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  from the middle of the nineteenth 
  century working people of modest means began increasingly to insure against periods of illness by subscribing to provident 
  and friendly societies and sick clubs
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  many public-spirited 
  medical practitioners would at 
  that time remit all or most of their fees to the poor
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  public measures to promote healthier living 
  conditions, however, preceded adequate 
  public provision for the care of the sick
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  rapid growth of towns in the 
  first half of the nineteenth century caused an 
  intensification of sanitary problems with consequent cholera, typhoid and other epidemics
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  a programme of sanitary reform, associated particularly with Edwin Chadwick (1800-90), Secretary to the Poor Law Commission, led to 
  the passage of the Public Health Act 1848 which, for the first time, established a comprehensive public health system under unified control and 
  laid down minimum standards for its services
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  the system was further developed and 
  consolidated by the Public Health Act 1875, 
  upon which all subsequent health legislation has been based
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  in the twentieth century the provision 
  for personal health services began to improve 
  rapidly as the result of the progress of medical knowledge and the wider availability of treatment
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  the National Health Insurance Act 1911 introduced a scheme whereby all people earning wages less than ?160 a year (later raised to ?420) 
  were entitled to the services of 
  a general practitioner in return for regular contributions made by themselves and their employers to certain insurance organisations, known as approved societies
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  the doctors who took part were paid a 
  capitation fee for the patients who 
  had asked to be on their list and been accepted
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  this scheme came to cover most 
  of the poorer half of the population while the rest were dependent for their medical care either on paying fees as private patients, 
  or on a certain number of voluntary sick
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  at the same time the voluntary hospitals 
  expanded their free services for the poor with 
  the aid of voluntary donations and contributions and the fees of other patients
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  after 1929 the Poor Law Infirmaries 
  began to develop into local 
  authority general hospitals
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  some local authorities began 
  to provide improved social and health 
  services, mainly for schools, mothers and children
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  these various health services, however, 
  were unevenly distributed and 
  were seen to be inadequate
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  troposals for a full health and medical 
  service were the subject of many reports in 
  the inter-war years; it was, however, the Second World War which precipitated reform in this, as in many other matters
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  to deal with the war wounded, the 
  Emergency Hospital Service, including both 
  voluntary and municipal hospitals, was developed within existing organisations as required
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  the welfare food service for mothers was introduced 
  and school meals services and 
  industrial canteens were expanded
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  in 1941 an inter-departmental committee was 
  set up under Sir William (later Lord) Beveridge to conduct a survey of the existing national schemes of social insurance and allied services 
  and to make recommendations on the way that social services should be reconstructed after the end of the war
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  the committee's report, known 
  as the Beveridge Report, was published in 1942; 
  it recommended far-reaching changes involving a considerable extension of both the health and social security services and formed the basis of much post-war social legislation
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  in 1943 the wartime all-party Government 
  announced its acceptance of the proposal in 
  the Beveridge Report that a comprehensive health service for all purposes and all people should be established
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  the first plan for a comprehensive 
  national health service was 
  published by the Government in 1944
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  the final plan was embodied in 
  the National Health Service Act 1946, 
  and the National Health Service started on 5 July 1948
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  this provided a complete general practitioner and 
  hospital service for the community, 
  and expanded the preventive social and environmental services provided by local authorities 
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  many other countries had 
  developed compulsory health insurance schemes, but under them rights to health care were generally confined to those who 
  had paid contributions and their dependants, and to pensioners
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  the principle of 
  universal coverage for 
  free medical care was entirely new
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  the British National Health Service (NHS) 
  was set up in 1948 and was designed to provide 
  equal basic health care, free of charge, for everybody in the country
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