[from "The Birth of a Service", 2008]

CHAPTER 1

The birth of the National Health Service in the Isle of Man was accompanied with some pain, and a considerable amount of labour. In fact, the First Report of the Health Services Board, covering the years to 31st. March, 1956, comments, "The early period of the scheme was fraught with serious difficulties, due largely to the complete absence of preparation for the introduction in the Isle of Man of so complicated a measure..."

A major factor was that for such far-reaching changes to the established order, whereas legislation usually stems from a Board or Department in the light of practice or experience indicating its desirability, there was initially no such body in existence to take responsibility for its overseeing.

What makes the introduction so remarkable, a feat of daring which seems quite extraordinary, and would hardly be countenanced today, and reflects on the dedication of all those responsible, is that not only was there an absence of preparation, but when the scheme was brought into operation on the 5th. July, they had in theory no legal authority to do so! Royal Assent to the 1948 Act was not announced to Tynwald until 16th. November, and their salvation was the inclusion of Section 64(1), which provided for the necessary retrospectivity to the 5th. July.

It is now difficult to see why there was this lack of preparation. Government Office was aware as long before as December 1944 that steps were taking place in the United Kingdom, initially as regards dentistry, with a view to its incorporation in the overall scheme. A note in the files at that date comments on the proposals as being "Quite interesting......" Nothing then happened until the receipt of the U.K.'s National Health Service Bill, in March 1946. The note of 3rd. April appended to the file reads:

"The National Health Service Bill contains many provisions which could be applied to the Island with some desirable benefit to our public health services, but there are others which do not appear to be necessary......"

A note on the file for the same month indicates that the Public Health Commission had made a report, but this is not on the file. However, the notes continue, pointing out that decisions would have to be made, initially after consultations with the two Government bodies most closely concerned, the Local Government Board and the Health Insurance and Pensions Board. This was set in hand in June 1946; thereafter nothing happened until April 1947, when the latter, which by this time had become the Board of Social Services, submitted their report.

In the meantime, the only sense of urgency displayed had been by the Isle of Man Medical Society, who informed Government Office in July 1946 that they had already had the question under consideration for some months, and enclosing a memorandum of their findings and the suggestion for the setting up of an Interim Health Council to facilitate progress. In late December they wrote to say that in the absence of any discernable action, or even acknowledgement of their memorandum and letters, they were preparing their own Bill!

Thereafter, the files fill up with correspondence with the numerous bodies with whom it had been found necessary to consult, and whom it would be tedious to list in full. The matter had finally reached the Governor in Executive Council on 29th. May 1947, when it was decided to ask all the bodies for a further submission of their views, in prospect of a joint conference, to take place on 14th. October 1947. It could not be held earlier because of His Excellency's impending vacation, and the Attorney General's advice that "...it was not wise to rush these matters, and that the urgency for a meeting was not so great that it could not well take place in October". In fact, due to the Governor's further absence, it was not held until 5th. December. In the meantime, in the United Kingdom their 1946 Act had already become law on 6th. November 1946, to operate from 5th July 1948, and it was becoming obvious for a number of reasons that the Isle of Man would have to meet this deadline.

(It might be pertinent at this point to mention that the dating, 5th. July, had not, as might be supposed, any connection with the Manx traditional day for legislation, Tynwald Day, but paradoxically was the day chosen by the United Kingdom.)

At least, now everybody had the opportunity of putting forward their views on how the Service should be organised, and work could start on preparing the legislation for another round of consultations. The only problem was the disparity of those views, and that some people had their own axes to grind.

Any comments, errors or omissions gratefully received The Editor HTML Transcription © F.Coakley , 2008