an identical set of twins.
The first UK transplant takes place at Edinburgh Royal
Infirmary on October 30 and involves a set of 49-year-old twins. The procedure
is a success, with both donor and recipient living for a further six years
before dying of an unrelated illness. Kidney transplants, which for many are a
welcome alternative to a lifetime of regular dialysis, now enjoy a high success
rate but demand outstrips supply due to an ageing population meaning an
increased incidence of renal failure, while the number of donor organs available
has fallen.
1961
The Pill made available
The contraceptive pill is made widely available and is
hailed as a breakthrough of the 20th Century.
The launch of the contraceptive pill, which suppresses
fertility with either progesterone or oestrogen or,
more commonly, a combination of both, plays a major role in women’s liberation
and contributes to the sexual freedom of the so-called Swinging Sixties.
Initially, it is only available to married women, but this is relaxed in 1967.
Between 1962 and 1969, the number of women taking the Pill will rise
dramatically, from approximately 50,000 to 1m.
1962
The Hospital Plan
Porritt Report is
published and results in Enoch Powell's Hospital Plan.
The medical profession criticises
the separation of the NHS into three parts – hospitals, general practice and
local health authorities – and calls for unification. The Hospital Plan
approves the development of district general hospitals for population areas of
about 125,000. The 10-year programme is new territory
for the NHS and it soon becomes clear that it has underestimated the cost and
time taken to build new hospitals. But with the advent of postgraduate centres, nurses and doctors will be given a better future.
1962
First hip replacement
First full hip replacement is carried out by Professor
John Charnley in Wrightington
Hospital.
Charnley begins to
devote his energies to developing full hip replacements from 1958 and moves to
the Wrightington Hospital where the first full hip
replacement takes place. He asks his patients if they mind giving back the hip
post-mortem. Apparently 99% of them agree, so his team would regularly collect
the replacement hips to check wear and tear, and aid research. He improves his
design with a low-friction hip replacement, and in November 1962 the modified Charnley hip replacement becomes a practical reality.
1967
The Salmon Report
This major report makes recommendations for the
development of senior nursing staff.
The Salmon Report is published and sets out
recommendations for developing the nursing staff structure and the status of
the profession in hospital management. The Cogwheel Report considers the organisation of doctors in hospitals and proposes speciality groupings. It also highlights the efforts being
made to reduce the disadvantages of the three-part NHS structure – hospitals,
general practice and local health authorities – acknowledging the complexity of
the NHS and the importance of change to meet future needs.
1967
Abortion Act
The Abortion Act is introduced by Liberal MP David
Steel and is passed on a free vote, becoming law on April 27 1968.
This new act makes abortion legal up to 28 weeks if
carried out by a registered physician and if two other doctors agree that the
termination is in the best mental and physical interests of the woman. In 1990,
the time limit is lowered to 24 weeks. The act does not extend to Northern
Ireland.
1968
Sextuplets born
Sextuplets born after British woman receives fertility
treatment.
In the morning of October 2 Sheila Thorns celebrates
her birthday by undergoing a caesarean section at Birmingham Maternity
Hospital. She gives birth to six children, four boys and two girls, but sadly
one of the girls dies shortly afterwards. With 28 medical staff at the delivery,
the five surviving babies – Ian, Lynne, Julie, Susan and Roger – are cared for
by a specialist team. Doctors say around one birth in 3,000m will result in
sextuplets. Mrs Thorns had been treated with the
fertility treatment gonadotrophin which contains two
hormones known as FSH and LH.
1968
First NHS heart transplant
A 45-year-old man becomes the first Briton to have a
heart transplant on 3 May.
Surgeon Donald Ross carries out Britain’s first heart
transplant at the National Heart Hospital in Marylebone, London. Ross leads a
team of 18 doctors and nurses to operate on the man in the seven-hour
procedure. The donor was a 26-year-old labourer
called Patrick Ryan. The British operation is the tenth heart transplant to be
undertaken in the world since Christiaan Barnard
carried out the first in Cape Town, South Africa, in December 1967. The patient
dies after 46 days and only six transplants are carried out over the next 10
years.
1972
CT scans introduced
Computer tomography scans
start to revolutionise the way doctors examine the
body.
These scanners produce 3-D images from a large series
of two-dimensional X-rays and the first one is started in 1967 by Godfrey Newbold Hounsfield, with his research reaching fruition
now. His concept will go on to win him a Nobel Prize, which he will share with
the American Allan McLeod Cormack, who developed the same idea across the
Atlantic. Since that initial invention, CT scanners have developed enormously,
but the principle remains the same.
1975
Endorphins discovered
The morphine-like chemicals in the brain called
endorphins are discovered.
John Hughes and Hans Kosterlitz
of Scotland isolate from the brain of a pig what they called enkephalins and will later be termed 'endorphin' from an
abbreviation of 'endogenous morphine'. These are polypeptides produced by the
pituitary gland and the hypothalamus in vertebrates, and they resemble opiates
in their abilities to produce analgesia and a sense of well-being. In other
words, they might work as natural pain killers.
1978
First test-tube baby
Louise Brown is the world’s first baby to be born as a
result of in-vitro fertilization.
The world’s first test tube baby is born on July 25.
Parents Lesley and John Brown had failed to conceive due to Lesley’s blocked
fallopian tubes. This new technique developed by Dr Patrick Steptoe, a gynaecologist at Oldham General Hospital, and Dr Robert
Edwards, a physiologist at Cambridge University found a way to fertilize the
egg outside the woman’s body before replacing it in the womb.
1979
Bone marrow transplant
The first successful bone marrow transplant on a child
takes place.
Professor Roland Levinsky
performs the UK's first successful bone marrow transplant in children with
primary immunodeficiency at Great Ormond Street Hospital for Children.
1980s
MRI scans introduced
Using a combination of magnetism and radio frequency
waves, MRI scanners provide information about the body.
Magnetic resonance imaging scanners prove more
effective in providing information about soft tissues, such as scans of the
brain. The patient lies inside a large cylindrical magnet and extremely strong
radio waves are then sent through the body. It provides very detailed pictures,
so is particularly useful for finding tumours in the
brain; it can also identify conditions such as multiple sclerosis and the
extent of damage following a stroke.
1980
Keyhole surgery
A surgeon uses a telescopic rod with fibre optic cable to remove gallbladder.
This first successful instance of keyhole surgery is
the removal of a gallbladder. Technically it’s known as laparoscopic surgery,
after the instrument that’s used to perform the surgery, a thin telescopic rod
lit with a fibre optic cable and connected to a tiny
camera which sends images of the area being operated on to a monitor. The
procedure will go on to be one of the most common uses of this kind of surgery.
It will also be used for hernia repairs and removal of the colon and the
kidney.
1980
Black Report
Commissioned three years earlier by David Ennals the report aimed to investigate the inequalities of
healthcare.
Commissioned three years earlier by David Ennals, then secretary of state, the report aims to investigate
the inequality of healthcare that still exists despite the foundation of the
NHS i.e. differences between the social classes in the usage of medical
services, infant mortality rates and life expectancy. Poor people are still
more likely to die earlier than rich ones. The Whitehead Report in 1987 and the
Acheson report in 1998 reached the same conclusions as the Black Report.
1981
Improved health of babies
The 1981 Census shows that 11 babies in every 1,000
die before the age of one. In 1900 this figure was 160.
Childhood survival has been revolutionised
by vaccination programmes, better sanitation and
improved standards of living, resulting in better health of both mother and
child. Increased numbers of births in hospital has meant that where unexpected
problems do occur, medical help is on hand. Around one baby in eight requires
some kind of special care following birth. Twenty years ago, only 20% of babies
weighing less than 1,000g (2lbs 2oz) at birth survived. Now that figure is
closer to 80%.
1986
Aids health campaign
The government launches biggest public health campaign
in history to educate people about the threat of Aids as a result of HIV.
Following a number of high-profile deaths, the
advertising campaign sets out to shock – with images of tombstones and
icebergs, followed early in 1987 by a household leaflet, “Don’t die of
ignorance”. This was very much in keeping with the NHS’s original concept that
it should improve health and prevent disease, rather than just offer treatment.
1987
Heart, lung and liver transplant
First heart, lung, and liver transplant is carried out at Papworth
Hospital.
Professor Sir Roy Calne and
Professor John Wallwork carry out the world’s first
liver, heart and lung transplant at Papworth Hospital
in Cambridge. Professor Calne describes the patient
as “plucky” and she survives for a further 10 years after the procedure. Her
healthy heart is donated to another transplant patient.
1988
Breast screening is introduced
Comprehensive national breast-screening programme introduced.
To reduce breast cancer deaths in women over 50 this
project is launched with breast-screening units around the country providing
mammograms. A mammogram works by taking an X-ray of each breast, which can show
changes in tissue that might be otherwise undetectable. This means that any
abnormalities show up as early as possible, making treatment more effective.
Screening, together with improved drug therapies will help to cut breast cancer
deaths by more than 20%, a trend that looks set to continue.
1990
NHS and Community Care Act
Internal market is introduced, which means health
authorities manage their own budgets.
Now health authorities will manage their own budgets
and buy healthcare from hospitals and other health organisations.
In order to be deemed a "provider" of such healthcare, organisations will become NHS Trusts, that is, independent organisations with their own managements.
1991
First NHS Trusts established
Fifty-seven NHS trusts are established to make the
service more responsive to the user at a local level.
New NHS Trusts will aim to encourage creativity and
innovation and challenge the domination of the hospitals within a health
service that is increasingly focused on services in the community.
1994
NHS Organ Donor Register
National register for organ donation is set up to
co-ordinate supply and demand after a five-year. campaign
The NHS Organ Donor Register is launched following a
five-year campaign by John and Rosemary Cox. In 1989 their son Peter died of a
brain tumour. He had asked for his organs to be used
to help others. The Coxes said that there should be a register for people who
wish to donate their organs. By 2005 more than 12m had registered. Organ
donation is needed as demand outstrips supply and this register ensures that
when a person dies they can be identified as someone who has chosen to donate
their organs.
1998
NHS Direct launches
A nurse-led advice service provides people with
24-hour health advice over the phone.
This service will go on to become one of the largest
single e-health services in the world, handling more than half a million calls
each month. It is the start of a growing range of convenient alternatives to
traditional GP services – including the launch of NHS walk-in centres, which offer patients treatment and advice for a
range of injuries and illnesses without the need to make an appointment.
2000
NHS walk-in centres
New health facilities open offering convenient access,
round-the-clock, 365 days a year.
NHS walk-in centres (WiCs) offer convenient access to a range of NHS services
and are managed by Primary Care Trusts. There are around 90 NHS WiCs dealing with minor illnesses and injuries. WiCs are predominantly nurse-led first-contact services
available to everyone without making an appointment or requiring patients to
register. Most centres are open 365 days a year and
are situated in convenient locations that give patients access to services even
beyond regular office hours.
2002
Primary care trusts launched
Primary care trusts are set up to improve the
administration and delivery of healthcare at a local level.
The primary care trusts oversee 29,000 GPs and 21,000
NHS dentists. primary care trusts that are in charge
of vaccination administration and control of epidemics also control 80 per cent
of the total NHS budget. They also liaise with the private sector when
contracting out of services is required. As local organisations,
they are best positioned to understand the needs of their community, so they
can make sure that the organisations providing health
and social care services are working effectively.
2004
Patient Choice Pilots
All patients waiting longer than six months for an
operation are given a choice of an alternative place of treatment.
Everyone who is referred by their doctor for hospital
treatment is given a choice of at least four hospitals. Nowadays you can choose
where and when to have your treatment from a list including local hospitals,
NHS foundation trust hospitals across the country and a growing number of
independent sector treatment centres and hospitals
that have been contracted from the private sector. You can choose according to
what matters most to you: waiting lists, MRSA rates, bus routes and so on.
2007
Robotic intervention
Introduction of robotic arm leads to groundbreaking
operations to treat patients for fast or irregular heartbeats.
This technological revolution is being used at St
Mary’s Hospital, London, and is less risky than more invasive techniques. It
works by inserting several fine wires into a vein in the groin, which are then
guided to the heart where they deliver an electric current to parts of the
heart muscle. Cardiologists control the robot arm via a computer and joystick,
but in future the system could be automated. Around 50,000 people develop an
irregular heartbeat each year, and it is a major cause of strokes and heart
attacks.
2008
Free choice is
introduced
Free choice is introduced on April 1 2008. Patients
can choose from any hospital or clinic that meets NHS standards.
Patients who are referred by their GP for their first
consultant-led outpatient appointment can choose from any hospital or clinic
that meets NHS standards. You can choose a hospital according to what matters
most to you, whether it's location, waiting times, reputation, clinical
performance, visiting policies, parking facilities or patients' comments.
2008
The NHS at 60
On July 5 2008, the NHS celebrates its 60th birthday
with events across the county.
The NHS was born out of a long-held ideal that good
healthcare should be available to all, regardless of wealth. Since its launch
in 1948, the NHS has grown to become the world's largest publicly funded health
service. On July 5 2008, the NHS celebrates its 60th birthday. Local events take
place across the country, and NHS staff and patients celebrate at Westminster
Abbey and 10 Downing Street.
2008
HPV
vaccination programme
Cervical cancer vaccination is introduced for teenage
girls.
In September 2008, a national programme
to vaccinate girls aged 12 and 13 against the human papilloma
virus (HPV) is launched to help prevent cervical cancer. A three-year catch-up
campaign is also introduced, which will offer the HPV vaccine, also known as
the cervical cancer jab, to girls who are 13 to 18 years old.
2009
New NHS
Constitution
The NHS Constitution is published on January 21 and
sets out your rights as an NHS patient.
The NHS Constitution is published on January 21 2009.
For the first time in the history of the NHS, the Constitution brings together
details of what staff, patients and the public can expect from the NHS. It aims
to ensure the NHS will always do what it was set up to do in 1948: provide
high-quality healthcare that's free and for everyone.
2009
New Horizons programme launched
The New Horizons programme
is launched to improve adult mental health services in England.
New Horizons brings together local and national organisations and individuals to work towards a society
that values mental wellbeing as much as physical health.[br][br]It aims to cover a
person's lifetime, from building the foundations of good mental health in
childhood to maintaining resilience in older age.[br][br]It also emphasises the
importance of prevention, effective treatment and recovery.
2009
NHS Health
Checks
The NHS Health Check is introduced for adults in
England between the ages of 40 and 74.
Primary care trusts begin implementing the NHS Health
Check programme in April 2009. It has the potential
to prevent an average of 1,600 heart attacks and strokes and save up to 650
lives each year. It could prevent over 4,000 people a year from developing
diabetes and detect at least 20,000 cases of diabetes or kidney disease
earlier, allowing people to manage their condition better and improving their quality
of life.
NHS Choices 2010