How the Valleys Inspired a World of Free Healthcare

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‘Aneurin Bevan visiting a patient in hospital’

Lasting peace is not just about preventing war but also about creating a fair and just world. WCIA volunteer Sophie Champion tells us how one community worked together to improve access to healthcare for all…

We all know the National Health Service very well, and most of us have received free healthcare under the service. But how many of us know where the idea came from, or the community that was the test-run for the idea? It was in fact a mining town in Wales that spurred Aneurin Bevan on to form a health service that the whole of the United Kingdom could use.

The NHS takes its roots from the Tredegar Medical Aid Society, which was formed following a merging of a number of societies in Tredegar, a mining town in the South Wales valleys. Many of these societies offered services such as funeralcare and medical benefits, and brought the community together through a sense of collective responsibility.

The success of the society led to Aneurin Bevan’s case for a National Health Service, which would go on to help the lives of millions of people living in the United Kingdom.

Beginnings

Tredegar Workmen’s Medical Aid and Sick Relief Fund

The end of the 19th century in Tredegar saw a system of organised labour which provided basic health care through a network of societies, trade unions, and insurance companies.

In 1890, a variety of local societies merged together, forming the Tredegar Workmen’s Medical Aid and Sick Relief Fund. Some of the services included medical and funeral expenses offered to its 3,000 members. This allowed the society to continue to grow, eventually into a hospital in 1904, which was known as Cottage Hospital, in Tredegar town.

The land was donated by Lord Tredegar and the Tredegar Iron and Coal Company and various other philanthropists, while the running costs were financed by the workers themselves, through half-penny a week contributions, which increased to a penny a week by 1909.

Tredegar Medical Aid Society

The success of the society continued to grow, and the hospital began offering healthcare to non-members, such as the wives and children of members, the elderly, and workers in other trades in the town such as railwaymen, teachers, shopkeepers and more. Miners and steelworkers paid a weekly fee of 2d in each £ of their wages while ‘town subscribers’ paid 18s a year. The society’s offices were based at 10 The Circle in Tredegar town, a building that still stands today.

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‘The original sign of the Tredegar Medical Society. Photo by Sophie Champion’

Notable People

Aneurin Bevan

· Whilst Bevan did not found the Tredegar Medical Aid Society, he joined the Cottage Hospital Management Committee around 1928 and became chairman in 1929–30.

· Bevan holds great importance in the Tredegar Medical Aid Society and the history of the National Health Service in general, as he brought the ideas he saw practiced within the Tredegar Medical Aid Society to the British Government, confident that a healthcare system on a national scale was possible.

When the National Health System was launched, Bevan declared:

‘All I am doing is extending to the entire population the benefits we had in Tredegar for a generation or more. We are going to Tredegar-ise you’.

Walter Conway

· Conway was born into poverty and orphaned at a young age.

· He began working in a workhouse and became friends with Aneurin Bevan, both of whom later joined the Query Club in 1920.

· He was appointed secretary of the Tredegar Medical Aid Society in 1915.

· Conway was more than just a friend to Bevan, he was a mentor and teacher to him and assisted Bevan in ridding himself of a disabling stammer.

· This allowed Bevan the confidence to go on to deliver inspiring, passionate speeches, that would persuade members of the British government to implement a free health care system.

Conway’s memory lives on in both Tredegar and on a wider scale. A street in Cefn Golau is named after him: Walter Conway Avenue, and the character Owen in the novel The Citadel, written by a former doctor at the Tredegar Medical Aid Society, A.J. Cronin, is named after him.

Lord Tredegar

· Lord Tredegar was a keen philanthropist in the area, and donated land that would be used to build the Cottage Hospital, ran by the Tredegar Medical Aid Society.

Without the generosity of individuals such as Lord Tredegar, or the commitment of members such as Walter Conway, who demonstrated community values, the Tredegar Medical Aid Society might never have been as successful, or efficient, as it was.

The community as a whole

· Although individuals such as Bevan and Conway are commonly associated with the success of the society, it is also important to note the contributions made by members of the community.

· The local people would meet at the society’s offices at 10 The Circle, developing ideas and strategies to improve the society.

The involvement of the local people in the society’s development and running helps demonstrate the community values that the Tredegar Medical Aid Society demonstrated, and the important role the community were given in the management of their society.

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‘The original safe which stored the membership payments paid by those who used the Tredegar Medical Aid Society’. Photo by Sophie Champion.

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‘The money would be used to maintain the society, such as for paying doctors’ and nurses’ salaries, and buying equipment’. Photo by Sophie Champion.

 

 

 

 

 

 

 

 

 

 

 

 

 

Notable buildings

The Tredegar Medical Aid Society was based at two buildings: the Cottage Hospital and 10 The Circle:

· The Cottage Hospital was situated in the heart of Tredegar town, and the land to build it was donated by local businessman Lord Tredegar. The hospital provided healthcare to the town’s population, and employed a number of healthcare professionals, including doctors and nurses.

· 10 The Circle was home to the society’s executive offices, wherein the secretary, Walter Conway, would work, and much of the decisions about how the society was

ran were taken here. Members of the executive would gather in the meeting rooms, discussing the running of the society, and local people would attend meetings, sharing opinions and advice on how to run the service efficiently.

How Did the War influence the Formation of the NHS?

During the aftermath of the Second World War British people sought a better future, for both them and their children, and aimed to achieve this by working collectively. There was also an aim of securing better lives for the working class, and a free health care service that discriminated against no one was instrumental in achieving this.

The Benefits of Working Together

The Dalai Lama once stated that, “when we have inner peace, we can be at peace with those around us. When our community is in a state of peace, it can share that peace with neighboring communities,” and this quote can be held true to the success of the Tredegar Medical Aid Society.

Before its creation, residents of Tredegar were forced to fund their own health care, to look after only themselves. Whenever an individual was unable to pay for their healthcare, they would find themselves on their own, perhaps they did not have enough money, or enough friends, to pay for their medical costs.

This could leave the individual marginalised, disadvantaged, and alone. Their physical health could worsen, and this could impact their mental health too.

Moreover, those able to cover their healthcare costs might adopt a mindset where they could separate themselves from their community, caring only for themselves. This sense of individualism could diminish the whole idea of ‘community’ and the values that come with it.

But an organisation like the Tredegar Medical Aid Society instilled the town of Tredegar with community values and the responsibility for people to look out for one another.

With a system that requires members to pay in each week and year to cover the whole of their medical costs and support the upkeep of the society, this encouraged the people of Tredegar to unite and work together to support each other’s health and wellbeing.

This unity was then introduced on a wider scale, as in accordance with the Dalai Lama’s quote, wherein the present day millions of British citizens pay into a health system that the whole population can use for free.

In his books, including In Place of Fear, Bevan made a number of allusions to the peace and harmony a universal healthcare service would bring to communities and society as a whole.

“Society becomes more wholesome, more serene, and spiritually healthier, if it knows that its citizens have at the back of their consciousness the knowledge that not only themselves, but all their fellows, have access, when ill, to the best that medical skill can provide. Society will be peaceful and happier if we support each other.”

Aneurin Bevan, In Place of Fear, Chapter 5

References

● Aneurin Bevan, In Place of Fear

● Information and access to items pictured provided by Geoff Thomas, from Time Banking Wales, based at 10 The Circle, Tredegar ● Wales Online: http://www.walesonline.co.uk/news/health/going-tredegar-ise-you-bevan-told-2187499

● Tredegar.co.uk: https://www.tredegar.co.uk/history/#Tredegar Cottage Hospital

● Do One Thing.org: http://www.doonething.org/quotes/community-quotes.htm

 

 

 

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IF Campaign, Business and Malnutrition

The IF Campaign has stamped its authority on the world and especially on those involved in the G8 summit. Mind boggling statistics were mentioned; Under-nutrition is the cause of 800 deaths every day, it stunts the growth of children contributing to 11% economy deficit in some countries. 1 in 4 (167 million to be exact) children in the  world, under 5 years old are stunted, 27% are born malnourished, 50% of children’s deaths are because of it etc. Pledges and commitments were made and £2.7 billion has been secured to tackle under-nutrition [1]. £1.9 Billion is core funding and the rest is matched funding. The UK has committed an additional £375 of core funding and £280m matched funding from 2013 to 2020[2].  As David Cameron put it blatantly, the UK’s tax payers’ contribution is a mere 0.7% of the country’s GDP, “For every £1 you pay in tax, just over 1 penny goes towards our aid budget. That’s a good investment.”[3]

nutrition for growth

Nutrition for Growth: Beating Hunger through Business and Science’ 8 June 2013

Under the banners, ‘Beating Hunger Through Business and Science’ and ‘Enough Food For Everyone IF‘, the campaign appealed to business and G8 country members to take notice and be the driving force to ensure that at least 500 million women and children are reached with effective nutrition interventions; to reduce the number of children under five stunted by at least 20 million and to save the lives of at least 1.7 million children under 5 by preventing stunting, increasing breastfeeding, and increasing treatment of severe acute malnutrition. It was agreed that the £2.1 Billion pledged by these stakeholders will be spent on making world-class scientific knowledge and evidence available, promote breastfeeding as a priority for protecting nutrition and saving lives, support governments of developing countries to formulate high quality national nutrition plans and ensure businesses in developing countries place good nutrition at the heart of their workforce welfare priorities.

Malnutrition is the result of a diet that doesn’t contain enough nutrients and under-nutrition is the lack of food or nutritional deficiency. Developing countries still suffer from such endemic diseases due to poor health facilities, poor health support, education as well as government’s failures to deal with the issues. Causes of malnutrition are numerous and whilst the problem is chronic in many countries e.g. 47% of Malawian children are stunted[4], not much has been done to tackle it as issues such as poverty and HIV were seen to be critical. With only 0.4% of current aid spent on tackling malnutrition, the global international community and businesses are responsible to ensure that this single large contributor of child mortality is eradicated as it underlies 45% or 3.1 million child deaths a year[5].

How do we tackle such issues?

 

 

David Cameron and other stakeholders dutifully acknowledge the importance of tackling the issue of malnutrition and nutrition in general. The issue has never been at the front page of many previous development initiatives….till now. During his speech, the Prime Minister highlighted one key issue which stood out the most, statistics are important BUT the people behind the statistics are more important. Malnutrition is a health, economic and education issue which affects all across the World…it is a massive issue for humanity and tackling it will encompass a combination of different approaches.

The message from the campaign is that we can end global hunger if the G8 and other stakeholders can work together in partnership to increase investment, improve transparency, accountability and governance of key aspects of the food system. These issues can be tackled through 8 main challenges; Tax Transparency, Nutrition, Land Transparency, Biofuels, Agricultural Investment, Budget Transparency, Climate Change and Accountability. These are ways of tackling the issue from a top-down approach. From a bottom – up approach, malnutrition can be tackled in many ways…through educating and empowering communities, developing better governing and monitoring strategies.

The message put across by the IF Campaign is that business should play a greater and effective role in tackling malnutrition. This can be through investing in research, innovative products, business approaches, as well as collaboration with government states. The idea of involving businesses to tackle the issue can be seen as a double edged sword and one which is crucial but should be handled delicately. There has to be checks and balances to monitor and assess their contribution. Businesses are profit driven and despite initiatives such as Corporate Social Responsibility (CSR), many companies do not adhere to the ethical values of the platform. Tax avoidance, land grabbing, corruption and lack of effective government policies to name a few, represents some of the problems arising from allowing private investors into developing states. Land grabbing and displacements of local indigenous communities are deemed prominent in the last few years. Furthermore empty promises for jobs, building infrastructures and social services by businesses exasperate the problem. In a twisted format, business can also be seen as the cause of malnutrition as displaced individuals are left jobless, landless, hopeless and foodless. There will be no hope for children to survive malnutrition related diseases if these issues are not tackled.

To sum it up, businesses can help eradicate malnutrition but there has to be nutrition justice, nutrition fairness and nutrition equality. I agree with David Cameron that through harnessing the power of enterprise and science and innovation, business can play a crucial role in combating malnutrition. However, effective government policies as well as monitoring and evaluation systems are just as important.

Fadhili Maghiya 


[1] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/205887/Global-Nutrition-for-Growth-Compact-Final.pdf

[2] UKaid Press Release (08 June 2013)

[3] https://www.gov.uk/government/speeches/pm-speech-at-g8-nutrition-for-growth-event[3]

[4] http://web.undp.org/africa/knowledge/WP-2012-019-garcia-working-afhdr-malnutrition-inequalities.pdf

[5] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/205887/Global-Nutrition-for-Growth-Compact-Final.pdf