SINCE the Victorian era, Liverpool has had a strong history of public health provision, with the establishment of several institutions dedicated to improving the health of the city’s inhabitants.

Dr William Henry Duncan pioneered this approach in the 19th century, by researching living conditions and pushing public health matters into the political arena.

But, a century later, the introduction of the National Health Service on July 5, 1948, transformed all areas of healthcare beyond recognition.

The structure of services was overhauled and, most importantly, it was free for all.

“The main impact of the new service was that is was free for everybody,” said Sally Sheard, senior lecturer in the history of medicine at the University of Liverpool.

“It is hard in this day and age to understand what this meant for poorer people.”

Before 1948, Liverpool hospitals, as with other cities in Britain, operated on a two-tier system, with charitable and fee-paying “voluntary” hospitals existing alongside former “poor law” hospitals.

In the first part of the 20th century, the Royal Liverpool Infirmary, then situated in a red- brick building on Brownlow Hill, attracted those who could either afford health insurance or a one- off fee every time they attended.

Other voluntary hospitals included the Northern, in Bootle, and the Southern, in Toxteth.

The poor would receive their care from various former poor law hospitals, such as Walton and Mill Road. In total, there were over 100 hospitals in Liverpool, ranging from rooms in doctor’s houses to the larger institutions.

But, post-1948, this all changed.

The Northern and Southern hospitals were shut and the Royal Liverpool moved to its current site in 1978.

Other satellite hospitals were built, such as Fazakerley, now named Aintree University Hospital, in the 1960s.

Dr Sheard said: “As a system, the NHS inherited very old and dilapidated buildings and a survey was carried out in Liverpool prior to its introduction to assess what needed to be done. The general ethos was to have one large city hospital and a ring of district hospitals surrounding it. So, in Liverpool, the Royal was the main centre and sites such as Fazakerley, Walton and Broadgreen were the district centres.

“Public health, including such things as vaccinations and infant health, continued to be the responsibility of the local authority, under the Medical Officer for Health, until the NHS’s first big reorganisation in 1974.

“In terms of the third arm of health, general practice, for the first time people could register with a doctor and be treated by them for free, and GPs were organised into executive councils.”

THE early NHS in Liverpool had some big successes, one of which was the fight against Tuberculosis, or TB.

“The disease was recognised as a problem, rates were high in the city and it was tackled in different ways.

“The introduction of the BCG jab and effective treatment developed in the 1940s were a big help, but there were issues with detecting carriers of TB,” said Dr Sheard.

“An X-ray campaign was therefore launched in Liverpool in 1958 and, amazingly, within two months, they had X-rayed 500,000 people.

“Mobile X-ray vans came into different area of the city and celebrity figures would be seen having an X-ray taken to promote the campaign.

“They found 1,600 people who were carrying it and did not know. If you can target and treat those people you make a serious impact.

“Of course, other areas were not so successful, such as cancer preventionas we can see in the city today. It was known in 1954 that smoking causes lung cancer but it has been a long-standing problem ever since. The current Smoke Free initiative is finally making a difference, I think.”

March on birthday reminds bosses of current day problems > > >