AT 72 years old, the National Health Service finds itself in the midst of one of the biggest challenges it has faced since it came into being on July 5 1948.

The coronavirus pandemic has tested its systems and its staff - everyone from doctors and nurses to porters and cleaners - in a way that even those who regularly have to work in the pressure cooker that is the NHS frontline could barely have imagined six short months ago.

The toll exacted by coronavirus has been unremittingly awful - measured in an appalling number of deaths, debilitating illness for millions worldwide, and severe economic damage that will take years to put right.

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A NHS birthday Clap for Carers will take place at 5pm today. Picture - Gareth Fuller/PA Wire

Every Thursday evening during April and May millions across the UK turned out to 'Clap for Carers', a weekly appreciation of the work of NHS staff who put themselves in the path of the disease - into harm's way - to help others.

The event was a heartfelt expression of gratitude to those staff, and also to the organisation that enables them to do the work they do, and for us to benefit from it. Millions of us across Wales and the rest of the Uk will do it again tonight, a special 72nd birthday round of applause for our NHS.

For those of us born after July 5 1948, the concept of healthcare free at the point of delivery is something that perhaps far too many take for granted, despite most of us of working age contributing financially to enable that to happen, and most too having had cause to be thankful for the treatments and care provided.

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Minister of Health Aneurin Bevan visits 13-year-old Sylvia Diggory, the first NHS patient, in hospital in Manchester on July 5 1948

The National Health Service Act that enabled the creation of the NHS - given Royal Assent on November 6 1946 - has been called the most important piece of social legislation created in Britain during the 20th Century.

The NHS is also the most enduring political football of the past seven-and-a-bit decades, its past, present and future argued and debated over by Right, Left and Centre, and just as often by factions within the aforementioned camps.

Among these ructions was the spring 1951 rift in the soon-to-be-ousted Labour Government over NHS spending, and a proposal to charge for some prescriptions, that prompted Aneurin Bevan - who had steered the NHS into existence three years previously - to resign as Minister of Health.

Even the issue of how much credit Tredegar-born Bevan should be given for the creation of the NHS is a source of regular debate.

What is not in doubt is that the principle of some form of universal healthcare service had been decades in the making before it fell to the then Ebbw Vale MP, as Minister of Health in the post-war Labour Government, to try to make it a reality.

Through the 1930s the idea had gathered support and momentum among the medical profession as well as in political circles, but with war an increasing prospect and then a stark reality as the decade neared its end, it remained just that - an idea.

The state-run Emergency Hospital Service, created during the Second World War provided a glimpse of what might be developed on a more comprehensive scale, and plans began to be developed during the conflict for a future national health service.

Note the lower case however - for this was not the National Health Service. In 1941, then Minister of Health Ernest Brown announced a Government proposal to create a free hospital service, to be run by local authorities.

The following year a Medical Planning Commission, set up by professional bodies, recommended that a national health service be created, with GPs working at health centres and hospitals run on a regional basis.

This was largely the same model as proposed in the Beveridge Report, published late in 1942.

The British Medical Association however, had other ideas. In 1943 it changed its policy and began to oppose the idea of local authority control of hospitals. Instead, it proposed that health insurance be extended.

Brown's successor Henry Willink issued a White Paper in 1944 proposing a national health service - backed by the wartime coalition Government cabinet - positing a free at the point of use service to be funded through general taxation instead of national insurance.

Willink, a Conservative member of that National Government, was denied the opportunity of pursuing that vision however, as Labour swept to power in the July 1945 General Election, and Bevan took up the baton intent on a radical overhaul.

The idea of local authorities running hospitals was out. Bevan knew - from experience as a Tredegar Urban District Council in the 1920s and Monmouthshire County Councillor in the 1930s - that such bodies were vulnerable to cuts made by central Government, and believed the buck must stop with the Government itself, through the Health Minister.


He also had as a blueprint the Tredegar Medical Aid Society, helmed for many years by Walter Conway, a key figure in Bevan's formative years. When Conway died in 1933, the organisation provided medical aid to 95 per cent of the town's population, comprising some 20,000 people.

It ran the town's hospital, and two doctors' surgeries, and at one point employed five doctors, two dentists - each with a mechanic - pharmacists and a nurse.

Members paid a small weekly subscription which effectively provided them with free at the point of delivery healthcare, a precious commodity in a pre-NHS world where the cost of treatments and medicines were beyond the means of many.

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Tredegar was not alone in having such organisations, but it also had Bevan (above), who before he became an MP in 1929 was involved in the management of the town's hospital and saw close-up how the society provided for the medical needs of the population in an industrial town where the harsh economic realities of the 1920s and 1930s meant poverty and unemployment were rife.

Thus it was that Bevan took Tredegar Medical Aid Society as a blueprint for what might be achieved on a national scale. Fate, history, ambition, can it what you will, put him in the position from 1945 to make real - to put the capital letters in - the National Health Service.

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The former Central Surgery in Tredegar, built by the town's Medical Aid Society, which was an inspiration for the NHS as delivered by Aneurin Bevan

He faced opposition from within his own party, members of the Labour Government, the Conservative Party, and the medical profession, the latter's implacable stance only being softened weeks before the service was launched.

He had, he said later "stuffed their mouths with gold" in order to bring them in board, through a contract that, among other attractions, enabled doctors to continue with private work.

Bevan later wrote, in his book In Place of Fear, of the idea of a national health service: "The collective principle asserts that... no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means."

It is a statement that has and will continue to be argued and debated over, rather like the organisation to which it indirectly refers.

But in these Covid-19 dominated days, it is perhaps the word "collective" that strikes most resonantly.

The phrase "we're all in this together" has been used regularly during this crisis and there has been a collective effort by NHS staff to ensure the very best of care is delivered to coronavirus - and all other - patients.

"Collective" too describes well the sense of community that has blossomed, not least in the voluntary effort to help ensure the vulnerable, the elderly and others were and are looked after.

It is exactly what Bevan saw happening in Tredegar a century or so ago, and what the NHS has and continues to embody now for all who need it. And that is something well worth applauding.