Jews in the National Health Service: from refugees to medicine’s cutting edge

The health service did not start in 1948 but before the First World War with Part 1 of the National Insurance Act 1911, whose chief proponent was David Lloyd George, a future Prime Minister.

William Harbutt Dawson, an authority on social insurance in Germany, was one of Lloyd George’s principal advisers on the scheme, and he in turn relied on advice from a German Jew, Emil Muensterberg, who was one of his country’s leading social security experts.

Mr Dawson encouraged Mr Lloyd George to spend more on the scheme in order to provide decent medical treatment and maternity benefits. Dr David Eder, a socialist and Zionist, started the prototype of the school clinic in Deptford.

Here an eye-witness recorded Eder’s “unfailing cheerfulness and ingenuity when eye-testing had to be done in a dark back-cupboard of a room, tonsils operated on when beds must be improvised on the spot, extra money collected here, there and everywhere”.

Through the columns of his journal, School Hygiene, he successfully campaigned for a national network of school clinics.

Incidentally, after the Great War, Dr Eder, at Chaim Weizmann’s instigation, joined the Zionist Commission in Palestine and inaugurated some of the first public health schemes in the country.

In a similar vein, when Herbert Samuel became President of the Local Government Board in 1914, he forcefully presented the case for state aid for maternity centres and health visitors.

Hence infant welfare centres increased from 650 in 1915 to 1,278 in 1918; at the same time, the number of health visitors employed by local authorities quadrupled.

The health insurance scheme, together with an anti-tuberculosis programme and supplemented by these networks of school clinics and infant welfare centres, laid the foundation of a rudimentary national health service by the start of the First World War.

Jews first started to enter British medical schools in large numbers during the First World War. Between the two wars, the number of Jewish doctors in London rose significantly from 100 to 800, a rate of increase matched in Leeds, Liverpool and Manchester.

Most of the medical students from East European families who qualified in the 1920s and 1930s became general practitioners, buying panel practices, often in run-down neighbourhoods.

Thus the movement of Jewish doctors into private practice at the lower level was governed by market forces, somewhat distorted by some discrimination practised by local authorities, but was hardly constrained by the antisemitism and fascism so prevalent at the time.

At this time, thousands of refugee doctors fled to Britain from Germany, Austria and Eastern Europe, many of whom were Jewish.

Because so many British doctors were serving in the Royal Army Medical Corps during the Second World War, the government was happy to place them on a temporary medical register for the duration of the war and they played an indispensable role in compensating for the shortage of medical manpower on the home front.

Aneurin Bevan, the Labour Minister of Health, was the architect of the National Health Service Act which obtained parliamentary approval in 1946.

It established the structure of a comprehensive new health service, while allowing time for Mr Bevan to negotiate the details of the service, as it was not going to come into operation until July 1948.

Next to Mr Bevan, the most influential personality in shaping the new health service was Lord Henry Cohen (1900-77), as chairman of the Standing Medical Advisory Committee of the Ministry of Health from 1947 until 1963.

Dr Solomon Wand (1899-1984), having served on all the influential committees of the British Medical Association, became the first Jew to chair its council (1956-61).

He led a struggle with the minister of health to ensure adequate remuneration for doctors, culminating in the pay award by Justice Harold Danckwerts in 1952 which found in favour of the doctors’ representations.

Dr Wand later led a deputation from the BMA which gave oral evidence to the Royal Commission on Doctors’ and Dentists’ Remuneration. The commission recommended the setting up of a review body to make pay awards, a system which favoured doctors.

Thus Dr Wand enabled doctors to remain independent, to avoid become part of a salaried service, and to secure high earnings in relation to other occupations.

As a means of enhancing their status still further, general practitioners in England decided to organise and become a speciality. “We were not second class hospital doctors, we were first class family practitioners”, noted Dr Stuart Carne.

With the aim of becoming a speciality, the College of General Practitioners was set up in 1952, but a new theoretical framework for general practice was required, to which a number of Jewish doctors made significant contributions.

For example, Dr Michael Balint (1896-1970) who was born in Budapest and, after graduating as a doctor, trained as a psychoanalyst.

In his Tavistock clinic seminar he “taught a whole generation of doctors that it was very important to listen to what patients were saying, and to listen without interpreting what they should be saying, or explaining to them what better to think”.

A number of Jewish doctors were active in the leadership of the Royal College, among them Dr John Fry (1922-94), who sat on its council for 30 years and inspired its study groups.

Dr Fry pioneered the description of common diseases in his own practice, charting their progress and outcome and publishing over 50 books on the subject. Dr Carne was the first Jewish president of the college from 1988-91, saving it from bankruptcy by doubling its subscription.

The second Jewish president from 1994-7 was Dr Lotte Newman, who was concerned with improving the position of women in the medical profession. It was not until the 1970s, however, that the college was able to secure postgraduate training for general practitioners.

Before 1948, hospital boards tended to be insular when appointing new staff members, but with the coming of the NHS a new regime was established.

When Martin Sarner qualified in 1959, he recalled that the number of Jews who were consultants in London teaching hospitals could “be counted on the fingers of a mutilated hand”.

Advisory boards were set up under the NHS with a wider membership and a more democratic selection process was instituted.

Partly because large numbers of doctors were returning from war service and partly because too many registrars were trained in the 1950s, consultant positions remained difficult to obtain.

But once the new appointments system had bedded down, candidates were chosen on their merits and some Jewish consultants have even claimed that they were appointed by antisemitic heads of hospitals.

Today there are many Jews at the cutting edge of medicine, following in the footsteps of their illustrious predecessors.

John Cooper is author of books on Jewish doctors and lawyers in England 1890-1990 and ‘The British Welfare Revolution 1906-14’ (2017)