A Chronology of State Medicine, Public Health, Welfare and Related ...

1941 Cont - 1942
1941 cont NMcA Gregg (1892-1966) drew attention to congenital defects in children born to
mothers who had had rubella during the pregnancy.
"Poverty and Progress", by BS Rowntree, the report of the second York survey (see
1901) published.
Introduction of purchase tax.
1942 "Social Insurance and Allied Services", Cmd.6404, (the "Beveridge Report") by Sir
William Beveridge (1879-1963, later Lord, economist, civil servant, and one time director of
the London School of Economics) laid the foundations of the post-war welfare state.
"Organisation of social insurance should be treated as one part of a comprehensive policy of
social progress. Social insurance fully developed may provide income security; it is an attack
upon Want. But Want is only one of five giants on the road of reconstruction and in some
ways the easiest to attack. The others are Disease, Ignorance, Squalor and Idleness. ... Social
security must be achieved by cooperation between the State and the individual. The State
should offer security for service and contribution. ... The plan proposed here involves three
particular assumptions ... of children's allowances, of comprehensive health and rehabilitation
services, and of maintenance of employment". Beveridge advocated a flat rate of subsistence
benefit, flat rate contributions, comprehensiveness, and unification of administrative
responsibility. See 1945, 1946 and 1948.
The reports "Land Utilisation in Rural Areas", Cmd.6378, (chairman, Sir Leslie Scott)
and "Compensation and Betterment", Cmd.6386, (chairman Mr Justice Uthwatt), were
concerned with future rural and town planning. See 1943.
The Medical Planning Commission, a body of 73 members nominated by 11
organisations including the Royal Colleges and the British Medical Association set up in
1940, issued an interim report (Br. Med. J., 1,743-753) suggesting that national health
insurance should be extended to cover 90 per cent of the population; that general practitioners
should continue to be paid by capitation fees, but there should be a basic salary and fees for
additional work (a minority advocated a salaried service); and that they should practise in
groups combining preventive and curative care and supported by nurses, midwives and health
visitors. The report favoured the organisation of all hospital, medical and allied services on a
regional basis either through a special committee (containing some non-elected members and
representatives of the medical profession) of new local authorities serving populations of not
less than 500,000 resulting from reform of local government or through new regional health
councils consisting of representatives of local authorities within the region and containing
representatives of the voluntary hospitals and of the medical profession. Grants should be
paid to the voluntary hospitals from Exchequer funds without change of ownership of the
hospitals. Consultant appointments should be full-time or part-time and be salaried, not least
to promote a more even distribution over the country. The central authority should be
concerned "solely" with the civilian health services; it might be a "government department in
the usual sense or it might be a corporate body formed under government auspices and
responsible through a minister to Parliament". No detailed suggestions were made about the
future of the traditional public health services and the duties of the medical officers of health.
No final report was produced. See 1944.
The Lancet published a report from its Medical Planning Research (Lancet, 2, 599-
622), a group of doctors aged under 45 years. The report was intended to present alternative
ideas to those of the Medical Planning Commission (see above). The Lancet report urged that
the central authority should be a corporate body (National Health Corporation) and not a