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The Five Giants: A Biography of the Welfare State
Giant Want. Giant Disease. Giant Ignorance. Giant Squalor. Giant Idleness.
These were the Five Giants that loomed over the post-war reconstruction of Britain. The battle against them was fought by five gargantuan programmes that made up the core of the Welfare State: social security, health, education, housing and a policy of full employment.
This book brilliantly captures the high hopes of the period in which the Welfare State was created and the cranky zeal of its inventor, William Beveridge, telling the story of how his vision inspired an entire country. The pages of this modern classic hum with the energies and passions of activists, dreamers and ordinary Britons, and seethe with personal vendettas, forced compromises, awkward contradictions, and the noisy rows of the succeeding seventy years. The Five Giants is a testament to a concept of government that is intertwined with so many of our personal histories, and a stark reminder of what we might stand to lose.
These were the Five Giants that loomed over the post-war reconstruction of Britain. The battle against them was fought by five gargantuan programmes that made up the core of the Welfare State: social security, health, education, housing and a policy of full employment.
This book brilliantly captures the high hopes of the period in which the Welfare State was created and the cranky zeal of its inventor, William Beveridge, telling the story of how his vision inspired an entire country. The pages of this modern classic hum with the energies and passions of activists, dreamers and ordinary Britons, and seethe with personal vendettas, forced compromises, awkward contradictions, and the noisy rows of the succeeding seventy years. The Five Giants is a testament to a concept of government that is intertwined with so many of our personal histories, and a stark reminder of what we might stand to lose.
816 pages, Kindle Edition
First published January 1, 1995
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Displaying 1 - 14 of 14 reviews
January 17, 2019
An 800-page book on the history of the welfare state might not seem like fun, but this book is actually a very good read, thanks to the engaging style of the author, a veteran journalist. The book traces the gestation of our welfare system to the liberal Beveridge Report and then its birth under the great post-war Attlee government, through to its current period of old-age and decline (and possible demise, thanks to Brexit).
In particular, the book makes great play of the heroic efforts of Bevan to create the beloved NHS - in the teeth, the book notes, of the opposition of the medical profession. The other main pillars of the post-war reconstruction/reform (housing, pension, social security and education) are also dealt with but the NHS is the lasting jewel of the Labour government of the era - an institution without which some of us would not be here, basically. Thereafter, as the British politics textbooks tell us, there was a period of general consensus between the two major parties over the need to maintain employment and services, which continued until the oil price shock of the early 1970s and the consequent counter-revolution of the monetarist right-wing, leading to the election of Mrs Thatcher in 1979. In truth, of course, as the book makes clear, there had always been fierce debates between and within both parties about the role of the state and the costs of the welfare state, and of the NHS in particular. Thatcher's era lead to a huge increase in unemployment (a result of a deliberate policy of 'rolling back the frontiers of the state') and hence a massive increase in social security and related costs, which made many of the formerly more marginal ideas of the liberal right seem more viable to subsequent governments (including Labour ones).
The book shows in detail how Blair's government continued the work of the Thatcher era, in looking for marketised solutions to huge social problems, and in particular to the key issues of health reform and education (not to mention the problem of the ever increasing benefits bill). These issues all came to a head following the unfortunate global economic crash in 2008, which opened up the field for more shock treatment from the far right, under the Cameron Coalition government. The latter chapters of the book are particularly sobering, as the author shows that Osborne's vicious cuts in services did little to cut the deficit (caused mainly by the banks) and did huge amounts to increase the misery of the most vulnerable in society. This trend was slightly halted under the May government, on the basis that people could take much more, but Universal Credit is still going through, in its disastrous way, and the vultures of the US health care system are doubtless hovering over the NHS as Brexit looms. The book notes that the 'Welfare State' as an idea has changed over recent decades, as society has become more individualistic and atomised, and the social solidarity of the post-1945 era has vanished. As a result, it was easy for the Tory government to blame the poor for the deficit, and to attack public services in general. At the same time, the book also notes that since government no longer runs things (like industry), the 'welfare state' is what the government does mostly now (excepting Brexit, which is foreign policy in essence). Anyone wanting to understand more about this should really get hold of this book, which is fascinating and also quite frightening.
In particular, the book makes great play of the heroic efforts of Bevan to create the beloved NHS - in the teeth, the book notes, of the opposition of the medical profession. The other main pillars of the post-war reconstruction/reform (housing, pension, social security and education) are also dealt with but the NHS is the lasting jewel of the Labour government of the era - an institution without which some of us would not be here, basically. Thereafter, as the British politics textbooks tell us, there was a period of general consensus between the two major parties over the need to maintain employment and services, which continued until the oil price shock of the early 1970s and the consequent counter-revolution of the monetarist right-wing, leading to the election of Mrs Thatcher in 1979. In truth, of course, as the book makes clear, there had always been fierce debates between and within both parties about the role of the state and the costs of the welfare state, and of the NHS in particular. Thatcher's era lead to a huge increase in unemployment (a result of a deliberate policy of 'rolling back the frontiers of the state') and hence a massive increase in social security and related costs, which made many of the formerly more marginal ideas of the liberal right seem more viable to subsequent governments (including Labour ones).
The book shows in detail how Blair's government continued the work of the Thatcher era, in looking for marketised solutions to huge social problems, and in particular to the key issues of health reform and education (not to mention the problem of the ever increasing benefits bill). These issues all came to a head following the unfortunate global economic crash in 2008, which opened up the field for more shock treatment from the far right, under the Cameron Coalition government. The latter chapters of the book are particularly sobering, as the author shows that Osborne's vicious cuts in services did little to cut the deficit (caused mainly by the banks) and did huge amounts to increase the misery of the most vulnerable in society. This trend was slightly halted under the May government, on the basis that people could take much more, but Universal Credit is still going through, in its disastrous way, and the vultures of the US health care system are doubtless hovering over the NHS as Brexit looms. The book notes that the 'Welfare State' as an idea has changed over recent decades, as society has become more individualistic and atomised, and the social solidarity of the post-1945 era has vanished. As a result, it was easy for the Tory government to blame the poor for the deficit, and to attack public services in general. At the same time, the book also notes that since government no longer runs things (like industry), the 'welfare state' is what the government does mostly now (excepting Brexit, which is foreign policy in essence). Anyone wanting to understand more about this should really get hold of this book, which is fascinating and also quite frightening.
July 1, 2018
This is a four-star book in that it’s by far the most comprehensive history of the British welfare state that exists, but is probably only a 3-star in that it simply tries to do too much. The extent of research and expertise which Timmins brings is remarkable, but it’s near-impossible to get through - even for someone who is aware of the history - without getting lost in the volume of detail that he provides on each policy area across each Premiership. Although you’re left with a good understanding of the different themes and dominant strains of thinking across each period, it still risks leaving readers with a great understanding of the individual trees, but less of the wood.
March 21, 2018
The best way to describe this is exhaustive. It isn't one book, it feels like 3 or 4 books in one. Most of it is readable and clear, but it is extremely long. It will tell you everything you could possibly want to know about the welfare state and more. After a while, I found it becoming a slog and started reading other books to give a change of pace.
September 19, 2025
A brilliantly exhaustive book on the welfare state up to 2002.
Greatly helpful in showcasing the contributions by the Conservatives, not just labour.
Not the easiest of reads, but well worth it.
Greatly helpful in showcasing the contributions by the Conservatives, not just labour.
Not the easiest of reads, but well worth it.
January 11, 2021
Essential reading for those of us who believed in the post-war consensus. The welfare state, education and Health. A Liberal, a Tory and a socialist. Beveridge, Butler and Bevan created the milieu that my generation grew to adulthood in. This was the consensus that Thatcherite radicalism destroyed, aided and abetted by Bennite reactionary socialism in a single country. But it is worth reading again about the achievements of my childhood.
July 25, 2018
Absolutely loved this. My notes are too long for goodreads(!) here’s the first section of them...
Introduction:
‘One theme which repeatedly emerges is the law of unintended consequences: that decisions taken for the best of motives will often go awry.’
Beveridge’s conversion to means testing started by knowing that otherwise families with lots of children would be better off not working. - interesting how not much changes over time
The 1834 poor law came at a time when poverty was seen as something to be punished. That meant Poor Relief had ‘no intent to preven poverty, only to avert starvation.’
I’m the 30s local authorities were responsible for unemployment benefits. This was then moved to national gov, which ensured a much more consistent offer but meant local gov stopped caring much about the unemployed - because they no longer had a direct financial responsibility.
The Beveridge report went down very well with the media and public. Very favourable public opinion polling, even among those who didn’t think they would gain anything from the measures.
Beveridge’s report recognised the value ofwomen’s non-work contribution to the home, a first, but still created a benefits system that assumed dependence on the husband’s income and didn’t account for women who work or single parenthood. This was in keeping with the WW2 times, but changed rapidly after - lots of illegitimate children, a rapid rise in divorce and many women staying in the workplace after the war ended
Many of beveridge’s ideas that weren’t implemented, eg no unconditional benefits for the young, have been tried or implemented since. Beveridge’s idea in this case was that young people go straight into training if unemployed. High employment rates in 40s and 50s meant it was deemed unnecessary.
The plan contained a strange mix of socialism (universality) and conservatism (only in return for clear cut duties), but this was ultimately the reason for its success - something for everyone
1942-1951
Education: early 30s saw quite strong anti-public school sentiment, eg ‘it is hard to resist the argument that a state that draws its leaders from a class so limited as this is not a democracy, but a pluto-democracy’
The education bill was the only element that passed before the Tories lost the election. It made education up to 15 mandatory and made it free. It’s also the bill that brought in free school meals and free school milk.
See page 87 for some of the most patronising description of pupils’ ‘ability to learn’ and therefore the need for selection between secondary moderns and grammar schools
‘Plenty of private education exists elsewhere in Europe, but it is often chosen for religious and cultural reasons, not for the class and opportunity-based divisions that have so marked Britain’s particular version of the public/private split’
Health: ‘wartime proved that a national health service could be run.’
An emergency medical service was created in fear of the Blitz, which wasn’t universally available but covered war casualties, child evacuees, firemen etc
There were local authority health services, eg GP, which combined private insurance with a ‘panel’ doctor - pay per treatment. This meant the surgeries were concentrated in wealthier areas.
The BMA described Bevan’s plan to give GPs salaries doled out by gov as dictatorial, giving him ‘enormous powers to direct’ the medics. There were comparisons to hitler, eg being termed the ‘medical Fuhrer’ and ‘the greatest seizure of property since Henry VIII confiscates the monasteries’
This chapter is proof that the BMA have always been dickheads
Health and social security: because the tories voted against the NHS bill (including at third reading), the public became suspicious of their ability to be a guardian of the welfare state - something that’s stayed with them over the years. A lot of their reasoning for going strongly against the bill was politics - Bevan was also in charge of housing, which was ‘in deep trouble’. Tories wanted to tar the nhs with the same brush by marking Bevan as incompetent.
Housing: this sat under the Ministry of Health. By not having everything in one department, up to 10 departments had a role eg in materials, works, labour etc. Very difficult to coordinate
Bevan places major emphasis on both quality and mix. On quality: he was under immense pressure to build fast and build lots. Bevan saw the need to build well - quality in balance with quantity (or at the expense of). The effect of the higher quality can be seen today - by comparison with later builds that repeatedly reduced quality standards. On mix: he was adamant that housing should not just be built for the working classes and was keen to avoid ghettos / class distinctions by housing. Similarly, he didn’t want old people to be clumped together in one housing district.
The conservatives lost the 1945 election so thoroughly that some advocated a change in name of the party or the intro of proportional representation as a route back to power
In the 40s and early 50s there was a large degree of consensus about the welfare state between conservative and labour. The differences between the parties led to an ‘oscillation around the mean’ rather than a pulling to either extreme. It’d be the late 70s and early 80s before the differences in aim became stark.
Legal aid started in 1950 as a pretty tiny part of the welfare state, but covered 80% of the population.
1951-73
Britain’s prosperity and economy grew after the war. But by the mid-50s it was clear that other European countries’ economies were growing at twice the rate. While other countries upgraded their infrastructure and industries, the uk fell behind.
When Macmillan was in charge of housing, the pressure to hit 300,000 homes meant quality and size suffered. Rent controls since the 30s meant that rent could vary by 2.5 times for properties on the same street. This was seen as a barrier to landlords carrying out repairs and meant many properties quickly became slums. A ‘repairs increase’ was allowed in the prs where a landlord could show they had put homes into good repair in past 3 years. This turned out to be too small to have much effect.
The new materials used on high rises were popular at the time of building, but soon proved inadequate. The buildings became rundown quickly and social housing was associated with these blocks.
The idea for housing associations came from Scandinavia and the first trial was in 63. By the 90s it was commonplace.
Education: the early 60s saw a major increase in number of units, in part because of baby boomers coming of age and in part because of more money now Korean War was over. The decision to introduce uni grants (60s) was based on knowledge that 90% of uni students got some sort of assistance from uni, LA or charity. Therefore it was viewed as standardising existing practice.
Health: the ministry of health (which had been rid of housing and local gov) didn’t even have a cabinet seat until 1968. Paying consultants more money (after a pay dispute) meant more even coverage across uk and fewer resorting to private practice. But it had a knock on effect on GPS, which became an undesirable profession. In 1963 there was the threat of mass GP walk out, leading to 33% pay rise and new contract. Very exnpensive, but did tether GPS to the nhs forevermore.
Social security: early pensions were intrusive and inconsistent - relying on claimants telling officers they were in need (eg showing their worn out clothes). This became increasingly unappealing when those around them were getting richer - easier straight after the war when friends/family were in similar position. A third didn’t even claim by the 60s. Labour promised an income guarantee (no means-test).
In the 60s, labour were vehemently anti-PRS. There was support for mortgages and council trenants, but a refusal to do the same on prs because it would benefit prs landlords - even thoug prs tenants were the poorest in society. Many wanted the prs to disappear. However there was a shift to promoting ownership and seeeing council homes as for the most needy. In 1970 Britain reached 50% home ownership for the first time.
In late 60s the debate shifted from quantity to quality - the number being built was predicted to outnumber households by 73. Furthermore, a gas explosion at a council high rise left 5 dead and epitomised the slum high rise associated with council property. High rises began to be demolished wish increasing frequency. Minimum size requirements were set up, but these became max sizes in council building and the Bevan era sizing was never returned to. Partly this was due to not enough money being put in and partly due to housing being more political than in late 40s, when only numbers mattered. The type of housing built now had social consequences - eg gentrifying, helping immigrants, helping long term working class.
Education: the first evidence that you can coach for an IQ test came in 1952. Why do we still use them???? Th polytechnics were meant to offer technical (science /vocational) degrees, as the old unis mostly offered art degrees, which Britain needed less of. But because the schools produced students fit largely for art degrees (and this is what they applied for) the polytechs mostly took on the role of offering second rate arts courses for those who didn’t get into the unis.
For a while post-WW2, people thought poverty had been basically eliminated (both Tory and labour). This was based on an absolute poverty level that didn’t take account of changes in living standards. Research also ‘discovered’ in work poverty and the number of children In poverty. These led ultimately to tax credits and child benefit
The late 60s saw greater financial difficulty and with it the first genuine questioning of the welfare state since 45. People didn’t like their taxes going up to pay for services. Emphasis on selectivity over universality grew, in labour and Tory camps.
Frank Field worked at CPAG before becoming a labour MP and his report saying labour had made the poor poorer probably played a part in labour’s 69 loss.
The Tory 69 manifesto contained no references to a reduction in the welfare state, though there were some references to decreasing tax. On individual elements of the welfare state their manifesto talked on retaining current standards.
In early 70s employment levels were diminished (reaching 1 million in 71). This was happening increasingly at the peak of each economic cycle, undermining a key condition of the affordable and effective welfare state of full employment.
Keynesian economics reigned supreme from 45 to 75. It was based on the idea that you could spend your way out of recession and increase employment by cutting taxes and boosting spending. But Callaghan denounced it, saying it resulted in cycles of inflation followed by higher unemployment. Instead he was finding that the higher taxation and inflation might not always bring full employment and growth. He shifted from deficit spending. This was the ‘first great fissure’ in the welfare state.
Health: in the immediate post-war period, the most junior doctors in some hospitals were only entitled to Christmas Day off. Even in 65, they worked 102 hours a week before any extra duty allowance or overtime kicked in. And many worked longer hours.
It was in Castle’s time that calculations of the money needed to ‘stand still’ were produced and helped protect nhs budgets with approx 2% increases. This was ended by Jenkins (Tory) in early 80s to cut costs - which meant the nhs couldn’t prove whether it had spent its money efficiently. This became a political problem, but it turned out that civil setvants had luckily kept some of the measures/metrics on the sly.
When thatcher was in opposition, rolling back the welfare state was a point of principle, but there were few tAngible policy asks except selling council homes. Other policy areAs took priority. This resulted in her being one of few politicians to be more radical in power than in opposition.
Right to buy was actually Heath’s idea, which thatcher opposed, saying it went against ‘our people’ who worked hard to pay off mortgages. There was an even more radical proposal in 75 by a cabinet member, which Thatcher shot down, to transfer ownership as soon as construction costs had been paid off. The aim of r2b was increase independence from the state throug rising ownership. Council tenants got 33% off their property after 3 years, rising by 1% each year up to 50% after 20 years. In conjunction, rents were increased to encourage sales and public house building slowed - this went unmentioned in the manifesto. Labour also considered council sales to spread wealth - but didnt act on it.
From thatcher’s victory in 79, labour entered a decade of not thinking constructively about the welfare state, mostly due to infighting.
79-92: Tory years. ‘Welfare state under fire’
A report in 77 on health inequalities was the first of its kind, pretty much globally. Tories tried to bury it and spent a decade denying health had anything to do with socio economic conditions - it conflicted with their belief in trickle down effects
Labour decided to oppose the r2b policy on the basis of reductions to the quality and quantity of the housing stock. Some argued they should support sales but insist on a continued building programme - which the tories were massacring.
A cabinet paper in 82 looked at options for reducing public spending, which inevitably looked like an attack on the welfare state. One option was replacing the nhs with insurance - it’s no wonder the tories are associated with dismantling the welfare state.
John Redwood ran the newish Number 10 policy unit under Thatcher’s second term, and was the author of much thatcher welfare state policy
The introduction of housing benefit in 1983 came amidst calls to cut costs but a ministerial desire not to have too many ‘losers’ from the new scheme. This meant, rather than a unified new system being introduced, HB was added on top of existing supplementary benefits. There weren’t enough staff to manage it, the computers weren’t set up properly and it led to the biggest admin fiasco the welfare state had experienced - evictions, disturbances, welfare centres closing their doors to major queues. None of the ministers seemed to understand the new scheme
The benefits system had lots of one off payments eg for cookers and beds. About half of people weren’t aware these options existed, and the other half used it extensively - encouraged by local authorities (especially labour ones unsympathetic to a thatcher govt) and welfare advisers. Social security was one of the few areas of welfare that central gov has major control - they might have to pass a law, but other than that their word became action. Health, education and social services were much harder to get action.
The review from No10 policy unit was less individual and therefore easier to administer. It also sought to remove the poverty trap by ensuring that taking on more work always meant more money, even once taxed. However, in order to prevent major rises in costs, this was combined with a much more severe tapering of housing benefit. Essentially this meant a shallower but wider poverty trap.
The most controversial change was introduction of the Social Fund to replace one-off payments for cookers, beds etc with interest-free loans that were cash-limited by local office - meaning they could and did run out of funds.
A ‘boomerang offer’ is an offer to the treasury to make a cut, which subsequently has to be reversed because the political cost is too high
Health: when the nhs was first created, the BMA was sceptical and pro-private practice, reflecting the view of its doctors who were used to working privately. As a new generation of doctors, protective of the nhs, came in, the BMA changed its stance. In terms of timing, this meant BMA stopped promoting privatisation just as a govt pro-privatisation came into power.
In Thatccher’s third term the rise of housing assocs began. They were required to introduce private finance to augment public funds. The result of this was higher rents. This meant that, increasingly, ‘welfare ghettos’ were created: because only those whose housing benefit covered all their rent could afford to pay, plus LAs increasingly used HAs to house the homeless. This repeated the 60s ‘sink estates’ grouping of vulnerable people.
1987 saw the introduction of the national curriculum - taking uk from one of the only industrialised countries without one to a country with one of the most detailed and prescriptive curriculum
John Moore took over DHSS, just as it split into DH and DSS - with him keeping social security. He introduced conditionality for 16 and 17 year olds to prevent them moving straight from school to dole. All young people had to undertake training in order to get benefits. In practice this was a disaster - the construct ignored children who’d left abusive homes, been discharged from care, whom gov couldn’t provide a training place for, people who were sacked.
Thatcher’s third term was when the Thatcherite approach to services really developed. This involved provider/purchaser splits between private/piblic - and versions of this could be seen across nhs, social care, education etc.
It was 1991 before the government accepted there’s a link between poverty and ill-health.
Labour really struggled while in opposition, with little fresh thinking. For a while it was stuck in 1970s thought, opposing cuts and anti-privatisation but not much nuance. Research came out showing that most public expenditure on social services benefits the better off more, with middle classes exploiting the welfare state more effectively. The right liked these findings as proof of the need to ‘wean’ those not genuinely in need off welfare. Those on the left liked it as proof of more radical redistributive measures being needed. Those in the middle stagnated.
Thatcher was based on trickle down economics: the richest lead the way, eg by buying luxury goods that eventually improve the minimum standard experienced by all. If you strive for equality the whole country stagnates and progress would never come. But in practice that didn’t happen: the bottom 10% got poorer through thatcher era, with inequality growing faster than any comparable western country. The extremes were further apart than any time since the war. This was not all down to gov policy or welfare policy, globalisation played a big part. ‘While salaries at the top of the earnings range had exploded, those at the bottom had fallen as the rewards for brain increased and those for brawn fell.’
In the 90s there was an internTional shift on welfare to conditionality with support, from lots of training through to job interview guarantees. Evidence shows the latter works better. This formed a big part of new labour’s approach to welfare. The concept of welfare as a springboard rather than a safety net stole lots of Tory language.
Back in 1996 there was discussion of how to prevent the ‘scandal’ of people losing their life savings/homes to fund long-term care. Blair obfuscated pre-election to avoid tricky questions, promising a royal commission instead. - an example of how effective it can be to kick tricky policy issues into the long grass...
The NHS Direct was originally called ‘888’ by civil servants.
Blair won with the largest majority ever (178) but also got the lowest turnout since 1935.
Making the Bank of England freed up the treasury to spend much less time on macro-economics - much of this now ran on autopilot - and much more on domestic policy, notably tax and benefit changes. It also meant the chancellor had significantly more domestic policy power.
Introduction:
‘One theme which repeatedly emerges is the law of unintended consequences: that decisions taken for the best of motives will often go awry.’
Beveridge’s conversion to means testing started by knowing that otherwise families with lots of children would be better off not working. - interesting how not much changes over time
The 1834 poor law came at a time when poverty was seen as something to be punished. That meant Poor Relief had ‘no intent to preven poverty, only to avert starvation.’
I’m the 30s local authorities were responsible for unemployment benefits. This was then moved to national gov, which ensured a much more consistent offer but meant local gov stopped caring much about the unemployed - because they no longer had a direct financial responsibility.
The Beveridge report went down very well with the media and public. Very favourable public opinion polling, even among those who didn’t think they would gain anything from the measures.
Beveridge’s report recognised the value ofwomen’s non-work contribution to the home, a first, but still created a benefits system that assumed dependence on the husband’s income and didn’t account for women who work or single parenthood. This was in keeping with the WW2 times, but changed rapidly after - lots of illegitimate children, a rapid rise in divorce and many women staying in the workplace after the war ended
Many of beveridge’s ideas that weren’t implemented, eg no unconditional benefits for the young, have been tried or implemented since. Beveridge’s idea in this case was that young people go straight into training if unemployed. High employment rates in 40s and 50s meant it was deemed unnecessary.
The plan contained a strange mix of socialism (universality) and conservatism (only in return for clear cut duties), but this was ultimately the reason for its success - something for everyone
1942-1951
Education: early 30s saw quite strong anti-public school sentiment, eg ‘it is hard to resist the argument that a state that draws its leaders from a class so limited as this is not a democracy, but a pluto-democracy’
The education bill was the only element that passed before the Tories lost the election. It made education up to 15 mandatory and made it free. It’s also the bill that brought in free school meals and free school milk.
See page 87 for some of the most patronising description of pupils’ ‘ability to learn’ and therefore the need for selection between secondary moderns and grammar schools
‘Plenty of private education exists elsewhere in Europe, but it is often chosen for religious and cultural reasons, not for the class and opportunity-based divisions that have so marked Britain’s particular version of the public/private split’
Health: ‘wartime proved that a national health service could be run.’
An emergency medical service was created in fear of the Blitz, which wasn’t universally available but covered war casualties, child evacuees, firemen etc
There were local authority health services, eg GP, which combined private insurance with a ‘panel’ doctor - pay per treatment. This meant the surgeries were concentrated in wealthier areas.
The BMA described Bevan’s plan to give GPs salaries doled out by gov as dictatorial, giving him ‘enormous powers to direct’ the medics. There were comparisons to hitler, eg being termed the ‘medical Fuhrer’ and ‘the greatest seizure of property since Henry VIII confiscates the monasteries’
This chapter is proof that the BMA have always been dickheads
Health and social security: because the tories voted against the NHS bill (including at third reading), the public became suspicious of their ability to be a guardian of the welfare state - something that’s stayed with them over the years. A lot of their reasoning for going strongly against the bill was politics - Bevan was also in charge of housing, which was ‘in deep trouble’. Tories wanted to tar the nhs with the same brush by marking Bevan as incompetent.
Housing: this sat under the Ministry of Health. By not having everything in one department, up to 10 departments had a role eg in materials, works, labour etc. Very difficult to coordinate
Bevan places major emphasis on both quality and mix. On quality: he was under immense pressure to build fast and build lots. Bevan saw the need to build well - quality in balance with quantity (or at the expense of). The effect of the higher quality can be seen today - by comparison with later builds that repeatedly reduced quality standards. On mix: he was adamant that housing should not just be built for the working classes and was keen to avoid ghettos / class distinctions by housing. Similarly, he didn’t want old people to be clumped together in one housing district.
The conservatives lost the 1945 election so thoroughly that some advocated a change in name of the party or the intro of proportional representation as a route back to power
In the 40s and early 50s there was a large degree of consensus about the welfare state between conservative and labour. The differences between the parties led to an ‘oscillation around the mean’ rather than a pulling to either extreme. It’d be the late 70s and early 80s before the differences in aim became stark.
Legal aid started in 1950 as a pretty tiny part of the welfare state, but covered 80% of the population.
1951-73
Britain’s prosperity and economy grew after the war. But by the mid-50s it was clear that other European countries’ economies were growing at twice the rate. While other countries upgraded their infrastructure and industries, the uk fell behind.
When Macmillan was in charge of housing, the pressure to hit 300,000 homes meant quality and size suffered. Rent controls since the 30s meant that rent could vary by 2.5 times for properties on the same street. This was seen as a barrier to landlords carrying out repairs and meant many properties quickly became slums. A ‘repairs increase’ was allowed in the prs where a landlord could show they had put homes into good repair in past 3 years. This turned out to be too small to have much effect.
The new materials used on high rises were popular at the time of building, but soon proved inadequate. The buildings became rundown quickly and social housing was associated with these blocks.
The idea for housing associations came from Scandinavia and the first trial was in 63. By the 90s it was commonplace.
Education: the early 60s saw a major increase in number of units, in part because of baby boomers coming of age and in part because of more money now Korean War was over. The decision to introduce uni grants (60s) was based on knowledge that 90% of uni students got some sort of assistance from uni, LA or charity. Therefore it was viewed as standardising existing practice.
Health: the ministry of health (which had been rid of housing and local gov) didn’t even have a cabinet seat until 1968. Paying consultants more money (after a pay dispute) meant more even coverage across uk and fewer resorting to private practice. But it had a knock on effect on GPS, which became an undesirable profession. In 1963 there was the threat of mass GP walk out, leading to 33% pay rise and new contract. Very exnpensive, but did tether GPS to the nhs forevermore.
Social security: early pensions were intrusive and inconsistent - relying on claimants telling officers they were in need (eg showing their worn out clothes). This became increasingly unappealing when those around them were getting richer - easier straight after the war when friends/family were in similar position. A third didn’t even claim by the 60s. Labour promised an income guarantee (no means-test).
In the 60s, labour were vehemently anti-PRS. There was support for mortgages and council trenants, but a refusal to do the same on prs because it would benefit prs landlords - even thoug prs tenants were the poorest in society. Many wanted the prs to disappear. However there was a shift to promoting ownership and seeeing council homes as for the most needy. In 1970 Britain reached 50% home ownership for the first time.
In late 60s the debate shifted from quantity to quality - the number being built was predicted to outnumber households by 73. Furthermore, a gas explosion at a council high rise left 5 dead and epitomised the slum high rise associated with council property. High rises began to be demolished wish increasing frequency. Minimum size requirements were set up, but these became max sizes in council building and the Bevan era sizing was never returned to. Partly this was due to not enough money being put in and partly due to housing being more political than in late 40s, when only numbers mattered. The type of housing built now had social consequences - eg gentrifying, helping immigrants, helping long term working class.
Education: the first evidence that you can coach for an IQ test came in 1952. Why do we still use them???? Th polytechnics were meant to offer technical (science /vocational) degrees, as the old unis mostly offered art degrees, which Britain needed less of. But because the schools produced students fit largely for art degrees (and this is what they applied for) the polytechs mostly took on the role of offering second rate arts courses for those who didn’t get into the unis.
For a while post-WW2, people thought poverty had been basically eliminated (both Tory and labour). This was based on an absolute poverty level that didn’t take account of changes in living standards. Research also ‘discovered’ in work poverty and the number of children In poverty. These led ultimately to tax credits and child benefit
The late 60s saw greater financial difficulty and with it the first genuine questioning of the welfare state since 45. People didn’t like their taxes going up to pay for services. Emphasis on selectivity over universality grew, in labour and Tory camps.
Frank Field worked at CPAG before becoming a labour MP and his report saying labour had made the poor poorer probably played a part in labour’s 69 loss.
The Tory 69 manifesto contained no references to a reduction in the welfare state, though there were some references to decreasing tax. On individual elements of the welfare state their manifesto talked on retaining current standards.
In early 70s employment levels were diminished (reaching 1 million in 71). This was happening increasingly at the peak of each economic cycle, undermining a key condition of the affordable and effective welfare state of full employment.
Keynesian economics reigned supreme from 45 to 75. It was based on the idea that you could spend your way out of recession and increase employment by cutting taxes and boosting spending. But Callaghan denounced it, saying it resulted in cycles of inflation followed by higher unemployment. Instead he was finding that the higher taxation and inflation might not always bring full employment and growth. He shifted from deficit spending. This was the ‘first great fissure’ in the welfare state.
Health: in the immediate post-war period, the most junior doctors in some hospitals were only entitled to Christmas Day off. Even in 65, they worked 102 hours a week before any extra duty allowance or overtime kicked in. And many worked longer hours.
It was in Castle’s time that calculations of the money needed to ‘stand still’ were produced and helped protect nhs budgets with approx 2% increases. This was ended by Jenkins (Tory) in early 80s to cut costs - which meant the nhs couldn’t prove whether it had spent its money efficiently. This became a political problem, but it turned out that civil setvants had luckily kept some of the measures/metrics on the sly.
When thatcher was in opposition, rolling back the welfare state was a point of principle, but there were few tAngible policy asks except selling council homes. Other policy areAs took priority. This resulted in her being one of few politicians to be more radical in power than in opposition.
Right to buy was actually Heath’s idea, which thatcher opposed, saying it went against ‘our people’ who worked hard to pay off mortgages. There was an even more radical proposal in 75 by a cabinet member, which Thatcher shot down, to transfer ownership as soon as construction costs had been paid off. The aim of r2b was increase independence from the state throug rising ownership. Council tenants got 33% off their property after 3 years, rising by 1% each year up to 50% after 20 years. In conjunction, rents were increased to encourage sales and public house building slowed - this went unmentioned in the manifesto. Labour also considered council sales to spread wealth - but didnt act on it.
From thatcher’s victory in 79, labour entered a decade of not thinking constructively about the welfare state, mostly due to infighting.
79-92: Tory years. ‘Welfare state under fire’
A report in 77 on health inequalities was the first of its kind, pretty much globally. Tories tried to bury it and spent a decade denying health had anything to do with socio economic conditions - it conflicted with their belief in trickle down effects
Labour decided to oppose the r2b policy on the basis of reductions to the quality and quantity of the housing stock. Some argued they should support sales but insist on a continued building programme - which the tories were massacring.
A cabinet paper in 82 looked at options for reducing public spending, which inevitably looked like an attack on the welfare state. One option was replacing the nhs with insurance - it’s no wonder the tories are associated with dismantling the welfare state.
John Redwood ran the newish Number 10 policy unit under Thatcher’s second term, and was the author of much thatcher welfare state policy
The introduction of housing benefit in 1983 came amidst calls to cut costs but a ministerial desire not to have too many ‘losers’ from the new scheme. This meant, rather than a unified new system being introduced, HB was added on top of existing supplementary benefits. There weren’t enough staff to manage it, the computers weren’t set up properly and it led to the biggest admin fiasco the welfare state had experienced - evictions, disturbances, welfare centres closing their doors to major queues. None of the ministers seemed to understand the new scheme
The benefits system had lots of one off payments eg for cookers and beds. About half of people weren’t aware these options existed, and the other half used it extensively - encouraged by local authorities (especially labour ones unsympathetic to a thatcher govt) and welfare advisers. Social security was one of the few areas of welfare that central gov has major control - they might have to pass a law, but other than that their word became action. Health, education and social services were much harder to get action.
The review from No10 policy unit was less individual and therefore easier to administer. It also sought to remove the poverty trap by ensuring that taking on more work always meant more money, even once taxed. However, in order to prevent major rises in costs, this was combined with a much more severe tapering of housing benefit. Essentially this meant a shallower but wider poverty trap.
The most controversial change was introduction of the Social Fund to replace one-off payments for cookers, beds etc with interest-free loans that were cash-limited by local office - meaning they could and did run out of funds.
A ‘boomerang offer’ is an offer to the treasury to make a cut, which subsequently has to be reversed because the political cost is too high
Health: when the nhs was first created, the BMA was sceptical and pro-private practice, reflecting the view of its doctors who were used to working privately. As a new generation of doctors, protective of the nhs, came in, the BMA changed its stance. In terms of timing, this meant BMA stopped promoting privatisation just as a govt pro-privatisation came into power.
In Thatccher’s third term the rise of housing assocs began. They were required to introduce private finance to augment public funds. The result of this was higher rents. This meant that, increasingly, ‘welfare ghettos’ were created: because only those whose housing benefit covered all their rent could afford to pay, plus LAs increasingly used HAs to house the homeless. This repeated the 60s ‘sink estates’ grouping of vulnerable people.
1987 saw the introduction of the national curriculum - taking uk from one of the only industrialised countries without one to a country with one of the most detailed and prescriptive curriculum
John Moore took over DHSS, just as it split into DH and DSS - with him keeping social security. He introduced conditionality for 16 and 17 year olds to prevent them moving straight from school to dole. All young people had to undertake training in order to get benefits. In practice this was a disaster - the construct ignored children who’d left abusive homes, been discharged from care, whom gov couldn’t provide a training place for, people who were sacked.
Thatcher’s third term was when the Thatcherite approach to services really developed. This involved provider/purchaser splits between private/piblic - and versions of this could be seen across nhs, social care, education etc.
It was 1991 before the government accepted there’s a link between poverty and ill-health.
Labour really struggled while in opposition, with little fresh thinking. For a while it was stuck in 1970s thought, opposing cuts and anti-privatisation but not much nuance. Research came out showing that most public expenditure on social services benefits the better off more, with middle classes exploiting the welfare state more effectively. The right liked these findings as proof of the need to ‘wean’ those not genuinely in need off welfare. Those on the left liked it as proof of more radical redistributive measures being needed. Those in the middle stagnated.
Thatcher was based on trickle down economics: the richest lead the way, eg by buying luxury goods that eventually improve the minimum standard experienced by all. If you strive for equality the whole country stagnates and progress would never come. But in practice that didn’t happen: the bottom 10% got poorer through thatcher era, with inequality growing faster than any comparable western country. The extremes were further apart than any time since the war. This was not all down to gov policy or welfare policy, globalisation played a big part. ‘While salaries at the top of the earnings range had exploded, those at the bottom had fallen as the rewards for brain increased and those for brawn fell.’
In the 90s there was an internTional shift on welfare to conditionality with support, from lots of training through to job interview guarantees. Evidence shows the latter works better. This formed a big part of new labour’s approach to welfare. The concept of welfare as a springboard rather than a safety net stole lots of Tory language.
Back in 1996 there was discussion of how to prevent the ‘scandal’ of people losing their life savings/homes to fund long-term care. Blair obfuscated pre-election to avoid tricky questions, promising a royal commission instead. - an example of how effective it can be to kick tricky policy issues into the long grass...
The NHS Direct was originally called ‘888’ by civil servants.
Blair won with the largest majority ever (178) but also got the lowest turnout since 1935.
Making the Bank of England freed up the treasury to spend much less time on macro-economics - much of this now ran on autopilot - and much more on domestic policy, notably tax and benefit changes. It also meant the chancellor had significantly more domestic policy power.
This entire review has been hidden because of spoilers.
June 27, 2018
It sure looks like a shallow endeavor. The cover with the man writing about a lot of threes, and needing only one job is cute, and emotional. Yet from the first pages it become a work of sensationalism. Hence eightpence magically becomes "under 2p". And the Welfare State starts somehow with a bloke born in the 19th century British Raj with a lots of servants -- that is somehow very relevant. Later on, the reader discovers the Welfare State means it is only a British Affair. *** the others!
The text itself is a mess. I have no idea if Timmins lacks the intelligence to structure his data, or he is going for mesmerising the readership. So Chapter 1 opens with "In June 1941..." to reach in a few pages May 1940 "When Churchill became Prime Minister".
> One by one, Keynes and the others were absorbed into Whitehall as part of the flood of academics whose presence was to do so much to help win the war against Nazi Germany.
Only Timmins does not hint at what Keynes was so good at in the war against Nazi Germany. Even the fact that Keynes was gay was well hidden, so the "up yours" thesis against the morals of Nazi Germany fails miserably.
In the end, everything reads like a gossip column: "At the beginning of June 1941 someone else got the job Beveridge wanted:"
The text itself is a mess. I have no idea if Timmins lacks the intelligence to structure his data, or he is going for mesmerising the readership. So Chapter 1 opens with "In June 1941..." to reach in a few pages May 1940 "When Churchill became Prime Minister".
> One by one, Keynes and the others were absorbed into Whitehall as part of the flood of academics whose presence was to do so much to help win the war against Nazi Germany.
Only Timmins does not hint at what Keynes was so good at in the war against Nazi Germany. Even the fact that Keynes was gay was well hidden, so the "up yours" thesis against the morals of Nazi Germany fails miserably.
In the end, everything reads like a gossip column: "At the beginning of June 1941 someone else got the job Beveridge wanted:"
May 28, 2018
I would recommend this book to anyone who wants to understand modern Britain.
With journalistic eloquence, Timmins offers a detailed and balanced account of the evolution on the welfare state.
He eschews ideological fixity, and critiques the rigid assumptions of left and right. There was no Golden Age of welfare during which the five giants were slain, as per the false memory of the left. Nor did the welfare state enfeeble a previously tall and proud civilisation, as per the Correlli Barnett formula. Instead, ministers and officials and muddled through in a typically British fashion.
The new chapters in the updated version are written in the same style, although they feel more rushed than the earlier chapters, which give more time to the ideological shifts and conflicts underpinning the policy battles of the immediate post-war decades. This may, of course, be a reflection of our times.
With journalistic eloquence, Timmins offers a detailed and balanced account of the evolution on the welfare state.
He eschews ideological fixity, and critiques the rigid assumptions of left and right. There was no Golden Age of welfare during which the five giants were slain, as per the false memory of the left. Nor did the welfare state enfeeble a previously tall and proud civilisation, as per the Correlli Barnett formula. Instead, ministers and officials and muddled through in a typically British fashion.
The new chapters in the updated version are written in the same style, although they feel more rushed than the earlier chapters, which give more time to the ideological shifts and conflicts underpinning the policy battles of the immediate post-war decades. This may, of course, be a reflection of our times.
August 11, 2019
A grand attempt at a comprehensive account of the whole of the NHS. In its early chapters it is magisterial. What lets it down is the excessively detailed account of post 60s, particularly the contortions it forms to present Conservative legislation as positive. I suspect this is due to the author maintaining contacts with many of the people involved and aiming to be fair to them. The result however is somewhat tedious as there is seemingly endless change, which is rarely for the better but he puts the most positive gloss possible on it.
June 21, 2021
Dense and poorly written in parts in need of some heavy editing. Was written for its time (i.e. assumed prior knowledge of facts and even some surnames), which would have been brief given that Tony Blair's election victory would have rendered its clarion call moot soon after its publication. But after 11 years of further Conservative governments pulling back funding for the welfare state, its lessons and the history contained within are well worth the re-write (or alternatively the trawl) for readers two generations on.
October 28, 2024
Authoritative guide to the welfare state in 20th century britain.
It's potentially quite a dry topic, and I won't lie, at times tracking the names of all the different people involved in social security in the 70s (or whatever) was a very good sedative.
That said, I actually thought it went fairly bracingly through a lot of material, letting you pull out high level threads as you went. Who knew they hadn't really worked out what Thatcherism meant until years into its beginning, for example?
It's potentially quite a dry topic, and I won't lie, at times tracking the names of all the different people involved in social security in the 70s (or whatever) was a very good sedative.
That said, I actually thought it went fairly bracingly through a lot of material, letting you pull out high level threads as you went. Who knew they hadn't really worked out what Thatcherism meant until years into its beginning, for example?
June 1, 2018
Five Giants
I chose this rating because even though this is very hard going it is worth the effort. It gives a full and vivid account of all the players and is very informative.
I chose this rating because even though this is very hard going it is worth the effort. It gives a full and vivid account of all the players and is very informative.
September 8, 2014
Excellent for those looking for a social policy history of post-war Britain. Very well-written.
Want to read
July 24, 2018Based on 5 points document written by Andrew beveridge as basis for modern welfare state
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