People's History of the NHS

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The idea of having been ‘born in the NHS’ has become a popular way for people to assert their identification with, and support for, the National Health Service. It is an idea with powerful emotional appeal. But its prominence is in fact relatively recent.

‘Born in the NHS’ mugs, tee-shirts, hoodies, and badges have recently become familiar objects. The rapid success of the phenomenon relates to a new politics of identity centred on single-issue statements and facilitated by the rise of social media. The catalyst appears to have been a message on twitter from social entrepreneur Lee Blake to comedian and left-wing activist Mark Thomas, on the way to watch Thomas in Birmingham in 2013. Blake asked whether his social enterprise, ‘Made by Young People’, run by young people outside of education, employment or training, could make Thomas a tee-shirt, and Thomas asked his Twitter followers for a suggestion. They came up with the ‘Born in the NHS’ slogan, integrating a version of the now ubiquitous blue NHS logo. ‘Made by Young People’ soon diversified to put the logo on a series of other items. The campaign spread by word of mouth and social media. It attracted other celebrity supporters including Caitlin Moran and the comedian Rufus Hound (who also announced in early 2014 that he would stand for the National Health Action Party in the upcoming election for the European Parliament). The twitter conversation indicates that the act of purchase rapidly came to be seen as a symbol of being proud about and a defender of the NHS. It was a statement that clarified and publicly announced the most intimate of bonds with the service. Of course, nobody actually remembered having been born in the NHS. Most people, however, had the stories of their own NHS births passed down to them, and many had gone on to experience giving birth to their own children within the NHS. For some people this was perhaps the main experience of going into hospital, and certainly often the most special one, associated with far more positive emotions than the use of hospital towards the end of life. Being born in the NHS was the perfect event to emphasise the universal gift of the NHS.

Launched on the anniversary of the opening of the NHS in 2014, the Labour Party also looked to utilise the born in the NHS idea as it prepared for the election the following year. Through an easy-to-use website, it gave people the opportunity to find out which number baby they were in the history of NHS (out of a total of some 44 million deliveries to date). In return, they hoped to obtain the contact details of voters who might be likely to vote for them as the founders and proclaimed defenders of the service. Using census data (and the calculation that 97% of people born in Britain since 5th July 1948 had been born in the NHS), and with details of respondents’ birth dates, the site was able to provide people with their own NHS baby number at the click of a button. This was a very rough estimate of course, but the act of confirming one’s identity as part of this history of being born in the NHS clearly had widespread appeal.

The origins of this appeal can be traced back further. Pictures of young Aneira Thomas had begun to appear in the press in 2008 in relation to the 60th anniversary of the NHS. This was the face of the first child born in the NHS, or so proclaimed the media coverage. It was accompanied by pictures of Aneira now grown up and a mother and grandmother, though no pictures of the moment of being the first baby. Aneira recounted how she had been born, after an 18-hour labour, in Amman Valley Hospital in Carmarthenshire at a minute after midnight, at the very dawn of the opening of the new service on the 5th of July 1948. Everyone was so excited by this that it was decided to call her Aneira, after the Minister of Health Aneurin Bevan, who had been so pivotal in the birth of the new service and who of course was a fellow Welshman. She would come to be known as ‘Nye’, like her namesake, and go on to work as a mental health nurse. Aneira would become a welcome asset for the Labour party, speaking at its 2008 Conference, meeting Gordon Brown, and used to front a Labour-produced youtube video on the NHS in 2013. In the context of the 2015 General Election, the Daily Mirror was still using her as a symbol for the importance of the NHS (though in 2010 she had also been used by the Daily Mail for a more critical slant on the service, with the headline that the first NHS baby had been betrayed as her family now faced a huge care bill). The first baby had certainly become a symbolic figure in the 7th decade of the NHS, but it is interesting that this only happened as this service itself reached a relatively old age. The absence of a baby picture in the publicity is revealing. This may have been an event that delighted staff and patients at the Amman Valley Hospital at the time, but it was not a national event and there were no photographers on hand. It seems reasonable to assume that there were many such exciting births of first NHS babies on the 5th of July 1948. But strikingly, such an event is absent from contemporary press coverage of this day. It was clearly special to those involved to be born in the new NHS – and, as Aneira recalled, the fact that her parents no longer had to pay the midwifery charge of a shilling and sixpence clarified the significance for her parents – but in 1948, and indeed perhaps for some decades after, such an event appears not to have had the symbolic power that it would gain as the NHS reached its old age and began to reflect back on its own birth.

Further indication of the emotive appeal of the idea of being born in the NHS comes in the realm of popular culture. In 2012 the BBC launched a new drama series, Call the Midwife. Its success led to further series in 2013, 2014 and 2015, with another planned for 2016. Based on the memoirs of Jennifer Worth, who had worked in the East End of London in the 1950s and 1960s, Call the Midwife became the BBC’s most successful drama series since 2001, with average weekly audiences of over 10 million. At the heart of the drama was the gift of free NHS medical care in the context of poverty. Speaking in 2015 the creators acknowledged that this was indeed in some respects a ‘campaigning programme’, and that they hoped to counter criticism of the service. Their influence is perhaps evident in the emergence of the Labour party’s promise of a midwife for everyone in the election of 2015. However there is also a tension when we think about the relationship of Call the Midwife to the idea of being born in the NHS. For the vast majority of Britons, being born in the NHS now meant being born in hospital, not through midwives travelling out to individual homes. The history of being born in the NHS is a history in fact of the move away from being born at home, aided by the midwife, to an increasingly medicalised birth in the setting of the hospital. Perhaps this explains why it was that when people began looking back to find the first baby born in the NHS, they had turned to Aneira Thomas in the setting of the hospital. Call the Midwife provided an emotive picture of how the NHS could deliver the most precious gift of all – new life – but the medical world that it presented was in fact one that the NHS would increasingly overtake.

In 1970, the government’s Peel Report advised that all births in future should take place in hospital. Before the NHS, giving birth in hospital was largely a privilege of those who could pay. The NHS transformed such inequality. Improvements in medical technology helped make birth safer and made hospital maternal care the people’s choice. By the time that the Carry On franchise turned to the setting of Finisham Maternity Hospital for its 1972 film Carry on Matron, around 95% of births in Britain were in such a setting. In Carry on Matron, the maternity hospital, with its scope for sexual innuendo, provides an ideal backdrop for the increasingly bawdy humour of the franchise. Yet it also provides us with glimpses of a culture of being born in the NHS that does not necessarily fit with our nostalgia over this event, and which was already in the early 1970s coming to be the subject of critique from a new generation of women. Criticism would centre on the inexorable medicalisation of birth – something that is not particularly evident in the film itself. But what is hinted at, and what was perhaps as much of an issue, was that going into hospital could see a loss of personal control, choice, and privacy. There is nothing very homely about the institutional atmosphere of Finisham or the rows of beds in ‘Bun’ and ‘Oven’ wards. The fathers are kept strictly out of the way. The mothers, and the young nurses, are under the strict eye of Matron. Mothers are bed-bound and passive. Yet for a generation of viewers for whom the prospect of dangerous home birth and inability to pay for hospital care was such a recent memory, it is easy to understand why this could be a site for gentle humour rather than complaint. There is no hint of danger to life at Finisham. Expectant mothers are portrayed spending weeks lying in wait and being looked after, and they appeared to welcome the break from their husbands. And all this takes place in the setting of a hospital now devoted to free maternal care, something that many of their mothers could only have dreamed of before 1948. For the mothers, and increasingly too the fathers who would gradually come to be more involved, the experience of giving birth in hospital may sometimes have lacked the personal touch. However, for parents and their offspring, the magic of coming into being in this setting, free of all charge, would be the lasting memory. It was this that would give such power to the idea of having been born in the NHS.

MT