The Emergency Hospital Service was established at the outbreak of World War II. One of the challenges for the service was to deal with the ‘normal’ population of sick people while freeing- up capacity to deal with injuries attributed to air raids or other attacks. Initially the balance between provision for war-related casualties and routine needs was not ideal, and the routine sick suffered through being denied hospital treatment. However, it took some months of negotiation before the government managed to convince the voluntary hospitals in particular to reallocate beds for routine cases. The Ministry of Health had been paying for beds to remain empty in London, and reopening routine beds required a redistribution of staff and resources. There was considerable opposition to reopening beds among voluntary hospitals, but public pressure and negotiations on doctors’ remuneration contributed to the reorganisation of services.
The Ministry of Health technically had broad powers to issue direction to hospitals but in practice it had to refrain from doing so given the strong independence and competition between the voluntary hospitals. The service was a loose alliance of separate organisations working together to deal with a national emergency.
The service paved the way for separate and competing institutions to come together as part of the National Health Service.