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Home , Barbara Drake, Beatrice Webb, Fabian Society, Margaret Cole, National Health Service, Socialized medicine

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Honors Theses Student Research

1972 The aF bians and : a study of Fabian attitudes toward national health services Linda McIntosh

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Recommended Citation McIntosh, Linda, "The aF bians and socialized medicine : a study of Fabian attitudes toward national health services" (1972). Honors Theses. Paper 284.

This Thesis is brought to you for free and open access by the Student Research at UR Scholarship Repository. It has been accepted for inclusion in Honors Theses by an authorized administrator of UR Scholarship Repository. For more information, please contact [email protected]. THE FABIANS AND SOCIALIZED MEDICINE: A Study of Fabian Attitudes Toward National Health Services

Honors Thesis for Dr. 5. Martin Byle

In Partial Fulfillment of the R~quirements of the Degree Bachelor of Arts University of Richmond

Linda Mcintosh 1972 DEDICATED to my Mother who generously supplied my bus rare to . and from the Library of Congress PREFACE

Concentrating on the Minority Report of the Royal Commission on the Poor taw (1909), the National Insurance Act (1911), the (1942), and the National Insurance and

National Health Service Acts (1946)~ this thesis studies the various Fabian attitudes and philosophies toward British health services. No one "Fabian·program" existeda the Society did not, as a single body, endorse specific programs or ideas, allowing its members freedom of thought and opinion. Inside Fabian publications this policy is enunciateda This pamphlet, like all publications of the , represents not the collective view of the Society,but only the view of the individual who prepared it. The responsibility.of the Fabian Society is limited to approving the publications which it .. issues as embodying facts and opinions worthy of consideration within the Labour Movement. It is the aim of the Society to encourage among socialists a high standard of free and independent research. Nevertheless, although the Society did not require its members t.:) :::..,. ~-:: :: ~J..:. :: .._ C-_:,3..:."'·~ ,·:.~:: ~S -~ .:..-..·.!- 't. ~~! '~:~ ·.. r~_, ~.,. ... ;.1 ("; ~ ~ ~ :~~ ~ ~-": :-. ~,.·:.~- t·~ to support a cer~1n program, a general consensus can be found among Fabians--1n tracts, research pamphlets and memoirs. It is primarily this general consensus that is expounded in this paper, although some attention.is paid to divergent views. In 188), the year Karl Marx died, the Fab~an Society was born. in. Great Britain._ Although a·. socialist organization, the Society 1ras not Marxist. 'The .. members of this.middfe­ class movement did not believe in the class struggle and aimed not for a' proletarian but for the gradual transformation of the capitalist state to a "in order _.to ensure to the people the means of decent · living •••• "1 G. D. H. Cole, a Fabian and author of the multi-vol~e History of Socialist Thought, claimed that the Society aimed not. for but "social changes pointing in a socialist direction."2 The Fabians, striving for "equality of opportunity,") formulated.practical policies along socialist lines to reform economic, political, and social ills. Named after Fabius Cunctator, the "delayer, •• or strategist of gradual methods, 4 the Fabians worlred through Parliament and other key government offices for implementation of their programs and especially strove for th'e election of Fabians to these pos1tions.5 They also worked for support of th~ British citizenry through publication of their ideas in well-researched tracts and research pamphlets. Shortly after the creation of the Labor Party in 1900,6 the Fabians, disappointed with the Liberals, whom they had been supporting, attached themselves to this new party.

George Bernard Shaw, the famous British pla~fright and one - 2 - of the best known Fabians, wrote of this attachments . Though the Society may be officially affiliated to · the Labor Party the true Fabian is not, and never can be, a Party man or woman •••• All Fabians have their price, which is always the adoption of Fabian measures no matter by what party •••• The.Fabian Society exists, not to furnish the Labor Party or any other party with another squad of yesmen, but to head off the bolts of the labor movement in the wrong direction, and keep it to its vital points.7 It was through the Labor Party that the Fabians achieved the improvement of the nation's health services, a goal long -~·, - advocated by them. Dr. D. E. Bunbury, a member of the Society, wrote that the Fabians were"perhaps the first to express their conviction that all was far from well with the health services. • • • " William A. Robson, a member of the Society's Executive Committee in the mid-1940's, stated that the Fabians claimed the origin of_a national medical service.a The Fabians believed that all should have an equal chance for survival in society and that any impediments to this chance must be removed. Ill health, a principal cause of poverty and destitution, was one of these impediments. The first Fabian thrust against the existing health services came with the Minority Report of the Royal Commission 9 on the Poor Law. This Report, issued in 1909, was written and signed by two prominent Fabians, and , the former being the primary author and _the chief propagandist of the Report's proposals. The overall aim of - :3 - the Minority Report was the abolition. of the Poor· Law,lO in the section dealing with health• the authors of the Report· proposed a statewide unified health service established on the idea ot prevention of illness as well as curative treat­ ment. In 1909 the medical services--Public Health, under the Local H~alth Authorities (county·organizations), and the· Poor Law Medical Service--overlapped in their duties, and there was thus a loss of efficiency and waste of much money. The main' complaint with the Poor Law Service was that it "comes too latea it waits until the patient is destitute. It cannot legally do anything for a workman until his illness is so far gone that it actually prevents him from earning his wages.~ 11 There was no effort at prevention of sickness with this Service, and, in addition, m~d&cal care was inadequate due to low salaries, lack of skilled personnel, etc. The Minority Report urged the merger of the_Poor Law Medical Services and the Public Health Authorities into a unified, preventive .and national service under the direction of the latter.12

The service would not be fre~~. howeverr charges for medical care would be assessed on the individual patient's ability to pay. ~ The ideas expounded in the Minority Report were, to a large extent, the yiews· of Sidney and Beatrice Webb. Both

Webbs were extremely active i~ the Fabian Society and were its best known membersll1 .Besides advocating the merger - 4- of the existing medical services, they, too, opposed_ free . services, "they.wanted people to pay according to theirmeans and to feel that this was their reciprocal obligation if they accepted the_service."15. To put the lUnority Beport into effect, Beatrice Webb established in 1909 the Nationa1 Committee for the Prevention of Destitution, an organization separate from the Fabian

Society. A number of Fabians participated-~in it, but many ' 16 of its most active members came from outside the Society •. Nevertheless. in spite of the Committee's efforts, its work was defeated by the Lloyd George National Insurance Bill of 1911.1? ' .

Lloyd George's scheme was primarily aimed at poverty and disease. His bill, which dealt with unemployment and sickness, aimed to alleviate these problems through a compulsory contributory insurance schemei but the scheme was not compre­ hensive. Its basic provisions relating to health were the compulsory insurance contributions of all males and all females, 'sixteen to seventy, in manual ettployment and all in non-manual employment earning~60 or less. Insurance was on a voluntary basis to anyone else wholly or mainly dependent for a living on a regular occupation, still subject to a~l60 income ceiling. (Narried women, who, it was thought,' were not "wholly or ttainly dependent" on a - 5- regular .occupation, could not become voluntary contributors.) Contributions from compulsorily insured workers were 4d. a week, Jd. from employers, and 2d. from the state. The contributor, in addition to receiving insurance benefits, could enroll on the "panel" of any doctor participating in the scheme and receive free medical treatment. ( services were not free, tha cost per patient being assessed according to his ability to pay.) Benefits were distributed through the countiesr medical benefits were administered by insurance committees and sickness payments by approved societies, state-directed non-profit insurance companies. The sickness benefit varied from Ss. to lOs. for men and from Js. to ?s.6d~ for women for 26 weeks and, after this, a disablement benefit amounting to 5s. a week. A maternity benefit of JOs. was also ~rovided.l8 The bill also appropriated~l,SOO,OOO for sanatoria for the treatment of i 9 tuberculosis for the-whole population.l Members of-the Fabian Society criticized the important aspects of the bill, especially the compulsory contributory principle.. Josiah Wedgwood, a Fabian and Labor NP in 1911, opposed the compulsory nature because it would force people t~ insure who might not want to.20 The Fabian Henry D. Harben "objected to a that fell on all alike, irrespective of their power to pay •••• "21 The Society's pamphlet

"The Insurance Bill and the ~l<:>rkers .. criticized the - 6 - contributory scheme as suchr A contributory scheme ••• carries with it the disadvantage that from its very nature it is so far :from being National. Moreover, it lays the heaviest-burden on those least able to bear it, involving as it does, a compulsory contribution o:f the nature of a tax from the poorest workers. I:f its benefits are conditional upon a share con­ tributed-to the insurance funds from individual earnings, then only those can be benefited who earn money :from which to contribute.22 Philip Snowden in his speech to the Fabian Society heatedly exclaimed that the bill "would be a tax on the starvation o:f the people, a pettiflogging, meagre, meddle­ some, inadequate and ineffective way of dealing with conditions which were a grave menace to the community."2J Feeling that "those who could really afford to_ pay contributions would, if they wished to do so, already have insured themselves,'" .the Fabian Executive Committee in June, 1911, offered two amendments to Lloyd George's bill: 1) "no contribution should be taken from persons receiving

~ess than a 'living wage• (with the deficiency being made good by the state, not by the employer)a" 2) "every insured person should get a certain 'minimum benefit' which, as things~ood, those who most needed i tlthose with incomes below /..l6oJ would not receive."24 Another criticism of the bill, running a close second to the contributory scheme, was that the bill was not 25 national, for it covered only one-sixth of those employed. - 7 - The Fabians wanted "a sound collective provision for all sick and disable:lcitizens, young and old ... 26 George Lansbury, a .Labor MP in 1911, complained that the scheme failed to provide for the person unable to contributes "My main objection is that • • • you are leaving out large ,.27 masses of the very poorest part of the population. • . . ' Josiah Wedgwood, besides opposing the contributory scheme, ' ' disliked the income limit ~160) because he would have liked to bring in the whole population.28 No married woman, even though earning a living in a regular occupation, could become a voluntary contributor.29 Wives and children of insured persons were also excluded from benefits. , a prominent Fabian and Labor HP, \'ranted to bring the married woman more within the scheme, commenting that her position as the bill stood was a very anomalous one.J0 I Benefits and the handling of these payments by •approved ' . societies" were another cause of Fabian complaints. George Lansbury criticized the small benefits, feeling there should be nothing in the bill to prevent a sick man's receiving benefits almost equal to his earning power.Jl Other faults - 8 - with the benefit aspect, according to the Fabians, wemthat 1) it was unfair to those who joined late in life because those over fifty weren't eligible for benefits until they had paid premiums 'for_r, SOO weeks 1 2) women got a lower rate of benefit than men• J) wives and children of insured men were excluded 'from benefits except maternity, although the husband's contribution, deducted from hissalary, meant the family had less spendable income. The whole family was, therefore, contributing to the schemet 4) sanatorium benefit was denied the wives or insured consumptives, 5} maternity benefit for the insured woman was not accompanied by sickness benefit unless a disabling condition,- other than mere child-birth, was associated with her pregnancy, or if her employment made it advisable to stay home.JZ Thus, she received no money in place of her wages, 6) funeral benefits were non-existent, and 7) different societies gave different benef1ts.Jg Every insured person was to enroll in an approved society, but an approved society could reject an applicant. Thus, those societies having healthy persons on their rolls had the money to give additional ~enefits" not available to members of less fortunate societies. This destroyed the concept or equal benefits for equal contr1but1ons.J4 The deposit contributors (those not in an approved society through no fault of their own) could receive no insurance--only medical care--and this was obviously un'fair as they had paid contributions - 9 - equal to those persons in approved societ1es.J5 In addition to these shortcomings, the bill made it difficult for trade unions to become approved societies. By the terms of·the bill, the was required to separate its benefit funds from the .rest of 1ts money. · Consequently its financial resources for other union . activities were dimin1shed36, malting it difficult for the union to·operate as a union. Besides attacking specific provisions of the bill, many Fabians disapproved of it because it was not preventive in nature--the philosophy behind the bill was wrong. One Fab1an,'Sydney Herbert, preferred using the money for housing and sanitary reform,37 apparently seeing this as being a greater step toward the health of the nation. Beatrice Webb, the most vocal Fabian on prevention of sickness, aimed to use social services "as a means of disciplining the recipient into self-improvement."38 Believing the insurance scheme inferior to the Minority Report,39 she felt it "put plasters on the wounds but made no attempt to prevent ill- toward Lloyd Georg~~ bill health ... 4o A Fabian writing of the Webbs' attitud.e/saidr "There were no provisions in his Act for averting or curing sickness or for checking mora:l lassitude. Benefits were linked with contributions and the wording of the Act did not permit of any synthesis between cash payments and preventive 41 and curative services." - 10 - Beatrice Webb, in connection with her complaint that sickness would not be prevented. . under. the National. Insurance Bill, thought persons receiving cash benefits would malinger. Obviously having little faith in the average person she wrote a "The:· fact .that siok and unemployed persons were entitled to money incomes without any corresponding obligation to get well and keep well, or to seek and keep employment, seemed to us ~Sidney .and her_? likely to encourage malingering and a disinclination to work for their livelihood."42 For this reason she opposed the free-choice-of-doctor provision of the bill, feeling that patients would choose the "least censorious about personal weaknessesand most indulgent in dragging out convalescence ...... 4J Medical aid should be available to all, yet the sick person had a moral responsibility to get well and s~ay healthy.44 one indirectly positive aspect of the bill that might prevent this malingering was that the benefits were "so wholly inadequate that it will be only the very worst workman who will want to claim it and n45 remain out of work. • • • In addition to criticizing the bill, the majority of Fabians hoped to prevent its enactment46, in spite of their inability even to gain complete support among their fellow members for their effort. The Labor Party, through which the Society worked, voted for the bill because to them it was a step in the right direction.47 (The parliamentary - 11 - party was censured by a vote of 241 to 39 for this action by the 1912 L~bor Party conference.48) Of the thirteen Fabian Labor MP's, only three voted against the third reading of the bill as a whole--Philip Snowden, James O'Grady, and George Lansbury.49 Differences or opinion among the Fabians even carried into the Society's Executive Committee, in spite of the overall critical attitude, Edward R. Pease, one of the Society's founders and its first secretary, and Sir Leo Chiozza Money, a Fabian MP, favored the bill. They wanted "to take the complacent view that the Society's principle was that of •accepting and making the best of' a 'Bill introduced ,, . by a strong government,• and that the Society ought therefore dissociate itself from the attacks upon the measure."SO Chiozza Money supported it especially in. hopes that this woUld be just the beginning of measures "for.the health and ~ ...... well-being or all ~lasses. of the community."Sl , a young Fabian, having joined in 1907, was even officially chosen to explain the 1911 Act.52

In spite of divisions withi~ the Society, a campaign to defeat the bill began soon after its introduction in the spring of 1911. The Crusade, ··organ for the National Committee for the Prevention of Destitution, denounced the bill. The Webbs "put forward ••• their criticisms and alternative .recommendations personally to ministers and officials and - 12- publicly in their works, .. SJ such as Prevention of Destitution (1911 In early July, at the Annual Conference or the Fabian Societies, a resoluti~n was passed .)8 to S that though the conference "would cordially' w_elcome a measure dealing nationally with / maternity, sickness,and unemployment ••• the Bill now before Parliament should be opposed." They cited the contributory scheme, the non-provision for insured members• families, and the remedial rather than preventive nature of the bill as their reasons.S4 On July 28 the Fabian Executive Committee and the and South Counties Division of'. Labor Party (ILP), for the same reasons as the Annual Conference, denounced the National Insurance Bill as "unsound in principle" and called tor opposition to itt Recognising that ••• these defects in the scheme. are fundamental and cannot be removed by amendments in Committee,SS this meeting urges all Socialists and Trade Unionists to unite in demanding the with­ drawal of the Bill nolf before Parliament in favor of measures dealing with maternity, sickness and unem- . ployment on non-contributory and truly national lines.S6 Nonetheless, the anti-bill Fabians did not have enough support and the bill became law in December, 1911.

The Fabian Society's political power in 1911 was minimal. In 1919 Parliament passed an amendment to the National Insurance

Act which, though raising the income ceiling to~\250, continued to exclude dependents.S7 Actually, Fabian agitation for improvement or· British health services had died out following - 13 - passage of the 1911 act. In 1924 and 19~i. two Fabians argued for improvement of the environment--clean air, more light, less crowding--to prevent s1ckness,58 but these were the only Fabian statements pertaining to health until 1941. This lack of. agitation for change in medical services can, to a great extent, be attributed to the Fabian Society's general silence on all matters in the 20's and 30's. l1argaret Cole, a Fabian and wife of G. D. H. Cole,. in her history of the Society, stated that the Society as a whole did not concern itself much with the Labor Party or socialist policy in the mid-twenties, and she called the 1930's a time of inertia.59 ,This lull in the Society's activities are evidenced by noticing the decline in the number of Fabian tracts during this time. Before 1914, the approximate number of tracts per year was six. In the twenties this average declined to 4.J and in the thirties t.o 1.7. But, by the late 1930's the Fabian Society had returned.to life. In 1941, with the appointment of the Beveridge Committee, the Society became more active than ever before.

The Inter-departmental Comm1ttee on Social Insurance and Allied Services, under Sir , was set up on JuAe 10, 1941, by , a Labor MP, to study the nation's social services and make recommendations tor their improvement. (This was the largest social survey

Britain had ever see~) It was not until the outbreak of - 14- of World War II that the government saw how bad the existing services were. The formation of this committee served as a kick-in-the• pants for the Fabian Society.. The Social Security Subcommittee of the Society, formed at this time, submitted much evidence to the Beveridge Committee, which used a good deal or it. This evidence called for ua free public medical service and • • • rehabilitation service," claiming that too much attention had formerly been placed on the cash aspects and not enough on positive services. Sickness benefits must be at an adequate level to meet need and must extend for an 1ndef1n1te period, although strong sanctions would be taken against the malingerer. Benefits would be awarded to all gainfully employed persons, but some allowance would go to even those unemployed.60

The Beveridge Report was submitted to Parliament~on November 20, '1942. Its principal recommendation was the establishment or a Social Insurance Fund to which all would contribute and which would provide sickness, unemployment, maternity, retirement, and other benefits. Those unable to contribute· would be exeopted from their weekly contributions and their needs supplied, to a subsistence level, by national assistance. Assistance would be given "subject to proof of needs and examination of means," and its cost born by the national exche~uer.61 - 15 - In regard to health the Report called for "the estab­ lishment of comprehensive health and rehabilitation services for the prevention and cure of disease and the restoration of capacity tor work. • • • n62 Restoration of a sick person to health was seen as the responsibility of the state and the isiok person.63 Adopting the Fabian ideas, the i!eport described .the proposed health service as providing "preventive and "curat1 ve treatment of every kind to every citizen without exceptions, without remunera~ion limit and ld thout an

~economic barrier at any point to delay recourse .to it. • • • .. '• Wi~h the contribution to the Social Insurance Fund all cit1sens would reoelve treatment without charge. Dental and ophthalmic appliances, however, would carry a charge.64 Also, the cash benefits would be separated from medical treatment.65 The Fabians, as well as the rest of the nation, enthusias­ tically supported the Heport.66 Enthusiasm was so strong

~hat members of the Society set up a special committee to further the Heport•s and research 1ts assumpt1ons.67 The Fabian Quarterly, the Society's journal, called for speedy enactment ofBmedgge's plans "The plan can be whole-heartedly supported by every one of us. In essentials, it 1s very similar to the evidence submitted by the Society's Social Security Sub-Committee. • • • Our task now is to get the plan n68 on to the Statute Book. • • • - 16 - Fabians called for adoption of the proposals in spite of the increased cost of Beveridge's scheme. , A Fabian and leader of the House of Commons in Attlee•s 1945 government, responded to critics of its cost& "Can we afford not to do it."69 One argument was that the Beveridge Plan would more than pay for itselfJ each of the persons presently ill, when restored to health and to work, would make a contribution of ~JOO a year to the national income.70 \

\. ' It is necessary to inject here the fact that the Fabians in. the early 40's were not sitting around letting William Beveridge do all the work. The formation of the Bommittee had sparked members of the Society to make numerous proposals concerning health services, in addition to those submitted to the Bommittee. The fact that these individual positions on health so closely coincided with Beveridge's ideas accounts for the great support among Fabians for his plan. F,or instance, the book Social Security (1943), edited by ' , William A. Robson (cited earlier) .and another c·U.tgrowth of the Fabian Social Security Sub-Committee, anticipated i mnch of the Beveridge Report.71 The general Fabian aim, as in 1911, was a·:WJ.ited, national, preventive health service. In 1941, , in his Fabian research pamphlet on post-war health service~ stated th~s rather conciselya - 17 - The service must be complete, providing everything that is necessary for the prevention and cure of disease,· it must be free, or at any rate there must be no consideration of direct payment for services rendered or of refusal to those who cannot afford to ~aya it must be positive in character and aim at maintaining everyone in the best possible health, and not merely at relieving them of the wo~~t effects of disease and keeping them alive.' · Dr. Brian Thompson in 1942 emphasized prevention of diseasea "health education of the people would be an essential feature of our programme"73, and the national aspecta "The same medical care will be available for all strata of the community, rich and poor alike, and it will be of such a standard that the rich could, if they would find no better."74 Some of the faults found with the health services under the 1911 Insurance Act, such as care only, lack of a unified hospital system, and others, should be remedied.· The whole serVice would be "organized and

1administered regionally and controlled nationally by the Minister of Health ... 75 The basic idea was to divide Great Britain into regions, which would contain counties.

) ~ch county would have accessible health centers staffed

:~th general practitioners and nurses. ·Near these centers r-ould be a well-equipped hospital with specialists and a sufficient number of beds. Unlike the 1911 system, the

~voluntary and public health would be formed into :-one national hospital system. A fully staffed rehabilitation ·service, also omitted by Lloyd George's Act, yet seen as a ~ 18 - vital. part of a good medica~ service, would be provided for all needing it. More emphasis would be placed on improving the tuberculosis, maternity, and school medical·services. (The school medical service was especially needed for prevention · and treatment of illness in children~) There should be a national salary and pension scheme for doctors, and patients should have free choice of a doctor.76 Doctors, however, would be allowed no more patients than they could efficiently serve. This policy represented a major change from national in which doctors were paid on a capitation fee and thus competed for patients, causing a decline in effective treatment and time for research. Under the Fabian scheme, the doctors would have time and be encouraged to conduct research.?? In regard to'sickness benefits, the Fabian Quarterly for the.summer of 1942 said that cash payments must be closely allied to positive medical treatment, yet must not be deemed more important than treatment.78 The Quarterly was responding . . . to the nature of ·the National Insurance Act of 1911, where medical treatment was a side benefit of insurance payments.

Cash ~eneflts should be higher--"high enougn to maintain an

c adequate standard of food, clothing and domestic amenities,

~o that long periods of benefit would not impair vitality as at present. ~ •• "--and there should not be a limited benefit period as in the 1911 scheme.79 These benefits· should also - 19 - come from the state, not approved so~ieties. 80

Aiming for enactment of the Beveridge Report, the Labor governmentr formed in late 1945 under the Fabian, Clement Attlee, succeeded in placing national insurance on the statute books. As in Beveridge's plan, the National Insurance Act, 1946, provided for a contributory insurance, compulsory on employees, employers, and the state. (Self­

employe~ persons paid the employer's contributio~too.) Similar also to Lloyd George's scheme in this respect, the pew act,:~1n addition,_ adopted the idea of weekly stamps:;

With every cont~1bution the insured person had a stamp placed on his insurance cardr the paid-up contributor was therefore ; easily identified from the non-insured or delinquent contributor •

.~enefits covered unemployment, sickness, maternity, retirement, .. . . ' disability, death, and other problems.81 Standard benefits, allowing for adequate living standards, were 26s. a week for ':'1 ~ single adult, 42s. a week for a couple living together, 7s.6d., weekly for the first child (subsequent children also being provided tor), and 16s. weekly for an adult dependent.82 Women now received the same benefits as men. Approved societies were out, the benefits being administered by the state for the period of need. It _is interesttng that a government, -~_;;ftf:Jfls Fabian, supp~rted aoompulsory ~o~tribubory insurance, when they had - 20- opposed this principle in 1911. The National Insurance Act was pass~d without even a count on February 11, 1946.83 This support can be attributed to the fact that though this act was slightly similar to Lloyd George's, there were a number of differences. For one, the act was national. All -tN.- were to contribute and thus everyone, including).Pontr1butor•s dependents, would receive insurance benefits. Those too poor .to make payments could be exempted from contributions and obtain relief under national assistance. (Provided for in ' the Beveridge Report, a National AsSistance Act was passed in 1947.) Secondly, ben~fits under this Act were higher than.under the 1911 scheme, where the benefits were hardly worth the contributions. Insured persons could now maintain a minimum standard of living as long as they needed benefits. Thirdly, .the health services, as sketched in the Beveridge Repo~, would .be free to all84 and did not depend, as did the 1911 act, upon whether or not a person participated in' the insurance scheme. Thus, poor persons could receive medical care. The National Heatth Services Act, 1946, provided the a~mprehensive and·rree health services mentioned above. It aimed at promoting "the establishment in and Wales. of .a .. _,. • health service, designed to secure improve­ ment in the physical and mental health of the people or England and Wales, and the prevention, diagnos$s·and treatment - 21 - of illness." The Ministry of Health was responsible for ensuring that health services of every kind and of the best quality were available to every citizen needing them.85 The country was divided into fourteen hospital regions, each with a teaching hospital and a medical school. A hospital board for each region has been in charge of planning and coordinating its region's hospital and specialist services. Below these boards were established 138 executive councils, one for almost every Br~tish county and county borough. These councils have been responsible for the administration and management of the counties' family practitioner services. The third anifinal administrative division are the local health authorities or county and county boroughoouncils, numbering 144 in 1946. (These councils previously had charge of public health.) The local health authorities have provided the preventive services--health visitors (for instruction on health matters), immunizations, maternity and midwifery services, and environmental services such as street cleaning and control of the water supply. Although the Hinistry of Health has supervised the regional hospital boards, executive councils, and local health authorieies, the latter have been almost autonomous.86 The variety of services administered under the 1946 act has included, besides a family doctor service, specialist treatment and out-patient departments in hospitals, such things as home visits (when the patient is unable to get to - 22 - the doctor), dental and ophthalmic services, pharmaceutical service, treatment for mental disorder and tuberculosis, rehabilitation care, public health,laboratory serv1ces,·and blood transfusion service.B7 (School medical services are separate.) As established in the aot, the patient was free to choose his doctor, a doctor's entry into the service being optional. If a doctor chose to enter the service, his salary would be a bas1c~JOO plus a capitation free for each patient on his list.88 Emphasis was placed on research and thus the doctor could not have an overwhelming number of patients. Financing of the scheme has been primarily through taxesa 85 to 90 percent of cost from general tax revenues and, 10 to 15 percent from the contribution by the National Insurance Fund to the health services.89

The actual health services bill, which received the ~oyal Assent on November 6, 1946, was enthusiastically supported by the great majority of Fab1ans.9° Dr. Bunbury summed up the general attitude when he wrotea "The Bill represents the greatest opportunity that bas ever been given to this country tor the development of a health service which from the point of view of the patient, which must be paramount, will provide everything he needs in the way of ...... 9l Besides the Fabians, the general population was extremely - 2J- pleased with the act as passed. Ninety-five percent of the population signed up for the service by the "appointed day", July 5, 1948, when approximately 3426 hospitals, convalescent homes, and went under government control. The medical profession also signaled approval of the service for, by 1948, 18,636 o~ the 21,000 general practitioners had signed up to \ participate, besides ninety-one percent of the 10,000 estimated ~' specialists and almost all of the , ophthalmic and dispensing opticians.92

The Fabians had advocated a comP,rehensive medical service for all the nation. They got it. The Fabians wanted the service to be free, meaning that no citizen should have to be ill because of lack of money to pay for treatment. This they also got. The does provide for even the poorest. The Fabians wanted a unified service. This, too, was achieved. The f.linistry of Health is in charge of the Public Health Services and the National Health Services, and both services are partially administered by the local health authorities. The one aspect of the health service that was not adequately accomplished was the prevention of sickness. The Natioaal Health Service is primarily a sickness insurance though it does direct some attention to prevention of illness. Laurie Pavitt, a Fabian writing in 196J, explained that the first stage of the health services had been achieved but that it was now time for stage two. One aspect of the second stage would be the shift of emphasis from cure to prevention.93 - 24 - The Fabians, as seen by responses to Lloyd George's bill, were not always a unified body as far as individual programs were concerned, but their basic objectives were essentially the same. The Society aimed for equality of opportunity and.prevention of disruption of earning power for all, and to achieve this, sickness, unemployment, etc.--those maladies which hampered citizens from obtaining a minimum standard of . . living--must be removed. In 1946, the National Insurance and National Health Serv~ce were, among other welfare measures, seen as a means to achieve this end. The Fabian Society had grown tremendously in size and political power (through the Labor Party) since its birth, having in 1946, approximately five thousand members. Technically speaking, the National Insurance and Natiom 1 Health Service Acts, and other welfare acts, can be directly attributed to the Labor government, under Clement Attlee, establ~shed in Augus~ 1945. Of the appr~ximate 393 Labor members, 229 were Fabians. Thirty-six Fabians were on the cabinet.94 But, it would be too easy and a mistake to give full credit to the Fabians. The Fabians favored these acts

I and the party which enacted these measures was approximately th1!Hh·flf'tf..s Fabian, yet the British populace also favored and backed these programs. Did the Fabians influence the citizenry or had the people moved on their own in the direction of a welfare state? The infludnce of the Fabian Society on British - 25 - policy and thus the answer to this question are unfortunately beyond the scope of this paper. It is most probable that no matter which party, Conservative included, had come to power in 1945 would have enacted similar plans. as early as 1941 had considered a comprehensive medical service as part of post-war reconstruction.95 Suffice 1t to say that in 1946 the Fabian Society played a vital role in achieving one of its goals and Great Britain moved closer toward becoming a welfare state. FOOTNOTES

1. G. D. H. Cole and , The 1Z46-1946 (New York, 1947), p. 356-7. 2. -Ibid., p. 356~ 3. Rule II of the Fabian Society cited in Mary E. r-turphy, "The Role of the Fabian Society in British Affairs," British Socialism Today, ~Julia·;;.E~-·Johnsen~-'·: comp. -c Tbe~~Beferenoe Shelf, v. 22, no. l) (New York, 1950), p. 18. 4. a. R. Palmer and Joel Colton, A History of the l·lodern World, 3rd Edition, (New York, 1965), p. 594. 5. Mary Murphy, p. 18. 6. The Labor Representation Committee created in 1900 became the Labor Party in 1906. 7. , "Fabian Failures and Successes," Fabian Quarterly, XLI (Zpril 1944), p. 4-5. H. G. Wells, the famous British writer, tho\tgh not specifically cited in this paper, was also a prominent Fabian • .• . 8. Dr. D. E. Bunbury, "The National Health Service Bill," Fabian !j.uarterly, L (June 1946), p. 2J and William A. Robson, "The Influence of Fabianism on British Social Policy," Fabian Quarterly, XLI (April 1944). p. 13. 9. The Minority Report was not only written by Beatrice Webb and George Lansbury, but it bore the Webb stamp.

10. A~ early as 1890~ Sidney Webb called for reform of the Poor Law in Tract No. 17. Joseph F. Oa~eshott in "The Humanizing fjf the Poor Law", Fabian Tract, LIV (1897), advocating the change of the Poor Law (no mention of its abolition), aimed for its humanization, and cited the health eervices. 11. National Committee for the Prevention of Destitution, The Case for the National H1nimum, (London, 1913), p. 56 • . 12. Sidney and Beatrice Webb, The State and the Doctor (London, 1910), passim. Sidney, though not a member of the Commission, supported the Minority Report's proposals.

13~ ~-· p. 254. - 2 -

14. Sidney ~ebb joined the Society in 1885 and was the leading Fabian theorist and expositor for a number of years. Be was also acti~e in the Labor Party and in the government, being a member of Parliament, President or the Board of Trade, Secretary for the dominions and colonies, etc. He and Beatrice wer~1:·partner socialists from the time or their marriage in 1892.

15. Joan Simeon Clarke, "The Break-up or the Poor Law," ~he Webbs and Their Work, , ed. (London, 19 9), p. 111. 16. Edward R. Pease, The History of the Fabian Society (London, 1918), p·. 218-19. 17. Joan Clarke, Break-up, p. lOJ-4.

18. Pauline Gregg, The Wel~are State1 An Economic and Social Elsto of Great Britain fron 1 4 to the Present Da Amherst, 19 9 , p. 12. To identify contributors each insured person had a stamp placed on his insurance card with every weekly contribution. 19. Maurice Bruce, The Coming of the Welfare State (New York, 1966), p. 184. Tuberculosis at that time was a very widespread disease, due especially to la.clr'"'of~"treatment. 20. Great Britain, Parliament, House of Commons, Parliamentary Debates, 1911 session, July 5, 1911, p. 1212-15. 21. Fabian Society, Fabian News, September 1911. 22·. Fabian Society, The Insurance Bill and the Workers (London, June 1911), p. 2. 2). Insurance' A Critical • 24. A. M. McBriar, Fabian Socialism and English Politics 1884-1918 (Cambridge, 1962), p. 277• 25. Carl F. Brand, The Br1t1sh Labour Party, A Short History (Stanford, 1964), p. 25. 26. FS, Insurance Bill, p. J. 27. Great Britain, Debates, July 5, 1911, p. 1153-4. "7/t? /1 28. Ib1d,.;1 p. 1249. - J -- 29. FS, Insurance Bill, p, 4. 30. Great Britain, Debates, July S, 1911, p. 1196-7. Remember that a.married woman could only be a compulsory contributor. 31. Ibid., July lQ, 1911, P• 1244-5. . . 32. An insured woman qualifying for sickness benefit with maternity benefit could not reveive the former for the first four weeks after confinement unless she was unmarried and her incapacity was not connected with chi1~-birth. 33. FS, Insurance Bill, p. 5· )4. Ronald 11endelsohn, Social Security 1n the British Common­ wealtha Great Britain, Canada, Australia, (London, 1954), P• 37-8. · 3S·. FS, Insurance Bill, p, 7-8.

36~ Fabian News, September 1911. 37 •. Ibid., August 1911. 38. Sidney and Beatrice webb, The Prevention of Destitution (London, 1911), p. 191-2.

39· McBriar, p~ 275. t,.o. Hargaret Cole, Beatrice Webb (};ew York, 1946), p. 118. lj.1. Joan Clarke, Break-up, p. 115.

~2 •. Beatrice Webb, Cur Partnership, and Margaret I. Cole, ed. (New York, 1948), p, 430. The Webbs (i'r1nc1pally Beatrice) were the only Fabians found to have this deep d1struet of people.

I :~ , , ~3. and Ruth Adam, Beatrice Webb, A Life, 1858-1943 (New York, 1968), p. 177. 4-4,'" Ibid, p. 177, .

~s. Webb, Cur Partnership, p, 468. -4-

46. It must be rioted that the Fabians were not the only persons in Britain criticizing the Bill. Lloyd George had much trouble bringing the doctors and others to his side. For further information on this, see William J. Braithwaite, Lloyd George • s Ambulande \-lagon a Be1ng the Hemoirs of W. J. Braithwaite 1911-1912 (London, 1957). See also Gregg, Welfare State, p. 12-13. 47. Brand, p. 25.

48. ~ •• p. 25-26. 49. McBriar, p. 325. It is interesting that Keir Hardie abstained from voting on the bill. so. ~ •• p. 276. 51. Great Britain, Debated, Hay 29, 1911, p. 796. 52. Clement R. Attlee, As It Happened (New York, 1954), p. 41-2. 53. HcBriar, p. 296. 54. Fabian News, August 1911. SS. The Fabian JtlP's on the bill's committee worlted to amend the bill, but the basic faults remained.

56. Fabian Ne~1s, September 1911. 57· Gregg, p. 14. 58. Charles P. Ch1lde, "Environment and Health," Fabian Tract, CCVIII (!!.arch 1924), p. 14. Also, Richard Henry Tawney, agual1ty {Halley Stewart Lectures, 1929)C London, 19Jl~,p. 197-8. 59. Margaret Cole,· The Story of Fabian Socialism (Stanford, 1961), p.l94 and 218. ,. 60. Fabian Society, "Memorandum of Evidence submitted to the Beveridge Committee by the Social Security Sub-Committee of the Fabian Society," "Appendix," Social Zecurity, HillAam A. Robson, ed. (London,194J), p. 4o6=409. 61. Beveridge, Sir William, Social Insurance and Allied Services, (New York, 1942), para 369, p. 141. Hereafter cited as · Beveridge Report. - s - 62. Willard c. Rappleye, "The National Health Ser~ice of Great Britain," British Socialism TodaY, p. 109. 63. Beveridge Report, para427, p. lS8. 64. Ibid.·, para ZJ..;24J?·, ~ p~· .... 16q.,.62. 6S. l.2!S•, para 106, P• 48, 66. Beatrice.Webb reacted unenthusiastically to the Report when she heard of it (Muggeridge, p. 252) although G. D. H. Cole commented that much of it reproduced the ideas ot the Minority Reprot (Anne Fremantle, Th~s Little Dand of Prophetsa The British Fabians (New York, 1959 , p. 188.) However, the main reasons Beatrice reacted this way were that those were such large-scale reforms she doubted they could be financed, and the unemployment insurance aspect brogght up the/old concept of malingering (Muggeridge, p. 252.).

67·. Fabian Society, "Fabian Research ~uarterly Report," Fabian Quarterly, XXXVII (Appil 1943), p. 35. Margaret Cole claims that though the Society approved of the Report, it lacked tee funds to popularize it (M. Cole, Fabian Socialism, p. 295. 68. Fabian Society, "Points for Planners," Fabian Quarterly, XXXVI (January 1943), p. 1. 69. Herbert Stanley Morrison, An AutobtograPhY (London, 1960), p. 229 70. R. W. B, Clarke, "Social Security Housekeeping, •• Social Security, ilm. A. Robson, ed. (London, 1943), p. 355. 11. H. Cole, Fabian Socialism, p. 294. 72. Somerville riastinga,·"The Health Services 2a The Hospital Servicesa A Policy for the War and Post-War Period," Fabian Research Series , LIX (1941), p. 2. Among other Fabians feeling the service should be teee wasr G. D. H. Cole, Fabian Socialism (London, 194J), p. 88. ?J. Brian Thompson, M.D., "A Letter to a Doctor," Fabian Letter, VI (1942), Pe J. . 74. Ibid., p. 2.

75• D. Stark Xurray, "Nationa~ l1ed1eal Service," Social Security, n_ ~0~-" - 6 -

?6.,Note the difference with Beatrice Webb over free choice of doctors. 77. These plans were found passim in Joan Simeon Clarke, "National Health Insurance," Social Security, p. 75-112J Joan Simeon Clarke, "Social Security," Fabian Quarterly, XXXII (Winter 1941/1942), Hastings, Dr. Donald c. Norris, "Rehabilitation of Disabled Persons," Fabian "{uarterly, XXXIX (October 1943)& R. B. Thomas, "The Health Services Ia Ylllternity and Child ~lelfare, the School Hedical Service, the Tuberculosis Service," Fabian Research Series, XL (1940)r Murray. 78. Fabian Society, "Fabian Research Quarterly Report," Fabian Quarterly, XXXIV (Summer 1942), p. 1. 79. J. s. Clarke, Fabian Quarterly, XXXII, p. 22. 80. R. w. B. Clarke, "The Beveridge Report and After," Social Security, p. 284. 81. Bappleye, p. 110. 82. Francis Williams, Fifty Year's Marcha The Rise of the Labour Party (London, 1949), P• J72. SJ. Gregg, p. 46. 84. Glasses, dentures and certain other appliances carried a small fee, as in the Beveridge Report. 85. Reference Division, Central Office of Indormation (London), Health Services in Britain (London, 1968), p. 8. Health service acts, similar to the one for Great Britain, were also enacted for Scotland and Ireland, and they, too, went into effect on July 5, 1948. 86. Ibid., p. 11-lJ. Por the numbers or regions, executive councils, etc. see Mendelsohn, p. 58. There are now 15 hospital regions, 1)4 executive councils and 174 local health authorities. For the duties or the latter see Gregg, p. 53. The health service has been run on a functional not regional basis--hospitals, practitioner services, etc., not each region handling its own services separately (Bruce, p. 28)). This was to ensure national uniform treatment. 87. Ref. D1v., J!ealth;,Services; passim. - 7 -

.88. Gregg, p. 61-62. 1 189, John G. Hill, ••Has Britain Shown that Health Insurance • · Can Work?", British Socialism Today, p. 114. ' 90. Beatrice Webb died in 1943. Her reaction would have been· favorable toward the NHS, but unfavorable to the National ! . Insurance scheme which made no provision for malingerers •. ·91. Bun bury, p. ·7. 92. Rappleye, p, 112.

'. 93. Laurie Pavitt, "The Health o:f' the Nationa the Second Stage o'f the N. H. S,", Fabian Research Series, CCXXXVI .. (December 1963), p. J. · . · 94. Fabtan News, ·september 1945.

95. Hill, p. 113~114. Also, Gordon Smith, Harold Wilsona A Critical Biography (London, 1964), p. 41. BIBLIOGRAPHY

Primacy Attlee, Clement R. As It Happened (New York, 1954). ~. This _book was no~elppas~a~s .personal views go, but did provide a few interesting facts. . . . Beyeridge, Sir William. Social Insurance and Allied Services (New York, 1942). The Beveridge Report. Bunbury, Dr. D. E. "The National Health Service Bill." Fabian Quarterly,·· L ·(June 1946) a 2-7. Childe, Charles P •. "Environment and Health." Fabian Tract, CCVIII (March 1924)a 1-14. · Childe stressed cleaning up the environment as a means to improve health. . . Churchill, Stella. "Socialization of the Medical Services." Fabian Quarterly, V (March 1935)• 16-19. Ms. Churchill emphasized the unification of the 1935 health services under the Ministry of Health. Clarke, Joan Simeon. "The Break-up of the Poor Law." The Webbs and Their Work, edited by Margaret Cole (London, 1949). ·. 101-115. ------. "SocialSecurity." Fabian Quarterly, XXXII (Winter 1941/2)1 21-27. . . Ms. Clarke favored a more personalized, efficiently run social service administration with more individual attention to patients. ------. "National Health Issurance." lSocial Securit:, edited by William A. Robson (London, 194J)c 75-112. · This book was being written at the same time Beveridge was working on his report, though it wasn't published until 1943. It contains g number of articles, which, when put together, ai~tQPinions (researched opinions) of. what should be doneJ~he. post-war social services. :larke, R. W. B. "The Beveridge Report and After." Social Security, edited by William A. Bobson (London, 1943)• 272-327. -----. "Social Security Housekeeping~" Social Security, edited by William A. Robson (London, 194J) .• )28-372. Cole, G. D. H. Fabian Socialism (London, 194J).

------. A History o~ the Labour Party from 1914 (London, 1948). Although this study spanned the 1940's,.noth•ng helpful was found in this book.

C~l~, ~argaret. Beatrice We~b (New York, 1946). Cole, Margaeet, ed. Beatrice Webb's Diar1es 1912-1924 (London, 1952: ' . The only information found in this volume was Beatrice's continuing complaints about Lloyd George's National Insurance Act. Cole, Y..argaret. "The Social Services and the Webb Tradition." Webb Memorial Lecture No. 2 (London, 1946). -----. The Story of Fabian Socialism (Stanford, 1961).

A j;haroUgh~eS.crtptt·orr o~ the Society from its birth, this history emphasizes what is going on with­ in the Society •. Fabian Society. Fabian News. This monthly paper ·or the Society is primarily .concerned wtth Society social functions--dinners, dances, meetings, etc. In the 1911 issues, however, some helpful "news" was found=meetin~s protesting the National Insurance Bill--but the only uaeable info found in the 1943-1946 issues pertained to election results. · --•---. "Fabian Research Quarterly Report." Fabian Quarterly, XXVIII (Winter 1940~1 2-J. ·Q.uarterly ·reports are summaries of the Research Bureau's activities for the previous quarter. -----. "Fabian Researcb.Quarterly Report." Fabian Quarterly, XXXIV (Summer 1942) a 1-3. · ·

------. "Fabian Research Quar~erly Report." Fabian Quarterly, XXXVII (April 194J)a 35-J?. ------. The Insurance Bill and The Workers (London, June 1911). - J - This nineteen page pamphlet contained the criticisms and amendments.prepared by the Society's Executive Committee to the National Insurance Bill. It proved very helpful. ------. "Memorandum or Evidence submitted to the EBveridge Committee by the Social Security Sub-Committee of the Fabian Society."· As reproduced as the "Appendix" in Social Security, edited by Wm. A. Robson (London, 194J)r 4o6-4J4.

------. "Points for Planners." Fabian ~uarterly, XXXVI (January 1943)• 1-J.

This article prcula1me<1~~the .Society's support of the Beveridge Report. ------. "Points for Planners." Fabian Quarterly, XXXVII (April 194J)s 1-J. Great Britain, Parliament, House of Commons. Parliamentary Debates, 1911 session. I specifically used volumes 26-Jl. The National Insurance Bill's committee debates were published in these volumes, and from these debates I used Fabian MP's critiques ot the bill. Guest, L. Haden. "The Case for School Clinics." Fabian Tract, CLIV (~.arch 1911) t 1~15. Guest argued eor improvement in the school clinics. Hastings, Somerville. · "The Health Services 2r The Hospital Servicesa A Policy for the War and Post-War Period," Fabian Research Series, LIX (194l)r 2-24, Very useful. Hastings called eor unification and enlargement of the hospital services. IHutohing, Elizabeth Leigb7. "What a Health Committee can do." Fabian Tract, CXLVIII (March 1910)s 1-15. Ms. Hutchins was concerned with public health. She advocated greater efforts to clean up the environment--improved sanitation, etc. She felt these efforts with alleviate a good deal of sickness. Lansbury, George. My Life (London, 1928). - 4- Though Lansbury was an author of the Minority Report and an MP in 1911, this book was totally useless as far as obtaining_his views of health services.

Morrison, He~bert Stanley. An Autobiography (London, 1960)~ ------. The Peaceful Revolutiona S eeches b the Rt Hon. Herbert Horr1son London, 19 9). Murray, D. Stark. ..National Hedical Service." Social Security, edited by Wm. A. Robson (London, 1943)1 395=405. National Committee for the Prevention of Destitution. The Case for the National Minimum (London, 1913). The NCPD was the committee founded by Beatrice Webb to furtherthe Minority Report. This book advocates the establishment of a "national minimum"--of health, etc.-..lbelow which no individual shall be permitted to fall." Norris, Dr. Donald c. "Rehabilitation of Disabled Persons." Fabian Quarterly, XLIX (October 1943)1 33-40. Oakeshott, Joseph F. "The Humanizing of the Poor Law." · Fabian Tract, LIV (Ma7 ~897)1 1-23. Parker, John. Labour Marches On (London,·l947). Parker was secretary of the New Fabian Research Bureau in 1933, general secretary of the Society, 1939-45, and vice-chairman in 1947. It was thought that this volume woUld contain some helpful information, though it did not. There ware no personal comments in it. Pavitt, Laurie. 'The Health of the Nationa The Second Stage of the N.H.S." Fabian Research Series, CCXXXVI (December 1963)1 1-37. Pease, Edward R. The History of the Fabian Society (London, 1918). Robson, w. A. "The Infulence of Fabianism on British Social Policy." Fabian QuarterlY, XLI (April 1944)a 8-14. Shaw, George Bernard·. "Fabian Failures and Successes." Fabian Quarterly, XLI (Appil 1944)a 1-5. Singer, H.· W. "can we af"ford 'Beveridge'." Fabian Research Series, LXXII (1943)• 3-22. - 5 - Tawney, Richard Henry. Eguality (Halley Stewart Lectures, 1929) · (London, 1931) •. Thomas, R. B. "The.Health Services I (Maternity and Child Welfare, the School Medical Service, the Tuberculosis Service)." Fabian Research Series, XLIX ~1940)a 1-44. Thompson, brian, H.D. "A Letter to· a Doctor. •• Fabian Letter, VI (1942)s 1-20. Webb, Beatrice. "The Abolition of the Poor Law. •• Fabian Tract, CLXXXV (Y.arch 1918) s 1-11. ------. Our Partnership, edited by Barbara Drake and Margaret Cole (New Yorlc, 1948). Mrs. Webb was writing of her partnership with Sidney. The book is divided up into years and days like a diary. This volume was.helpful in obtaining the Webb's views of Lloyd George's scheme, Webb, Sidney and Beatrice. The Prevention of Destitution (London, 1911). ------. The State and the Doctor (London, 1910). Both of these books by the Webbs concern themeelves with improvement of the British health services, and both were used to the greatest extent for the Webb attitude toward the <1JDproyement of these services. The latter volume was primarily written to publicize the Minority Report, and it was this book that was used to obtain the Minority Report proposals re medicine. The Webbs in this volume spend much time stressing the merger of the Public Health Authorities and the Poor Law Medical Service.

Secondary Braithwaite, William J. Lloyd George's Ambulance Wagons Being the Hemo1rs of W, J. Braithwaite 1911-1912.(London, 1957). This is an excellent volume on Lloyd George's attempts to gain support of his bill, but it doesn't help bn regard to the Fabians. - 6 - Brand, Carl F. Tha British Labour Paryya A Short History Stanford, 1964). Bruce, Maurice. 'The Coming of the Welfare State (New York, 1966). This book was helpful in obtaining a description of the National Health Service •. Cole, G. D. H. and Postgate, Raymond. The British People 1746-1946 (New York, 1947) Fremantle, Anne. This Little Band of Prophetsa The Brtttsh Fabians (New York, 1959), Gregg, Pauline. The Welfare Stater An Economic and Social History of Great Britain from 1945 to the P~esent Day Amherst, 1969). Ms. Gregg's book was the most useful secondary source I used. Though not discussing the Fabians, this book was used as a standard text in obtd.ining information ofi the 1911 Act, the Beveridge Report, and the 1946 Acts. Hill, John G, "Has Britain Shown that Health Insurance Can Work?" British Socialism Today, compiled by Julia E. Johnsen (The Reference Shelf, vol. 22, no. 1) (New York, 1950)a 113-121,

Levy, Hermann. National Health Insurances A Critical Study (Cambridge, 1944). McBriar, A, M. Fabian Socialism and English Politics 1884-1918 1 (:camb.tidge, 1962) • This book was only slightly helpful in this study, l1ccarran, Sister H. Hargaret Patrtcia. Fabianism in the Political Life of Britain, 1919-1931 (Chicago, 1954). This book was Sister McCarran's dissertation. It was almost useless because these years were the rather 1nacttve years of the Society's life, Nothing could be found in her book on health services. Mendelsohn, Ronald. Social Security in the British Common­ wealth: Great Britain, Canada. Australia., Hew Zealand (London, 1954).

This was a:~descriptive account or the social services. It was only used to obtain information on the NHS. i:.'-.:.. ;,, ·- 7 - Muggeridge, Kitty and Adam, Ruth. Beatrice Webb, A Life, 1858-1943 (New York, 1968). Murphy, Mary E. "The Role of the Fabian Society in British Affairs." British Socialism TodfY, compiled by Julia E. Johnsen (The Reference Shelf, vol. 22, no. 1) (New York, 1950): 17-2J. Palmer, a. H. and Colton, Joel. A History of the Modetp'World, Jrd ed. (New York, 1965). Rappleye, Willard c. "The National Health Service ot Great , Britain." British Socialism Today, compiled by Julia E. Johnsen (The Reference Shelf, vol. 22, no. 1) (New York, 1950)t 107-11). Reference Division, Central Office of Information (London). Health Services in Britain (London, 1968). This was the most detailed description or the NBS.

Sm~th, Dudley Gordon. Harold Wilsons A Crit1cal Biography (London, 1964). Wilson was a Fabian, but was not influential until the 1950 • s. This book wasl·not concerned with personal attitudes.

Wi~iams, Francis. Fifty Year's Marcha The Rise ot the Labour Party (London, 1949).