The preparations made to deal with the Second World War on health services were significant. Once the emergency medical service had been established in 1939, the question was not whether there should be an NHS but what form it should take and who should be in control. The white paper A national health service, published in 1944, detailed the wartime coalition government’s vision for a comprehensive, free and unified health service.
It was proposed that the new responsibility for providing the comprehensive health service would lie with the Minister of Health at the central level and at the centre a new body was to be created to perform functions in relation to general practice.
Local responsibility would rest with local government (at county and county borough council level), operating over their existing areas and jointly over a larger boundary (joint authorities). The joint authorities would have a general duty to plan and administer a hospital service for their area either through direct management of hospitals or though contracts. Nationalising hospitals was not on the agenda and there were many arguments between the powerful interests involved, resulting in proposals that were a difficult compromise and which were later rejected by Bevan.