The ''Enquiry into the Cost of the National Health Service'', known popularly as the Guillebaud Report, was a 1956 report of the Government of the United Kingdom into the financial efficiency of the National Health Service. The chair of the independent Committee of Enquiry, and lead author of the report, was the Cambridge economist C. W. Guillebaud.

Background

The enquiry was called by the Conservative government and announced on 1 April 1953 by the then Health Minister,

Iain Macleod Iain Norman Macleod (11 November 1913 – 20 July 1970) was a British Conservative Party politician and government minister. A playboy and professional bridge player in his twenties, after war service Macleod worked for the Conservative Researc ...

. The National Health Service (NHS) had been established in 1948 and, in its first few years, costs had risen faster than anticipated. The independent enquiry would examine the long-term issues of funding the Service. The terms of reference were to examine the present and prospective financial situation of the NHS, to recommend structural changes that would improve efficiency, and to advise and recommend how the Service could maintain quality without escalating expense. Guillebaud had been Macleod's tutor at Cambridge.

Committee

In addition to Guillebaud, the committee included: * J. W. Cook, Professor of Chemistry at Glasgow University * Anne Godwin, Assistant General Secretary of the Clerical and Administrative Workers' Union * Sir John Maude, past Permanent Secretary of the

Ministry of Health Ministry of Health may refer to: Note: Italics indicate now-defunct ministries. * Ministry of Health (Argentina) * Ministry of Health (Armenia) * Australia: ** Ministry of Health (New South Wales) * Ministry of Health (The Bahamas) * Ministry of ...

* Sir

Geoffrey Vickers Sir (Charles) Geoffrey Vickers, VC (13 October 1894 – 16 March 1982) was an English lawyer, administrator, writer and pioneering systems scientist. He had varied interests with roles at different times with the London Passenger Transport Board ...

of the National Coal Board The Committee was appointed by Macleod and James Stuart,

Secretary of State for Scotland The secretary of state for Scotland ( gd, Rùnaire Stàite na h-Alba; sco, Secretar o State fir Scotland), also referred to as the Scottish secretary, is a Secretary of State (United Kingdom), secretary of state in the Government of the Unit ...

. For statistical background, the committee used a memorandum published by Cambridge University Press: "The Cost of the National Health Service in England and Wales" by Brian Abel-Smith and Richard Titmuss.

Findings

The published report found no extravagance or inefficiency beyond the inevitable imperfections of any organisation. It recommended no structural changes to the National Health Service. It found that the cost of the Service was not escalating as rapidly as had been feared, once inflation was taken into account. It called for more public funding for hospital modernisation, recommending £30 million pounds per year for seven years from 1958 onwards. It also recommended increased funding for

community care ''Community Care'' is a British trade magazine for the social care industry previously published by Reed Business Information Ltd. From 2017 it is part of the Mark Allen Group. ''Community Care'' was launched in 1974. It is now entirely online. ...

. The committee concluded that charges for dental treatment and for spectacles were undesirable. Citing the shortage of dentists, the report recommended keeping the dental charges but reducing the charges for spectacles as soon as resources allowed. The committee were divided about prescription charges that the Government had introduced in 1952. The report said that they "hindered the proper use of the Service by at least the great majority of its potential users" but still recommended that they be kept. The committee rejected the idea that there was a natural limit to the demand on the NHS. Instead they argued that the "acceptable" level of performance would rise indefinitely: "The advance of medical science continually places new demands on the Service, and the standards expected by the public also continue to rise."

Reaction

On its publication in 1956, Minister for Health Robin Turton told Parliament that the Government "broadly accepted" the conclusions of the Enquiry."No Change In N.H.S."
''Times'' ondon, England26 Jan. 1956: 8. ''The Times Digital Archive''. Web. 26 Feb. 2014. An editorial in '' The Times'' said the report might superficially seem to be "a bluebook full of hogwash" but that in fact the committee had "argued their case with considerable thoroughness." It was at a dinner to celebrate the publication of the report that

Aneurin Bevan Aneurin "Nye" Bevan PC (; 15 November 1897 – 6 July 1960) was a Welsh Labour Party politician, noted for tenure as Minister of Health in Clement Attlee's government in which he spearheaded the creation of the British National Health ...

(who as Minister of Health had introduced the NHS) remarked to

Julian Tudor Hart Alan Julian Macbeth Tudor-Hart (9 March 1927 – 1 July 2018), commonly known as Julian Tudor Hart, was a British doctor who worked as a general practitioner (GP) in Wales for 30 years. He was involved with research and wrote many books and s ...

that "ultimately I had to stuff their mouths with gold" about his handling of the hospital consultants during the founding of the NHS. The comment is often quoted as "I stuffed their mouths with gold".

References

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External links