It was in the early afternoon of Saturday 20 July 2019 that I was admitted to A&E at Ysbyty Gwynedd. At 8pm, after lots of procedures, the consultant returned. You can stop worrying now, she said to my wife Susan. In five words, she had captured the very essence of the NHS. Providing reassurance to people has been a guiding purpose of the NHS since it first came into operation on 5 July 1948.
For Aneurin Bevan, the architect of the NHS, its creation proved far more significant than a personal triumph. He created a lasting institution that has changed the lives of millions. From Bevan’s vision, the principle of healthcare free at the point of delivery based on need, not wealth, became firmly embedded into our national life. His goal of transforming society via his vision for the NHS was born out of his upbringing and early life.
Born on 15 November 1897, on the eastern side of the South Wales coalfield in Tredegar, like his father he was a miner at the Ty-tryst Colliery. The coalfield was a nursery of political talent and a seedbed of ideological ferment. He became a trade union activist, joining the Independent Labour Party and in 1919 won a scholarship to study economics, politics and history at the Central Labour College, London.
On returning to Wales, Bevan was a driving force in the miners’ strike, called to protest at a proposed reduction in pay combined with increased working hours – hence their slogan Not a penny off the pay, not a minute on the day – which led to the General Strike of May 1926. Following this, in 1929, he was elected as Labour member of parliament for Ebbw Vale.
Following the 1945 General Election, he was given the Cabinet position of Minister for Health – aged forty-seven, Bevan was the youngest member of the Cabinet. Driven by a deep feeling of injustice, Bevan thought that it should be the clear responsibility of government to provide comprehensive, consistent high-quality healthcare across the country, and be best delivered by nationalisation of the hospitals.
The Tredegar Medical Aid Society provided the inspiration for Bevan’s model for the NHS. It provided healthcare to thousands of people locally funded by individual financial contributions. Bevan saw what could be achieved by people collecting together to provide healthcare services. However, whilst voluntary groups, and local councils could provide decent healthcare, it was not a guarantee of a universal standard of healthcare provision for every citizen.
Firstly, he oversaw the National Insurance Act, which created the infrastructure of what was to be the Welfare State, with mandatory contributions from employers and employees towards financing welfare provisions for old age pensions, unemployment, sickness, maternity and widows’ benefits. Then in 1948 his National Health Service Act became law. This allowed for people to receive, free at the point of use, medical diagnosis and treatment, and in addition dental and ophthalmic treatment. Bevan was now in charge of 2,688 hospitals in England and Wales.
It was the decision to nationalise the hospitals that made the profound difference in the structural change brought about by the creation of the NHS. This decision was Bevan’s and its implementation was down to his skill, patience, and application. It is the most significant and lasting reform in the history of the Labour Party.
The General Election of October 1951 saw the Conservatives return to power under Churchill, and Bevan was never again in the position to introduce legislation. He was elected Deputy Leader of the Labour Party in November 1959, but this was a post he was to hold on a sadly short tenure. Bevan gave what was to prove his last speech to the party conference at Blackpool in the autumn of 1959. He was diagnosed with cancer. He never returned to the political mainstream. His health progressively deteriorated, and he died in his sleep on 6 July 1960.
The overwhelming impression is of a man whose intellect was capacious, lively, and illuminating, a man whose emotions were strong and human, a man who believed greatly in the power of ideas. Bevan was a visionary, a pragmatist, a leader, an orator and an innovator. He displayed many entrepreneurial characteristics and qualities on his journey to introducing one of the greatest institutions in our country, which startup founders can learn from today.
1. Have a purpose Nye Bevan was a visionary. I can think of no one in Labour’s pantheon who evoked and inspired the vision of a socialist society more eloquently and vibrantly. Growing up in a mining community in South Wales, he saw hardship first hand, and Westminster was a place to build a better future for the people he represented.
In the Art of the Start, Guy Kawasaki states that it’s all about making meaning and defines three defining motivations that will lift, inspire and carry you through when following your vision:
– Increase the quality of life
– Right a wrong
– Prevent the end of something good
Kawasaki advises that if you’re starting something without any of these three at your core, you may want to reconsider what you’re doing. Bevan’s vision of healthcare was born of his own practical experience of hardship in the valleys of South Wales, and it was radical, challenging and difficult to deliver. Bevan had a purpose and a vision at his core, do you for your venture?
2. Be true to your values Bevan was inspired by the Uruguayan philosopher Jose Enrique Rodo’s emphasis on individual fulfilment, and argued that free healthcare was uplifting for everyone. Bevan was that rare being, a practical politician with a philosophy for his actions beyond the minutiae of political activity, which was in turn, only a means to achieve social and cultural ends.
A democracy cannot survive without the example of individual leaders who dare all as individuals, and leave the imprint of a great human being. Bevan’s language of priorities were essential ingredients of his outlook no less than his socialist bedrock, for example, he made this statement at the beginning of the 1945 general election campaign: We have been the dreamers, we have been the sufferers, now we are the builders.
You need an underpinning philosophy to drive your startup venture that shapes your North Star, a purpose, a ‘Why?’ What’s yours?
3. Show passion and compassion, persistence and patience For me, it was his passion and compassion alongside his hard work, persistence and patience that delivered the greatest achievement of Labour, and his lasting legacy. He had a reputation as an effective organiser and strategist as well as a firebrand activist and agitator, but it was his passion that made a difference.
The NHS was not born without opposition. The medical profession of the 1940s was very conservative, fearful of ‘nationalisation’. There were over 1,300 voluntary hospitals, and municipal hospitals run by local councils. It seemed like a fight against all comers to unify them with his vision, and often was.
Bevan had to endure a long battle with the British Medical Association, before the NHS could come into being. He was willing to compromise on inessentials. He allowed hospital consultants to keep their lucrative private pay beds. On the central points, however, he displayed a formidable combination of unyielding will, grasp of detail and, above all, a profound moral commitment that reflected the instinctive communalism of the South Wales valleys
There will be times in your startup journey where situations call for diplomacy, emotional intelligence and concessionary thinking – it’s not always about you. Bevan had cast-iron integrity and a raging passion, but showed that to overcome hurdles you have to manage your own frustrations, and sometimes sit the other side of the table to understand and empathise with others’ perspectives.
4. Hold pragmatism as a key trait You either learn the lesson of history or you repeat the mistakes of history. Bevan was both a thinker and a doer, a man of principles, who understood that the purpose of principles is to inspire action, not to provide a substitute for it. Bevan was a pragmatist. He compromised when necessary, he was a realist who was prepared to take the tough decisions when that was not the politically expedient thing to do.
Bevan’s hard-working determination and charm persuaded the British Medical Association that a proper health service for all could only be financed by government on a nationalised basis. After a long, complicated process of negotiation with the vested interests of the health-care system, during which the very future of the NHS itself was cast into doubt, Bevan put aside purity, giving the various parties important concessions on earnings and pay beds – but without ever compromising the founding principles of the NHS.
With skilled and subtle negotiation, he masterminded the creation of the NHS, the most far-reaching extension of social citizenship in British history. As the social theorist Richard Titmuss later described it, the NHS was the product of the most unsordid act of British social policy in the C20th.
By holding your vision and values, passion and patience, you’re emotionally energised to keep pushing your venture forward no matter what the challenges hold. I’m minded by the achievements of Elon Musk, who has all these qualities, but also has a steak of pragmatism underpinning his boldness. Reflect on this trait, and apply it to your own situation, maybe you have to take a step back before you can move forward.
5. Lead from the front: This is my truth, now show me yours This is one of many memorable quotes from Bevan, who was an inspirational orator and impassioned platform speaker – despite struggling with a stammer for all of his life. As a technique of mastering the demon by meeting it head-on, he used to practice speaking large chunks of poetry to himself on walks.
Even before he was first elected to Parliament in 1929 he had established a reputation as a brilliant speaker with a gift to inspire and lift an audience, his oratory could be extraordinary. It was not rhetoric but a capacity to develop arguments on his feet. Bevan’s speeches’ power lay in their subtle, elegant but sinewy thrust, they combined irresistible logic with creative imagination. These traits were buttressed by a mixture of charm, wit and intellectual breadth.
You have to lead from the front at all times in a startup, hands-on and hands-in, be seen and be counted on, taking the hearts and minds of your team, customers and investors and showing them the art of possible. Are you painting a picture of your startup with the forward view that energises and inspires? By the strength of our common endeavours we achieve more than we achieve alone, but you need to make it happen.
When introducing the National Health Service Bill in the House of Commons, Bevan declared: I believe it will lift the shadow from millions of homes. As we make the tentative steps forward from Covid-19, we all appreciate more than ever before that the NHS is there for us at times of acute need. As we do, we should remember Bevan the architect of this entity, his spirit, his passion, his foresight, the entrepreneurial thinker who set out to achieve the impossible, and made it a reality.
I think back to that afternoon of Saturday 20 July 2019 in A&E at Ysbyty Gwynedd. The NHS has certainly brought light to my own family. Nobody will ever send me an invoice for my treatment. The NHS, with its brilliant staff, took away the anguish of my family and replaced it with serenity.
Bevan made big things happen. One man’s extraordinary vision, commitment and tenacious mindset achieved something remarkable. Have the same traits in your own startup endeavours, and you can achieve something amazing too.