The Cultural History of the NHS

For links to our publications, please scroll down. For more about the project itself, read on!

Introduction

In 2018, Britain’s pioneering National Health Service turned seventy. In preceding decades, the NHS had been the subject of several major political and policy histories. Astonishingly, however, given the sheer scale of its impacts on local and regional communities, and on Britain’s national and international identity, the cultural history of this key institution of post-war British life remained largely undeveloped before 2015. There was no history that addresses the realm of meaning, feelings, and representation, and none that responded to Nigel Lawson’s striking observation that ‘the National Health Service is the closest thing the English have to a religion’. This neglect, highlighted in a major review of historiography to mark the 60th anniversary of the NHS, was remarkable, and in 2015, the Wellcome Trust awarded Principal Investigators Roberta Bivins and Mathew Thomson and their team of postdoctoral researchers an Investigator Award to produce the first major cultural histories of this subject.

Central to this cultural history of the NHS, and emerging from each of the four research strands they proposed, was the study of its meanings. The project as a whole responded to the powerful sense, as Lawson’s remark highlighted, that people in Britain ‘believe’ in the NHS.

However, we knew little about the nature, meaning and implications of this belief; the degree to which it has differed across time, between social groups, or in the various regions and constituent nations of the United Kingdom, or the relationship between this belief and a history of often harsh criticism. Our research (which you can access from the lists below) between 2015 and 2021 addressed these gaps in our understanding of the NHS, and explored the impacts of the NHS on British culture, identity, and health from 1948 to the present day, as the NHS responds to the effects of the global Covid pandemic.

Involving the Public

One part of our bigger academic project was the development of a website that collected personal stories and memories of the National Health Service from members of the public and NHS workers across the spectrum. The team gathered recollections of the NHS and what it meant and means to people via a series of public events and via our People's History of the NHS website. The complete collection of these stories are now available for researchers at the Modern Records Centre, based at the University of Warwick. A selection of them also informed our fantastic Voices of the NHS: A People's History comic book, created by artist Darryl Cunningham and freely available for download courtesy of the Wellcome Trust (CAUTION: it's a big file and may download slowly, but it's worth it!). We also curated the first (virtual) Museum of the NHS and produced entries for our highly idiosyncratic People's Encyclopaedia of the NHS drawing on suggestions offered to us by our public membership.

NHS poster

Research Questions

• How have the popular meanings of the NHS changed since 1948, and how have such changes influenced public attitudes towards, responses to, and feelings about the health services?
• To what extent have cultural representations of the NHS captured and inflected its unique position in British daily life?
• How has the NHS been perceived and represented by its own staff, trade unions and regulatory bodies?
• Has the NHS – as an institution and a resource, as well as an emblem of wider and deeper social beliefs -- changed British identity in identifiable and distinctive ways? Have ambitions to use the NHS as vehicle for the transmission of cultural norms been fulfilled or frustrated?

Scholarly Publications

Roberta Bivins

'A spawning of the nether pit'? Welfare, warfare and American visions of Britain's National Health Service, 1948-58, in Jennifer Crane and Jane Hand, (eds), Posters, Protest and Prescriptions: Cultural Histories of the National Health Service in Britain (Manchester: Manchester University Press, forthcoming May 2022).
'Suspect' screening: the limits of Britain's medicalised borders, 1962-1981. in Sevasti Trubeta, Christian Promitzer and Paul Weindling, (eds),
Medicalising borders: Selection, containment and quarantine since 1800 (Manchester: Manchester University Press, 2021).
Commentary: Serving the nation, serving the people: echoes of war in the early NHS. Medical Humanities, Online First, (June 2020), DOI: 10.1136/medhum-2019-011760
'Weighing on us all? Quantification and cultural responses to obesity in NHS Britain', in History of Science, Vol 58, Issue 2, (June 2020), doi.org/10.1177/0073275319842965.
With Stephanie Tierney and Kate Seers, 'Compassion in Nursing: Solution or Sterotype?', in Nursing Inquiry, Online First, (Dec 2018), DOI: 10.1111/nin.12271.
With Julie A Schmittdiel, Wendy T Dyer and Cassondra J Marshall, 'Using Neighborhood-Level Census Data to Predict Diabetes Progression in Patients with Laboratory-Defined Prediabetes', in The Permanente Journal, (Oct 2018): doi.org/10.7812/TPP/18-096.
With Kate Seers and Stephanie Tierney, 'Compassionate Care: Not easy, not free, not only nurses', in BMJ Quality & Safety, Online First, (Sep 2017): doi: 10.1136/bmjqs-2017-007005.
'Picturing Race in the British National Health Service, 1948-1988', Twentieth Century British History, Vol 28, 1, (March 2017): doi: 10.1093/tcbh/hww059.

Andrew Burchell (Visiting Postdoctoral Fellow)

(with Mathew Thomson), 'Composing Well-being: Mental Health and the Mass Observation Project in Twentieth-Century Britain', Social History of Medicine, 2021;, hkab104, https://doi.org/10.1093/shm/hkab104

Jenny Crane (3 Year Public Engagement Fellow)

Jennifer Crane and Jane Hand, Posters, Protests, and Prescriptions: Cultural Histories of the National Health Service (forthcoming May 2022).
Jennifer Crane, ‘"Loving" the National Health Service: Social Surveys and Activist Feelings’, in Jennifer Crane and Jane Hand, Posters, Protests, and Prescriptions: Cultural Histories of the National Health Service (Manchester University Press, forthcoming May 2022).
Jennifer Crane, ‘The NHS … Should not be Condemned to the History Books’: Public Engagement as a Method in Social Histories of MedicineLink opens in a new window, Social History of Medicine, 34 (3) (2021), pp. 1005-1027.
Jennifer Crane, ‘Save Our NHS: Defending the NHS and Reassessing the 1980s’Link opens in a new window, Contemporary British History, 33 (1) (2019), pp. 52-74.
Jennifer Crane, ‘Why the History of Public Consultation Matters for Contemporary Health Service Reform’Link opens in a new window, Endeavour, (2018), 42(1), pp. 9-16.

Hannah J. Elizabeth (Visiting Postdoctoral Fellow)

' "If it hadn't been for the doctor, I think I would have killed myself': Ensuring Adolescent Knowledge and Access to Healthcare in the Age of Gillick' in Jennifer Crane and Jane Hand, Posters, Protests, and Prescriptions: Cultural Histories of the National Health Service (Manchester University Press, forthcoming May 2022).

George Gosling (18 month Research Fellow)

Payment and Philanthropy in British Healthcare, 1918-48 (Manchester University Press, 2017).
'Gender, money and professional identity: medical social work and the coming of the British National Health Service', Women's History Review 27(2):310-328.

Jane Hand (3 Year Research Fellow)

Jennifer Crane and Jane Hand, Posters, Protests, and Prescriptions: Cultural Histories of the National Health Service (Manchester University Press, forthcoming May 2022).
‘Tucking in your tummy isn’t the answer!’: visualising obesity as a public health concern in 1970s and 1980s Britain’, in Mark Jackson and Martin Moore (eds) Balancing the Self: Medicine, Politics and the Regulation of Health in the Twentieth Century, (Manchester: Manchester University Press, 2018).
‘Marketing Margarine: Advertising, Gender and Healthy Eating in Britain from 1954-c.2000’, Contemporary British History 31:4 (2017), 477-500.

Natalie Mann (Natalie Linda Jones) (Public Engagement Fellow)

'Breaking the frame: abortion under arrest in contemporary visual art?' Research Chapter in Jani McCutcheon and Fiona McGaughey, Research Handbook on Art and Law (Edward Elgar Publishing, 2020).
(with Nikki Godden-Rasul), 'Dying for our Biographies: The UK Abortion Act 1967'‘Dying for our Biographies: The 1967 Abortion Act’. Book chapter for Women’s Legal Landmarks edited collection, Hart Publishing (Bloomsbury), 2018.
‘Hanging On: Reflections on Visual Reproduction and the UK 1967 Abortion Act’, Feminist Legal Studies, 25:3, November 2017.

Jack Saunders (3 Year Research Fellow)

'The making of "NHS staff" as a worker identity, 1948-85', in Jennifer Crane and Jane Hand, Posters, Protests, and Prescriptions: Cultural Histories of the National Health Service (Manchester University Press, forthcoming May 2022).
‘Emotions, social practices and the changing composition of class, race and gender in the National Health Service, 1970-79’, History Workshop Journal, 88 (Autumn 2019), 204-228

Mathew Thomson (co-PI)

'Representation of the National Health Service in the Arts and Popular Culture', in Jennifer Crane and Jane Hand, Posters, Protests, and Prescriptions: Cultural Histories of the National Health Service (Manchester University Press, forthcoming May 2022).

(with Andrew Burchell), 'Composing Well-being: Mental Health and the Mass Observation Project in Twentieth-Century Britain', Social History of Medicine, 2021;, hkab104, https://doi.org/10.1093/shm/hkab104

Content for Wider Audiences

The People's History of the NHS Website is chock full of blogs, encyclopaedia entries, museum galleries and curated museum objects exploring aspects of the NHS ranging from appointments to vaccinations, birth to old age, and public health to private medicine. Enjoy!

History Centre for the History of Medicine