Conservatism, Health Policy and Health Care Policy: From the Royal Commission to the White Paper

Abstract

The Conservative party’s attitude towards the NHS has always been somewhat ambiguous. For example it voted against the third reading of the NHS bill in 1946, a gesture usually interpreted as indicating opposition to the principle of a bill, rather than to its technical limitations (see Foot, 1975). Conservative chancellors during the 1950s, a similar period of electoral ascendancy, attempted to challenge the concept of a state-funded and publicly provided NHS (Lowe, 1989; see also Pimlott, 1989). On the other hand the Conservatives introduced the Hospital Plan of 1962 (MoH, 1962a), the largest single injection of new capital investment into the service. Given the public attachment to and political support for the NHS, attempts to alter its basic structure — to date — have not proved feasible. While Conservative ideologues have consistently probed the limits to state funding of health care, the government’s policies towards the welfare state have focused more sharply on social security and housing than on health; the distinction between parts of the welfare state seen to be ‘deserving’ of support and those ‘undeserving’ seems relevant here. Once radical options from the left (such as implementing the preventive programmes proposed by the Black Report — DHSS, 1980a) or right (insurance-based schemes) were ruled out, the government’s scope for manoeuvre was going to be greatly circumscribed.