Gordon Brown: Fife owes huge debt to its dedicated health staff

Gordon Brown (Pic: John Devlin)
Gordon Brown (Pic: John Devlin)

Former Kirkcaldy MP and Prime Minister Gordon Brown writes on how the NHS was created in Fife – and why it must be cherished

So it was with the creation of the NHS.

On July 5, 1948 in Edinburgh, local notables held a memorial service to mourn the passing of the voluntary charitable and private hospitals which were being nationalized.

In Glasgow University medical students unfurled a red flag on the roof of the city’s main infirmary to celebrate a socialist advance.

In Fife NHS staff simply got down to work. Jeanette Duncan and Anne Parker were two Fifers born on that day on 5 July 1948, who came together ten years ago to celebrate the 60th birthday of the NHS in Fife.

Also at the NHS party was nurse Isobel Fettes, who started her nursing career a day later on July 6 1948 and completed her career as a sister at Victoria Hospital.

It is often forgotten that, starting in wartime between 1939 and 1945, Scotland led the way to the creation of the UK-wide NHS in 1948.

Before then, healthcare services in Fife were an untidy patchwork of facilities – some local authority some run by voluntary and charitable groups.

Across Scotland there were 256 local authority hospitals and 219 voluntary hospitals with 35,000 beds between then. In the east including Fife there were 33 and 39 respectively with nearly 3800 beds

But it was the pressures of war that did most to change things.

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When war broke out, it was expected there would be 300,000 casualties in need of treatment and that the country would need 100,000 hospital beds.

In Scotland this led to the creation of a network of national hospitals run for the first time not by local authorities or the voluntary or private sectors, but by the Department of Health for Scotland.

One of them was on the borders of Fife, Kinross and Perthshire at Bridge of Earn whose hospital opened in 1940 and across its hutted ward blocks it housed 1020 beds.

However, with casualties much less than at first feared, the hospitals were soon brought into civilian use, and theyt were the building block for the NHS we know today.

But creating a peacetime health care system was controversial.

The patchwork of voluntary charitable local authority and private hospitals had to be integrated with the private GP services and maternity and midwifery as well as dental services into the new NHS.

Only Fife County Council and Dunfermline and Kirkcaldy Councils ran local authority hospitals. In Kirkcaldy there was also the Hunter Hospital built as a home and then gifted in 1896 and equipped as a hospital.

The now demolished Kirkcaldy Cottage hospital in Nether Street had been opened in 1890 largely due to the patronage of Sir Michael Nairn and was in fact Scotland’s only cottage hospital to contain circular wards.

In Thornton was Kirkcaldy infectious diseases hospital which had opened in 1902 and latterly became known as Strathore Hospital, before it closed in 1990.

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Forth Park was a later addition. Kirkcaldy Burgh Council acquired the 1860s Jacobean style villa, Forth Park House, in the 1930s and in 1937 it was converted into administration offices and a nurses’ home alongside e new 30‑bed hospital built on the site. Abden House remained a poor house situated between Kirkcaldy and Kinghorn.

Only later did we have the recently renovated and giant Victoria Hospital and Whyteman’s Brae Hospital with its 180 beds and 80 day places.

Some favoured local authority control of the new service, others wanted control retained in the voluntary sector.

Kirkcaldy Council advocated a regional hospital system and had a major role to play in the representations made by the Convention of Royal Burghs’, two of whose five members were the Provost of Kirkcaldy and the Town Chamberlain.

But instead of local control, the wartime Scottish Secretary of State, Tom Johnston, drew up a plan for the establishment of a comprehensive health service in Scotland – and he wanted it to be free of charge as well as universally accessible .

Without his intervention – and effectively his veto – the wartime cabinet would have voted for an insurance-based service with fees for a trip to the doctor’s surgery and means-testing when you visited the hospital. Our history might have been very different.

It was Johnston’s Scottish blueprint for a national service that the then Prime Minister Clement Attlee and his Health Minister Aneurin Bevan adopted for the UK.

Johnston won agreement that healthcare should be financed from general taxation and the pooling and sharing of risks and resources right across the United Kingdom.

When it officially began at 9am on Monday, July 5, 1948, the UK NHS had a budget of £437million. Wind forward 70 years and very soon it will spend more than 300 times as much – £150 billion.

Sixteen years ago our Labour government announced a better way to refinance the NHS for the new century.

With a £9 billion a year tax rise from a 1p rise in employer and employee national insurance, we were able to employ 30,000 more doctors and 80,000 more nurses and create the biggest hospital-building programme in NHS history.

Now, in 2018, despite the latest announcements of more money, the National Health Service in Scotland remains under-staffed, under-equipped and under-financed.

Average increases in health spending under the Labour governments between 1997 and 2010 were six per cent, the largest average annual increase of any government.

By contrast, under the Conservatives the NHS growth rate at around 1 per cent is lower than at any time since 1948 and the Scottish figure has come in lower than in England.

In both Scotland and the UK, the annual spending growth should be five per cent a year to meet the unprecedented needs of a rising elderly population.

I recall 10 years ago, when I was Prime Minister, we held a service of commemoration at Westminster Abbey to celebrate 60 years of the NHS. The most powerful speech on that day came from one of the service’s first nurses who vividly described the bleak conditions that existed before 1948. She forcefully reminded us that hard-working nurses had to leave the beds of their patients to run charity flag days, just to pay for life-saving equipment. We cannot return there.

All of us owe a debt of gratitude to the hundreds of thousands of staff who give us such comfort. But if we want to help them celebrate the NHS’s 80th birthday and 90th and 100th, then we require not just reforms to update the NHS to meet 21st century demands, but also the resources to be there for people when they need it.