Health, happiness, and security: the creation of the National Health Service

eugenics from the 1930s (by which time it had effectively lost steam as a campaign) to the age of the Pill and legalized abortion. He traces the highjacking of the cause by younger researchers, above all, David Glass, who used its good offices, and its funds, for social science investigation into demographic problems. By demonstrating that, with an ageing workforce, Britain's problem was likely to be under-rather than overpopulation , Glass, Eversley and Titmuss mined the basic premisses of the movement. Soloway also elegantly suggests that the British refuted the need for "eugenics", in their bedrooms. They stood by the nuclear family, took to contraception, and reliably produced 2.4 children per couple. With growing prosperity, they were visibly healthier than the "unfit" specimens over whom early eugenists had fretted. Eugenics has now been comprehensively surveyed by Kevles and Soloway. To prevent overpopulation, responsible scholars should now exercise voluntary restraint. Anyone who knows Honisgbaum's book on The division in British medicine is already familiar with his thorough scholarship. His new volume dealing with the role of civil servants in the creation of the National Health Service is yet another example of his careful research and analysis. Honisgbaum chronicles a battle from 1936 to 1948 between two opposing factions whose ideologies stemmed from different social standpoints. The most significant theme in his story is the influence of the British social class system lurking behind all negotiations surrounding the NHS. On one side there were Oxbridge-educated, distinctly upper-class civil servants imbued with the highest ideals of service and noblesse oblige. On the other was the general-practitioner stratum of the medical profession, whose history of commercial competition had turned them, in the eyes of the civil servants at least, into tradesmen. The chief civil servants, above all Sir John Maude, the permanent secretary at the Ministry of Health from 1941 to 1945, were horrified by this degradation of what should have been the most noble of professions and sought to elevate doctors to gentlemen by making them salaried employees in a government service. General practitioners, however, protected their economic and occupational independence more jealously than anything else and believed they had witnessed its diminution, first by club practice, and later, most seriously, by the introduction of National Insurance in 1911. Municipal administration of the system was logical to tidy-minded civil servants. To GPs, however, who hated the sight of Medical Officers of Health for …