NHS at 70 - invoking the vision of Bevan

No-one needed to explain housing’s impact on health to the founding fathers of the NHS. Nye Bevan was, after all, health and housing minister in the much-revered Labour Government elected to build a new society from the rubble of total war. Cutting his political teeth in deprived Tredegar, Wales, Bevan saw the impact of damp, cold and over-crowded housing on the lives of the most vulnerable. During this time, more than half a century before the first HAPPI report, he sought to improve the quality of specialist housing choices, Councillor Bevan was setting out new design and space standards for council housing.

As we mark the NHS’s 70th birthday, it is appropriate that Public Health England, NHS England and the Government have updated a Memorandum of Understanding (MoU), ‘Improving Health and Care through the home’, with a range of trade and professional partners - including the Housing LIN.  It will provide fresh impetus to the unending search for improved partnership working across health, social care and housing services. The MoU and its accompanying action plan commit signatories to work together to boost collaboration and integration of health and housing services and policies.

I was also pleased when in 2016 NHS England published a good practice guide on health and housing. The ‘Better use of care at home: health and housing’ guide outlines and illustrates that working with housing is good for NHS finances and the vulnerable people they serve. It focusses on the practical – highlighting innovations such as ‘step down’ services that see vulnerable people discharged and supported to recover and recuperate either back in their homes or in temporary accommodation with the appropriate support.

On the eve of the health service’s birthday it is interesting to look back to a blog I wrote when that guide was published. In ‘Home where the health is’, I concluded then: “Housing professionals can not only support personalised care in a person’s own home – they can help save the NHS.”

However, two years on and with last week’s promises of an extra £20bn for the NHS in return for even greater efficiencies, it was disappointing that neither the Prime Minister or the Secretary of State hardly referred to social care or addressed the wider determinants of health, such as housing and the built environment. Bevan would surely have done so.  

And with a long-awaited adult social care green paper now expected this autumn, the Housing LIN, our members and our MoU partners have led the way in showing the potential savings to the health and care system delivered by high quality housing provided across a range of tenures to support people at home. Our ‘Health Intel’ webpages are brimming with a selection of useful resources that evidence this ‘health dividend’.

Clearly, once we’ve packed away the anniversary bunting the hunt will continue for those efficiencies and new ways of delivering more joined up care for the next 70 years. Now is the time to reinvoke some of Bevan’s original vision for our NHS.

"Now is the time to reinvoke some of Bevan’s original vision for our NHS"

Follow Jeremy on Twitter - @HousingLIN

Comments

Posted on by Jerome Billeter

With thanks to Bill Ellson at Creekside Forum for this additional information:
He points out that housing was under the Ministry of Health from 1919 to 1951. A new Ministry of Housing and Local Government was created under Harold Macmillan in 1951 to increase construction rates. Apart from a new clause vesting hospitals in the Minister of Health (nationalisation) and replacing councillors on Willink's Regional Hospital Boards with Whitehall appointees the National Health Service Act 1946 was closely based on Henry Willink's 1944 white paper. Nationalisation of hospitals was a disaster. Hospitals whether local gov or voluntary (charitable foundations) had been built by local fundraising and endowments, all of which stopped. Bevan failed to provide any alternative funding mechanism which meant no new hospitals until the 1960s. By 1954 Bevan had realised his mistake and wrote in the Municipal Journal of returning hospitals to local government. Bevan did not set out any design or space standards for council housing in government, the Dudley Committee's 1944 standards were still in place the day he left office.

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