12 - The Guillebaud Committee and the Early years of the National Health Service

Summary

Introduction

Even before arriving at the LSE, a significant proportion of Titmuss’s work was concerned with health. He had researched population health, was interested in eugenics, and had contributed to the origins of social medicine. Much of what he argued was shaped by the idea that ill health might have socioeconomic, or even psychological, causes. Consequently, treatment or, preferably, prevention should involve dealing with the individual's environment as much as their body. In terms of how this might be realised, Problems of Social Policy had drawn attention to the supposed shortcomings of existing provision, and called for largescale social reconstruction once the war was over. To some extent this materialised perhaps most successfully in the shape of the NHS, whose creation, as we noted in Chapter 1, Titmuss was later to describe as ‘one of the most unsordid and civilised actions in the history of health and welfare policy’.

This chapter examines Titmuss's analysis of health and healthcare in the first decade or so of the new service. Although an enthusiastic supporter of the NHS, and proponent of the idea that it constituted good value for money, Titmuss was not unaware of its shortcomings. It is important to recognise, too, that the post-war era saw not only organisational changes in healthcare. Startling advances in drug therapies and surgical techniques seemed to further advance the phenomenon of ‘scientific medicine’. Reviewing a clutch of books on social medicine in 1954, Titmuss noted that the ‘new accent’ on the social content of medical theory and practice was, in part, a response to ‘the scientific revolution’ which had been sweeping through medicine since the discovery, in 1935, of sulphonamides, the first class of drugs to effectively tackle certain pathogenic bacteria. Medicine had to respond to this ‘revolution’ in ‘not one but in a hundred and one ways’. Scientific advance was not, in other words, unproblematic, a theme which informed Titmuss's interventions on healthcare.