ANEURIN Bevan is well remembered as the architect of the NHS in 1948. Less well known are the backroom staff who actually built it for him, writes Chris Holme.

He came into office with Atlee’s Labour landslide in July 1945 – a young firebrand with a pledge to launch a national health service within three years.

This was ambitious enough, even with the existing plan from his Coalition government predecessor Henry Willink. But Bevan read it over in his first weekend in office and threw it into the bin.

Not a great start then. Consternation started to reach levels of apoplexy among his key civil servants: Sir William Douglas, who had just been appointed as his permanent secretary, and chief medical officer Sir Wilson Jameson.

The Herald: Sir Wilson Jameson (left)Sir Wilson Jameson (left)

Bevan had little in common with the two older Scots but they overcome initial suspicions to develop an extraordinarily close bond of mutual respect and trust.

Bevan’s idea was simple – nationalise every hospital (almost without exception) under a new administrative system funded by general taxation. Care would be free and available to everyone. This included women, children and older people – not just mainly male workers covered under the 1911 national insurance scheme.

Any lingering affection for the old model had been dispelled by AJ Cronin. He was the JK Rowling of his era. Hollywood fell over itself to turn his novels into cinematic blockbusters.

In 1937 The Citadel broke all records in America for publisher Little Brown. It portrayed contemporary medicine as then practised in Harley Street as corrupt and immoral. The film’s impact was sufficient to merit a re-release in 1948.

Cronin also had a direct link with Bevan whose politics were formed by the mining community of Tredegar in South Wales. Bevan returned there in 1921 – around the same time that Cronin started work for the Tredegar Workmen’s Medical Aid Society which provided free health care to subscribing miners and their families.

Douglas had been secretary to the health department in Scotland. He knew how do get things done in Whitehall from his work in the Labour and Supply ministries and the Treasury.

The first challenge was drafting and passing of enabling legislation (Scotland had its own act), followed by creating administrative structures from scratch.

On top of this they had to prepare for the anticipated avalanche of unmet need, such as for free hearing aids. They took the best model available and mass produced it as the Medresco – named after the Medical Research Council which carried out the assessment.

Jameson had impeccable credentials as CMO from more than 30 years working in London. He could float ideas not yet formulated as policy. As relationships with the BMA deteriorated into vitriolic hostility he still held its confidence - in his early career he had set up the BMA division in Finchley.

He had previously compared the health department in Whitehall unfavourably to a chaotic girls' school. Appointed in 1940, he went through the place like a dose of salts. His career had been in public health, latterly as Dean of the London School of Hygiene and Tropical Medicine.

Jameson also believed that public health worked better if it actually involved the public. He instituted monthly press briefings where he answered journalists’ questions. In 1941 he became the first civil servant in post to broadcast on the BBC - to promote diphtheria vaccination.

Aside from the day job, he also played a leading role in establishing the World Health Organisation, attending meetings in Paris, New York, and leading the UK delegation at the first WHO assembly in Geneva, one month before the start of the NHS.

Much of the civil service’s contribution to creating the NHS might have been forgotten but for Bevan’s speech in Parliament for the tenth anniversary in 1958 in which he broke civil service convention by naming and thanking Douglas and Jameson.

The two Scots shared an outside passion for the game of golf. The run-up to the 1948 Open created a late problem. It was held in Gullane where Whatton Lodge, one of the finest houses in Scotland, had been bought as a convalescent home for injured miners.

It had been the home of surgeon Sir Harold Stiles (successor to Joseph Bell, the inspiration for Sherlock Holmes). The sale ran counter to the policy of nationalisation and also created shudders of horror among affluent residents of Hill Road.

His nearest neighbour was his former assistant Sir John Fraser, considered by many as the finest surgeon of his generation, who died the year after Stiles.

The matter was finally resolved after a letter from Lady Fraser and her son said they had no objection “as they feel certain that had Sir John been alive, he would have been the last person to stand in the way of such a project”.

Bevan, Cronin, Jameson and Douglas would have applauded. Even the king came to watch Henry Cotton win his third championship – as if with surgically precise timing – three days before the NHS came into being.