Labour leader pays tribute to little known Scottish politician who ‘blazed the trail’ for NHS

By Katrine Bussey4th July 2018News ScotlandGovernment / Politics, Hospitals, News Scotland, NHS

A little-known Scottish politician who “blazed the trail” for the creation of the NHS has been remembered.

Scottish Labour leader Richard Leonard paid tribute to Tom Johnston, who served as secretary of state for Scotland between 1941 and 1945 in Winston Churchill’s wartime coalition government.

New hospitals had been built to deal with anticipated casualties from German bombing raids, but when this did not require all the beds available, Kirkintilloch-born Mr Johnston saw an opportunity.

Mr Leonard: “Tom Johnston was appointed as the secretary of state for Scotland in the wartime coalition cabinet in 1941, and one of the things he decided to do was to consider how the civil defence hospitals, which had been established for expected civilian casualties, could be used to both provide diagnosis and treatment for civilian workers involved in the war effort.

“During the wartime years, Tom Johnston saw an opportunity in and around Glasgow, in the Clyde basin, to put together the long waiting times people were experiencing for operations like hernias and so on, ear nose and throat treatment. He saw there was spare capacity that could be used to diagnose and treat war workers and he put the two things together.

“He rolled it out across Scotland and in so doing it drove down hospital waiting lists by 34,000. It helped form the basis for the 1944 white paper and it blazed the trail for the National Health Service of the post-war years.”

The Scottish Labour leader himself described the introduction of the NHS as “practical socialism in action”, adding that the service – brought in in 1948 by Labour health secretary Aneurin Bevan – brought about massive change in healthcare provision.

The new health service brought an end to the days of “worrying about whether you could afford to go to the doctors” for most people, he said, with this replaced with an understanding amongst the public that “because you were paying through general taxation it was free at the point of need”.

Speaking about this key principle of the service, Mr Leonard said: “It’s a defining idea of the Labour Party.

“It is precisely why we always champion the National Health Service and look for investment in it and for it to honour the founding principles which brought it into being.”

However he claimed the NHS in Scotland is now suffering because of a “significant failure in workforce planning” under the SNP Government.

Mr Leonard also demanded that the Scottish Government is “more radical” in how it funds the service, calling for Scottish ministers to reintroduce the 50p top rate of tax for high earners.

The additional cash this could raise could also provide much needed investment for social care, which is funded by local councils, he argued.

He said: “We want to see the Scottish Government using the tax powers it has got to better fund the NHS.

“An ageing population is a good thing but with an ageing population the demands are going to increase and we can’t just stagger on from year to year and try to manage it, it demands a more radical approach and change in the funding of public services.

“There is a need to address the funding crisis that is facing local government if we’re going to see an end to delayed discharge, if we’re going to see a health and social care system that treats people with dignity at the time of need.”

While the Scottish Government increased the top rate of tax north of the border from 45p to 46p in this year’s budget, ministers shied away from returning to the 50p rate which had been applied by the last Labour government at Westminster, citing fears that it could cause wealthy Scots to leave the country, thereby cutting income tax revenues.

But Mr Leonard said: “I don’t buy this behavioural change argument the SNP Government hide behind, a I genuinely don’t think there would be a flight of wealthy individuals from Scotland if the rate of taxation was increased.

“I think there is a huge over-exaggeration about this behavioural change factor.”

SCOTLAND HAD HEALTHCARE SYSTEM PRIOR TO BIRTH OF NHS

A large part of Scotland already had a state-funded health system in place when the NHS was created 70 years ago.

The Highlands and Islands Medical System, which had been set up some 35 years earlier, covered half of Scotland’s land mass.

Poverty was rife in the area and health cover was limited in remote and island communities, leading to the creation of the system in 1913, under which doctors fees were set at minimal levels.

The Second World War brought further advances in healthcare, with seven new hospitals created and new annexes built at others to treat those injured in German air raids.

But when casualty numbers were lower than expected, then Scottish secretary Tom Johnston put them to use to treat civilian patients who were facing long waits for surgery.

By the end of the war, nearly 33,000 people had been treated as a result.

Mr Johnston built on the success of this scheme with the Clyde Basin project, launched in 1942, which saw industrial workers referred to GPs – and on to hospital if necessary – in a bid a to prevent greater levels of ill health.

Former prime minister Gordon Brown has claimed that “Scotland led the way to the creation of the UK- wide NHS”, adding that without Mr Johnston “our history might have been very different”.

Breakthroughs continued after the formation of the National Health Service, with ultrasound scanners developed in Glasgow in 1958 and the UK’s first nursing studies unit created in Edinburgh the following year.

The UK’s first successful kidney transplant was carried out at Edinburgh Royal Infirmary in October 1960, and the Glasgow Coma Scale – which is used by medics across the world to rate patients’ level of consciousness – was developed in 1974.

Breast cancer screening was introduced across the UK in 1988, following a report produced by Sir Patrick Forrest, a professor of surgery at Edinburgh University – with this work building on pioneering efforts in Dumfries, Aberdeen and Dundee to screen women for cervical cancer.

The establishment of the Scottish Parliament in 1999, with health one of the key issues devolved to MSPs at Holyrood, saw more changes.

In 2002, the Scottish Parliament introduced the flagship policy of free personal care for the elderly, while Scotland again led the way in the UK with the introduction of the smoking ban in public places in March 2006.

More recently, the Scottish Government has focused efforts on the integration of health and social care, with plans brought forward in 2015 for local authority leaders and health bosses to work together in new joint boards.

Now the NHS in Scotland has more than 160,000 staff working across 14 regional health boards, seven special NHS boards and one public health body.