Physician, Lead Thyself: It all began with a good meal

Sometimes, things are so large and complex that one can hardly believe that there was a point where their existence was merely a thought in someone's head. For the NHS, the world's fifth largest employer and one of the most envied healthcare systems in the world, this point came in 1948.

The BMA had whipped itself into a frenzy at the moves made by the Minister for Health Aneurin Bevan to introduce a universal healthcare system. One former chairman compared the intended founding of the NHS with the road to recreating the Third Reich when he said, "I have examined the Bill and it looks to me uncommonly like the first step, and a big one, to national socialism as practised in Germany."
 
Into this febrile atmosphere stepped Bevan. It's hard to imagine anyone who could be more alien to the stuffy, educated and highly urbane clique of doctors than this avid socialist son of a miner from South Wales. He was in the unenviable position of trying to implement a vision for the NHS that was a radical break from the way healthcare had been delivered in the UK for centuries, yet having to secure the active support of those that stood to lose the most from it all - the doctors.
 
So when things came to a head and a make or break meeting was called between the two sides, everyone expected fireworks. Bevan could not achieve his dream of a nationalised health service without getting the doctors on board, and the doctors had a string of reservations and objections that seemed insurmountable. This meeting was going to be no talking shop snooze-fest. The outcome would affect the lives of millions for generations to come.
 
But instead of the lengthy war of attrition that was expected to develop, Bevan put on a masterclass of visionary leadership, conflict resolution and presentation skills. The venue for the showdown was carefully selected to be a fashionable (and exclusive) London restaurant. He arrived wearing an impeccably tailored suit which made him look like he was one of them rather than the class warrior they all knew he was. Most importantly, he approached the meeting with an attitude that was as non-confrontational as it was pragmatic. The doctors began to get the sense that they were struggling against the inevitable. Somewhere between the good food, cigars and plush armchairs, all the insurmountable objections became surmountable. When he walked out of the lunch meeting, Bevan had secured the agreement of the BMA and thus effectively founded the NHS.
 
65 years later, the tables have turned. Now its the healthcare professionals and patients that are struggling to keep the dream of the NHS alive in the face of mounting political and financial challenges. We lurch from crisis to crisis feeling battered and bruised by the heavy burden of safeguarding the NHS (and by extension our patients) wondering if it is even possible to succeed with the number of interests arrayed against it. At such times, it is useful to remember that it has survived such difficulties before.
 
It took a performance of breathtaking ingenuity, pragmatism and leadership by one man to bring the NHS to life. Now, 65 years later, it will take similar determination to sustain it in the turbulent times ahead.