NHS at 75: hope for cardiac patients since its birth

Historical hospital archives have revealed a poignant letter exchange between a patient and a member of staff in 1948 – 75 years ago, the year that the NHS was formed.

On 7 October 1948 the patient writes: “I am really not too well – my heart troubles me quite a lot, I do not see my Dr very often (as expenses are high) & I just try & carry on as best I can.”

Less than a week later, the acting almoner – a medical social work position that was then based at Brompton’s tuberculosis sanatorium in Frimley – replied: “I am sorry to hear that you are not well, and that you do not see a doctor very often because of the high cost of living. Since the Fifth of July this year, it has become possible by law for everyone to have free medical treatment.”

The Brompton Hospital, now Royal Brompton Hospital (part of Guy’s and St Thomas’ NHS Foundation Trust), came under the control of the NHS in 1948. Before that time, the Lady Almoner’s department would be responsible for assessing patients’ means and keeping contact with them to understand the impact of treatment. Further information about the role of this department can be found in an article in the journal Medical Humanities.

Chief executive for Royal Brompton and Harefield hospitals, Richard Grocott-Mason, said: “This remarkable exchange of letters, at such a poignant moment in time, shows just how precious the NHS is, and why. While nearly everything else about it has changed over the last 75 years, the principle of free care for all – as illustrated here – has remained exactly the same.”

These letters can be found in the Barts Health NHS Trust Archives. Giskin Day, a senior teaching fellow in the centre for co-curricular studies at Imperial College London, discovered them as part of her doctoral research and shared them with Royal Brompton.

Dear Madam

I am returning your paper filled in to the best I can – I’m afraid I cannot give you much information, I am really not too well – my heart troubles me quite a lot, I do not see my Dr very often (as expenses are high) & I just try & carry on as best I can, but I would send for Dr should I have to stay in bed. He is very good.

I have not been in touch with any other Frimley patients for years.

With thanks for interest taken in we old patients.

Yours faithfully

XXX

Dear XX

Thank you for your letter. I am sorry to hear that you are not well, and that you do not see a doctor very often because of the high cost of living.

Since the Fifth of July this year, it has become possible by law for everyone to have free medical treatment. In order to do so, you should ask a doctor who is taking part in the service if he will take you on his list. Medical cards are issued at the Post Offices. You should obtain one, fill it up, and take or send it to the doctor you have chosen., and if he accepts you, you will then be able to have both medical treatment and medicines free of charge. I think it would be a good idea if you did this, because you would then be able to call the doctor even if you feel ill, [illegible] worrying about the expense.

I shall look forward to hearing from you again next year, and I hope you will feel better by that time.

Yours sincerely,

Acting almoner