(c) crown copyright
Catalogue Reference:CAB/65/41/17
Image Reference:0001
THIS D O C U M E N T !S T H E PROPERTY OP H I S B R I T A N N I C MAJESTY'S
Printed
for the War Cabinet.
S E C R E T .
W.M.
February
GOVERNMENT
1944.
.
Copy N o .
(44)
17th Conclusions.
WAR
CONCLUSIONS
S.W.
CABINET
17
(44).
of a Meeting of the War Cabinet held at 10 Downing
1, on Wednesday,
9th February,
1944* cut 7 - 3 0 p.m.
Street,
Present:
T h e R i g h t H o n . WINSTON S. CHURCHILL, M . P . , P r i m e M i n i s t e r (in
the
T h e R i g h t Hon. C. R. ATTLEE, M . P . ,
L o r d P r e s i d e n t of t h e Council.
T h e R i g h t H o n . ANTHONY EDEN, M . P . ,
Secretary
of S t a t e
for
Foreign
Affairs.
T h e R i g h t Hon. S i r JOHN ANDERSON,
M . P . , Chancellor of t h e E x c h e q u e r .
T h e R i g h t H o n . ERNEST BEVIN, M . P . ,
M i n i s t e r of L a b o u r a n d N a t i o n a l
Service.
T h e R i g h t H o n . OLIVER LYTTELTON,
M . P . , M i n i s t e r of P r o d u c t i o n . T h e R i g h t H o n . HERBERT MORRISON,
M . P . , S e c r e t a r y of S t a t e for t h e
H o m e D e p a r t m e n t a n d M i n i s t e r of
Home Security.
The Right
H o n . LORD WOOLTON,
M i n i s t e r of R e c o n s t r u c t i o n .
T h e following w e r e also p r e s e n t :
T h e R i g h t H o n . VISCOUNT CRANBORNE,
S e c r e t a r y of S t a t e for Dominion
Affairs. '
T h e R i g h t -Hon. LORD
L o r d P r i v y Seal.
ARCHIBALD
The
Right
Hon.
Sir
SINCLAIR, Bt., M . P . , S e c r e t a r y of
S t a t e for A i r .
T h e R i g h t H o n . THOMAS JOHNSTON,
M . P . , S e c r e t a r y of S t a t e for S c o t l a n d
(Items 1-2).
T h e R i g h t H o n . S i r STAEEORD CRIPPS,
K . C . , M . P . , M i n i s t e r of A i r c r a f t
Production.
T h e R i g h t H o n . H . U . WILLINK, K . C . ,
M . P . , M i n i s t e r of H e a l t h (Items 1-2).
T h e R i g h t H o n . BRENDAN BRACKEN,
M.P.J M i n i s t e r of I n f o r m a t i o n . BEAVERBROOK,
T h e R i g h t H o n . LORD
Paymaster-General.
CHERWELL,
Secretariat :
S i r EDWARD BRIDGES.
M r . NORMAN BROOK.
M r . W . S. MURK IE.
CONTENTS.
Minute
No.
Page.
Subject.
H R J E . Princess Elizabeth
2
N a t i o n a l H e a l t h Service
78
3
A u s t r a l i a - N e w Z e a l a n d A g r e e m e n t of 2 1 s t J a n u a r y
79
[26931-1]
'..
....
78
1
H . B . H . Princess
Elizabeth.
1. The Prime Minister i n f o r m e d t h e W a r C a b i n e t t h a t he h a d
been i n c o m m u n i c a t i o n w i t h H i s M a j e s t y T h e K i n g i n r e g a r d t o t h e
s u g g e s t i o n w h i c h had"been m a d e i n some q u a r t e r s t h a t a t i t l e should
be c o n f e r r e d on H . R . H . P r i n c e s s E l i z a b e t h on t h e occasion of her
18th b i r t h d a y .
T h e P r i m e M i n i s t e r asked t h e W a r C a b i n e t to
a g r e e t h a t h e should t e n d e r advice to H i s M a j e s t y i n favour of the
issue from Buckingham" P a l a c e i n t h e n e a r f u t u r e of a s h o r t official
a n n o u n c e m e n t t h a t T h e K i n g d i d not c o n t e m p l a t e a n y change i n
t h e style a n d t i t l e of H . R . H . P r i n c e s s E l i z a b e t h on t h e occasion of
h e r a p p r o a c h i n g 18th b i r t h d a y .
T h e P r i m e M i n i s t e r said he u n d e r s t o o d t h a t t h i s w o u l d be in
accordance w i t h H i s M a j e s t y ' s o w n wishes i n t h e m a t t e r .
T h e K i n g ' s P r i v a t e S e c r e t a r y would, of course, i n f o r m the
G o v e r n o r s - G e n e r a l of the D o m i n i o n s of the p r o p o s e d a n n o u n c e m e n t
before i t w a s m a d e .
The W a r C a b i n e t A p p r o v e d the course proposed.
National H e a l t h
Service.
2. T h e W a r C a b i n e t h a d before t h e m a M e m o r a n d u m by the
M i n i s t e r of Reconstruction, t h e M i n i s t e r of H e a l t h and" the
S e c r e t a r y of S t a t e for Scotland ( W . P . (44) 74) r e g a r d i n g the scheme
for a N a t i o n a l H e a l t h Service. A t t a c h e d t o t h e M e m o r a n d u m were
t h e d r a f t of a W h i t e P a p e r o n t h e scheme, a n d a shorter
M e m o r a n d u m w h i c h w a s to be issued as a S t a t i o n e r y Office
publication.
The Minister of Reconstruction
e x p l a i n e d t h e m a i n f e a t u r e s of
t h e scheme, w h i c h w a s the r e s u l t of m a n y m o n t h s of w o r k by the
W a r C a b i n e t Committees concerned w i t h r e c o n s t r u c t i o n .
There
h a d been differences of o p i n i o n on a n u m b e r of p o i n t s , as w a s
inevitable i n the consideration of so extensive a n d complex a
p r o b l e m ; b u t t h e scheme now p u t f o r w a r d h a d the u n a n i m o u s
s u p p o r t of t h e R e c o n s t r u c t i o n C o m m i t t e e . H e sought t h e a u t h o r i t y
of the W a r C a b i n e t to p u b l i s h t h e d o c u m e n t s c i r c u l a t e d w i t h t h e
M e m o r a n d u m , n o t as r e p r e s e n t i n g t h e G o v e r n m e n t s final decisions
in t h i s m a t t e r , b u t as a basis for p u b l i c discussion of the scheme.
P o i n t s in discussion w e r e :—
(a) T h e scheme d i d not involve t h e abolition of p r i v a t e medical
p r a c t i c e . A l t h o u g h the public service would p r o v i d e free medical
t r e a t m e n t for all who cared to a v a i l themselves of it, i t would be
i n e x p e d i e n t t o p r e v e n t those w h o so d e s i r e d from m a k i n g p r i v a t e
a r r a n g e m e n t s for t r e a t m e n t . E q u a l l y , it w o u l d have been w r o n g to
exclude a n y class of persons from t r e a t m e n t u n d e r t h e p u b l i c service
merely on the g r o u n d t h a t they could afford to p a y for t r e a t m e n t as
private patients.
(b) I t m u s t be recognised t h a t the scheme would c o n s t i t u t e
some t h r e a t to p r i v a t e medical p r a c t i c e - a n y p r o p o s a l s for the
e s t a b l i s h m e n t of a comprehensive m e d i c a l service m u s t have t h a t
effect.
O n t h e o t h e r h a n d , i t w a s p o i n t e d o u t t h a t "the p r o p o s a l s for
g r o u p e d p r a c t i c e — w h e t h e r i n h e a l t h centres or o t h e r w i s e — w e r e
likely to lead to increased efficiency a m o n g t h e r a n k a n d file of the
m e d i c a l profession.
(c) T h e suggestion w a s m a d e t h a t the scheme would involve the
e s t a b l i s h m e n t of a l a r g e b u r e a u c r a t i c m a c h i n e which, t h r o u g h t h e
p r o p o s e d C e n t r a l Medical B o a r d , would d e t e r m i n e w h e r e each
doctor should practise.
I t w a s p o i n t e d - o u t t h a t , if t h e r e w a s a s h o r t a g e of doctors a n d
t h e S t a t e h a d u n d e r t a k e n to p r o v i d e a u n i v e r s a l service, t h e S t a t e
m u s t h a v e some power to control t h e g e n e r a l d i s t r i b u t i o n of doctors
i n t h e p u b l i c service. T h e degree of t h i s control w a s not, however,
so d r a s t i c as h a d been suggested. I n t h e case of s e p a r a t e practice,
for example, all t h a t w a s proposed w a s t h a t t h e consent of the B o a r d
should be r e q u i r e d before a v a c a n t public p r a c t i c e w a s filled or a
new public p r a c t i c e e s t a b l i s h e d ; a n d it w a s i n t e n d e d t h a t t h i s
consent should.be w i t h h e l d only if t h e r e were enough or too m a n y
doctors in the area.
(d) I t w a s suggested t h a t t h e scheme w a s likely to meet w i t h
keen o p p o s i t i o n from the doctors, a n d would be r e p r e s e n t e d a s
u n d e r m i n i n g t h e whole basis of t h e medical profession.
T h e W a r C a b i n e t w e r e i n f o r m e d t h a t , while o p i n i o n a m o n g
doctors m i g h t be divided, i t w a s likely t h a t t h e scheme w o u l d be
s u p p o r t e d by a s u b s t a n t i a l p r o p o r t i o n of t h e profession. I t w a s
also p o i n t e d o u t t h a t a scheme on somewhat s i m i l a r lines h a d been
i n o p e r a t i o n for over t h i r t y y e a r s in t h e H i g h l a n d s a n d I s l a n d s of
S c o t l a n d — w h e r e i t had proved h i g h l y beneficial to the p o p u l a t i o n ,
h a d increased the efficiency of t h e service, a n d h a d not h a d t h e effect
of k i l l i n g p r i v a t e p r a c t i c e .
(e) I t w a s suggested t h a t the reference to Sir W i l l i a m
Beveridge i n the i n t r o d u c t o r y p a r a g r a p h s in each of the t w o P a p e r s
m i g h t , w i t h a d v a n t a g e , be o m i t t e d .
T h i s w a s a g r e e d to.
The Prime Minister
asked t h a t , i n p r e s e n t i n g t h i s scheme t o
the public, M i n i s t e r s should stress the fact t h a t it d i d not r e p r e s e n t '
the final views of t h e G o v e r n m e n t ; t h a t it w a s p u t f o r w a r d for
public discussion a n d t h a t constructive criticism would be
welcomed; t h a t , w h e n t h e r e h a d been a n o p p o r t u n i t y for t h e
formation of public opinion, t h e d e t a i l s w o u l d be f u r t h e r discussed
w i t h t h e medical profession a n d o t h e r i n t e r e s t s affected; a n d t h a t
only then would t h e G o v e r n m e n t proceed i n the l i g h t of all these
discussions to f o r m u l a t e t h e i r final conclusions a n d to b r i n g f o r w a r d
proposals for legislation.
The W a r
Cabinet­
(1) A p p r o v e d on t h i s basis t h e scheme outlined in t h e
documents a t t a c h e d to W . P . (44) 74.
(2) A u t h o r i s e d the p r e s e n t a t i o n of t h e W h i t e P a p e r to P a r l i a ­
m e n t a n d t h e s i m u l t a n e o u s p u b l i c a t i o n of the shorter
memorandum.'
(3) Took note t h a t these d o c u m e n t s w o u l d be published on t h e
17th F e b r u a r y , a n d t h a t a r r a n g e m e n t s would be m a d e
for t h e m to be debated in P a r l i a m e n t after a n interval
of t w o or t h r e e weeks.
AustraliaN e w Zealand
Agreement of
21st January,
1 9 W
3. T h e W a r C a b i n e t h a d before t h e m a M e m o r a n d u m by t h e
S e c r e t a r y of S t a t e for D o m i n i o n Affairs ( W . P . (44) 70) about t h e
A u s t r a l i a - N e w Z e a l a n d A g r e e m e n t of the 21st J a n u a r y , 1944.
A t t a c h e d to the M e m o r a n d u m w a s the t e x t of the agreement,
t o g e t h e r w i t h a t e l e g r a m on the subject, d a t e d the 25th J a n u a r y ,
from the P r i m e M i n i s t e r s of N e w Z e a l a n d a n d A u s t r a l i a .
The Secretary of State for Dominion Affairs e x p l a i n e d t h a t we
h a d h a d v i r t u a l l y no p r i o r knowledge of t h i s conference, w h i c h we
h a d t h o u g h t w a s i n t e n d e d to be a m u t u a l consultation between t h e
two Governments of a p r e l i m i n a r y c h a r a c t e r before consultation
w i t h ourselves a n d o t h e r foreign countries. I t was, therefore,
p e r h a p s s o m e w h a t u n f o r t u n a t e t h a t t h e t w o G o v e r n m e n t s should
have published t h e i r conclusions w i t h o u t a n y p r i o r consultation
w i t h us. Nevertheless, on a b r o a d view, he t h o u g h t t h a t t h e results
of t h e conference m i g h t well prove to be useful. I n p a r t i c u l a r , h e
p o i n t e d o u t t h a t t h e two G o v e r n m e n t s h a d s t a t e d publicly t h a t they
h a d a p r i m a r y i n t e r e s t i n the defence of the Pacific.
T h e S e c r e t a r y of S t a t e also d r e w a t t e n t i o n to p a r a g r a p h s 7, 10
a n d 14 of the agreement, in w h i c h t h e two Governments asked for
r e p r e s e n t a t i o n on c e r t a i n bodies, i n c l u d i n g r e p r e s e n t a t i o n a t t h e
h i g h e s t level on all a r m i s t i c e p l a n n i n g a n d executive bodies. H e
t h o u g h t t h a t it m i g h t be difficult to give effect to such claims
w i t h o u t g i v i n g rise to a w k w a r d claims on t h e p a r t of the U n i t e d
N a t i o n s generally.
T h e m a i n p o i n t d e a l t w i t h in the course of a p r e l i m i n a r y
discussion w a s w h a t r e p l y should be r e t u r n e d to t h e t e l e g r a m from
the t w o P r i m e M i n i s t e r s of the 2 5 t h J a n u a r y .
The W a r C a b i n e t I n v i t e d the S e c r e t a r y of S t a t e for Dominion Affairs to
a r r a n g e for a r e p l y t o be d r a f t e d , in consultation w i t h t h e
other D e p a r t m e n t s concerned, a n d s u b m i t t e d to t h e W a r
C a b i n e t on the b r o a d lines i n d i c a t e d in h i s M e m o r a n d u m .
T h i s reply w o u l d include- a s t a t e m e n t t o the effect t h a t we
took the view t h a t t h e m a t t e r s d e a l t w i t h by the conference
Would be s u i t a b l e for discussion a t t h e f o r t h c o m i n g
m e e t i n g in L o n d o n of D o m i n i o n P r i m e M i n i s t e r s .
Offices of the War Cabinet, S.W. 1, 9th February,
1944.