The National Health Service Act 1946 received royal assent in November 1946

The Labour victory in the general election brought a new Minister of Health, Aneurin Bevan, who rejected previous proposals for local authorities to take control of a national health service and argued that the variation in the quality and size of local authorities would worsen health inequalities.

The National Health Service Act 1946 established a comprehensive health service that was free at the point of use and universally available to all. The act went further than had been anticipated in the1944 white paper. In 1945, Labour had won the general election and Minister of Health Bevan pushed for more radical reform. He favoured nationalisation of municipal and voluntary hospitals.

The newly formed National Health Service (NHS) was based on a tripartite system.

  • Hospital services were organised through 14 regional hospital boards established across England and Wales. Four hundred hospital management committees were responsible for administering hospitals. Teaching hospitals had differing arrangements and were managed by boards of governors.
  • General practitioners were independently contracted to provide primary care services and were paid for each person on their list. Executive councils were health service bodies who appointed GPs, administered contracts and salaries and allocated patients. Local authorities continued to hold responsibility for community services such as the provision of domiciliary midwifery and health visiting services, immunisations and public health functions (Gorsky et al, 2014).

The act came into force on 5 July 1948.


Prime Minister: Clement Attlee

Health Minister: Aneurin Bevan