Exploring 70 Years of the British National Health Service through Anniversary Documents

Document Type : Perspective


Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK


The British National Health Service (NHS) celebrates its 70th birthday on July 5, 2018. This article examines this anniversary through the lens of previous anniversaries. It examines seven documents close to each anniversary over a period of some 60 years, drawing on interpretive content analysis, based on the narrative dimensions of context (structure and finance); success or achievements; problems; and solutions or recommendations. It finds that the anniversary documents tend to show change rather than consistency. For example, the Guillebaud Report tended to dismiss the problem of ageing populations, for it to reappear in 1979 and 1989, to fade in 2009, and reappear once more in 2017. Despite being downplayed or ignored in some years, the problems identified by most of the documents such as demography and technology are unlikely to disappear. Some solutions such as market-based reform have flowed and ebbed over the years, and the ‘solution’ of structural reorganisation in one year has become the ‘problem’ in a future year. While predicting the future is always hazardous, it can be said with some confidence that future anniversaries are likely to see discussion of similar themes.


Main Subjects

  1. Pollitt C. The Evolving Narratives of Public Management Reform. Public Management Review. 2013;15(6):899-922. doi:10.1080/14719037.2012.725761
  2. Minister of Health. Report of the Committee of Enquiry into the Cost of the National Health Service. (Chair: C. W. Guillebaud). London: HMSO; 1956.
  3. Minister of Health. National Health Service: the Administrative Structure of the Medical and Related Services in England and Wales. London: HSMO; 1968.
  4. Royal Commission on the National Health Service. Report. (Chairman: Sir Alec Merrison). London: HMSO; 1979.
  5. Secretary of State for Health. Working for Patients. London: HSMO; 1989.
  6. Secretary of State for Health. The new NHS. Modern. Dependable. London: TSO; 1997.
  7. Secretary of State for Health. NHS 2010–2015: From Good to Great. Preventative, People-Centred, Productive. London: TSO; 2009.
  8. House of Lords Select Committee on the Long-term Sustainability of the NHS. The Long-term Sustainability of the NHS and Adult Social Care. 2017:151.
  9. Klein R. The New Politics of the NHS. 7th ed. Abingdon: Radcliffe Medical; 2013.
  10. Timmins N. The Five Giants. 3rd ed. London: William Collins; 2017.
  11. Drisko J, Maschi T. Content Analysis. Oxford: Oxford University Press; 2016.
  12. Timmins N. Rejuvenate or retire? Views of the NHS at 60. London: Nuffield Trust; 2008.
  13. Sheard S. The Passionate Economist. Bristol: Policy Press; 2013.
  14. Secretary of State for Health. High Quality Care For All. London: TSO; 2008.
  15. The Parliamentary Review of Health and Social Care in Wales. Transforming Health and Care in Wales. Cardiff: Welsh Government; 2018.
  • Receive Date: 20 December 2017
  • Revise Date: 24 February 2018
  • Accept Date: 24 February 2018
  • First Publish Date: 01 July 2018