THIS WAS A.TIME OF EXPANSION in thought, in action, in total membership and in the quality of leadership so far as the Socialist Medical Association was concerned. The SMA now had many professorial figures connected with its work. Major Greenwood and J. R. Marrack were very active members and support was always forthcoming from figures like John A. Ryle, J. M. MacIntosh, W. Nixon. Younger men who were later to become recognized, Lipmann Kessel, Philip Wiles, Ruscoe Clarke, Lindsay Neustater, T. O. Garland, were making their progressive views known. Outside the Association there was growing recognition of the need for change in the health services and this was increased by the growing fear of war and the need for thinking out how the medical and allied professions would meet the challenge if it came. The British Medical Association was discussing and was publishing its views, the hospitals were getting together under the Nuffield Provincial Hospital Trust in ways that were new; the organization PEP was preparing a report on the health service which was to provide facts and figures for many debates, the staff at the Walton Hospital, Liverpool, were winning an award for the best plan for reorganizing our hospitals, and the SMA was preparing to launch Medicine Today and Tomorrow.

The SMA idea of having a journal had not been dropped, in spite of the failure to establish The Socialist Doctor on a permanent basis. Dr David Stark Murray had been increasing his own personal contact with newspapers and magazines and was continually writing articles on health service problems. He realized that the SMA needed a journal if its members were to be given the information they needed, that there was an element of professional journalistic skill needed which no one in the SMA possessed and that some advertising revenue is essential to running a magazine. So he proposed, and the SMA agreed, to try to establish a monthly magazine, Medicine Today and Tomorrow, and found the needed help from a skilled journalist, Leonard C. J. McNae, then and until his retirement in 1967, on the editorial staff of the Press Association. He was anxious to contribute something to the Labour movement and offered his unremunerated services to the new magazine. Dr Murray had close contact with Reynolds News and through it was able to get the assistance of Alan Hutt, recognized as a leading expert in typography, to design the journal and advise on the types to be used. Ambitious schemes for circulation were worked out, a fund was raised by SMA members and the first issue appeared in October, 1937.

Medicine Today and Tomorrow continued until the end of 1965 when its title was changed to Socialism & Health which the EC of the SMA thought gave a better interpretation of its purpose than the older title. Its story is embodied in its own pages. Its impact was greater than could have been calculated, its place now is as a source of information on the development of socialist thought in the field of health over nearly thirty years. Its first format, with ample illustrations, was too ambitious for an organization not able to subsidize it heavily and the advertising revenue never became adequate. War would have made its continuation on that basis exceedingly difficult; but wisdom and the advice of the new Treasurer of the SMA, Dr Leslie T. Hilliard, reduced its size, cut it down to a quarterly but still left it of sufficient size and frequency to record new advances in medical care and to keep the SMA programme in front of an expanding audience. At the same time Medicine Today and Tomorrow ceased to be the official organ of the SMA which gave it editorial liberty and absolved it from publishing the more internal news of the SMA (which was issued as a separate Bulletin); and in the hope of developments in circulation it was handed over to a Friendly Society, Today and Tomorrow Publications Ltd. Events to be recorded in a later chapter led to all this being reversed and Medicine Today and Tomorrow reverted to being the official journal of the SMA with its name changed to Socialism & Health but continued to be edited as before.

At the start the new journal revealed how far spread was the interest in developing some form of organized health service. Articles poured in and in its first few numbers contributors included Alfred Cox, Secretary of the London Public Medical Service; Sir Daniel Hall, formerly Chief Scientific Adviser to the Ministry of Agriculture; David Forsyth, Physician to Charing Cross Hospital; Edward R. C. Walker, then Hon Secretary to the Aberdeen Branch of the British Medical Association; and Major Greenwood, Professor of Epidemiology, London University. Expert contributions were also found in fields of occupational disease, from overseas contributors like Joseph and Phyllis Gillman of Johannesburg, on medical and educational films, in books and increasingly on the threat of war.

While calling on ‘medical men and women to do all that is in their power to convince both peoples and their rulers that War must be avoided at all costs’, the Editor condemned the whole Fascist movement and endeavoured to alert doctors as to what was happening to the Jewish doctors of Germany, Austria and Czechoslovakia. As war drew nearer every medical aspect of modern warfare, use of gas, defence against high explosive bombs, evacuation of populations were all examined and weaknesses in Government proposals exposed.

One contributor to Medicine Today and Tomorrow whose writings were known over a wide circle was Dr Irwin Brown. His regular articles in Reynolds News and in a whole range of magazines, journals and daily newspapers were quite a feature in propaganda both for a national health service and for education in many fields of health. The present writer has to confess, with appropriate blushes that Dr Irwin Brown, and a number of other names, were pseudonyms for Dr D. Stark Murray. When variety was needed in the pages of Medicine Today and Tomorrow both Dr Murray and Leonard McNae attempted a variety of styles and tackled a variety of subjects. The journal appeared monthly for just one year and then as a quarterly for some years. In its third form it appeared every two months and Socialism & Health has continued at that frequency. It was, however, supplemented by the issue of a monthly Bulletin which now became the official publication of the SMA, leaving Medicine Today and Tomorrow available for the printing of longer statements of policy but also being free editorially to explore all new ideas on the organization of health services. It can be claimed with certainty that most of the ideas later incorporated in the NHS, and many still being discussed after twenty years of that service, first appeared in MTT as its readers called it.

Thus the first issue of the new series, March quarter 1939 carried The Walton Plan, a historic document in the growth of health service thinking. This was the work of Dr Henry H. MacWilliam, then Medical Superintendent of the Walton Hospital, Liverpool, hence the name given by the Editor of MTT to this plan for a National Medical Service. It was a hospital orientated plan, but a vastly different type of hospital from any that then existed. It was to be a district general hospital but the words district and general took on new meanings. Each was to have its chain of health centres and each was to have a group of house doctors on its staff. Team work was to be the theme and every speciality was to be covered, including psychiatry (to be served by an acute treatment unit such as was only accepted as essential some twenty-five years later). For each 100,000 people in areas so designed that ‘the hinterland’ of cities had the same service as the centres, there were to be 1,200 beds staffed by 84 whole time medical officers including 33 general practitioners. The figures in this plan would no longer be considered adequate but at that time no better estimates were available or had ever been accepted. The Walton Plan strongly advocated that all doctors in a national service should be whole time salaried employees in sharp distinction from the views of the British Medical Association which was still asking for a capitation fee system for general practitioners but had moved forward quite a long way in its 1938 booklet A General Medical Service for the Nation.

Meantime, the Socialist Medical Association was moving forward and growing in membership. Dr Charles Brook had felt it necessary in May 1935 to give up the Honorary Secretaryship because of the growth of his own medical practice. His place was taken by Dr D. F. Buckle who was an Australian working in Britain. He held the position until the approach of War forced him to return home. It was just before Dr Brook’s resignation that two new members joined the Executive and began work for the Association which was to transform it over the next twelve years and who were to give thirty years service to it. They were Drs Leslie T. Hilliard and Elizabeth Bunbury, husband and wife, and both with strong political views which to them meant complete commitment to any task they undertook and who were by temperament and experience exceedingly able organizers. At the 1938 Annual Conference Dr Hilliard was appointed Treasurer and Dr Bunbury, Editor. Dr Bunbury during that year began the editing of the Bulletin of which four numbers appeared in duplicated form. The Bulletin was then enlarged and continued in duplicated form for 23 issues up to December 1940. That the Bulletin met with approval was shown by the decision of the 1939 Annual Conference that Dr Bunbury should become Propaganda Secretary. That annual conference elected to the EC three new members, Dr Mary Gilchrist who was later to do valuable work in nutrition and public health, Dr G. B. Shirlaw, whose book Casualty based on his two years service in Spain greatly influenced thinking on the subject of air raid casualties, and Dr G. de Swiet, a general practitioner very active politically in Kensington where he practised, and where he was later to be Mayor.

War was now imminent and the SMA took an increasing interest in the effects war would have on health. The 1939 Annual Conference passed resolutions demanding bomb proof shelters for all, pointing out the futility of much that was being proposed: and asked that hospitals should be organized as a single service to deal with all air raid casualties. There was close collaboration with many other organizations who had been alarmed by the statement of the then Minister of Health, Dr Walter Elliot, that ‘possibly a quarter of a million casualties would have to be dealt with in England within three weeks of the outbreak of a war’. A joint committee was set up by the SMA, the Universities Labour Federation and the Left Book Club Medical Group, to prepare and publish War and the Medical Services which concerned itself not only with bombing questions but with nutrition, the effects of evacuation on children and the danger of tuberculosis in war time conditions.

During 1938/39 the SMA became increasingly involved in the question of refugees. Medical men and women were arriving daily from European countries, and the end of the Spanish Civil War brought to Britain some 250 doctors and 500 nurses who had been with the anti-Franco forces and included some who were disabled. The SMA started a campaign to assist these people and appointed Dr Mary Gilchrist and Professor J. R. Marrack to be Joint Secretaries of the Refugee Committee. War problems increased rapidly and early in 1939 a China Medical Aid Committee was formed, with Dr Mary Gilchrist acting as secretary of this also, and a great effort was made to send medical men and nurses to give much needed help in China. But most SMA members were anxious to avoid war entirely and in the name of suffering humanity to replace it as a means of settling international problems with some other system. So we find in June 1939 Dr Mary T. Day as Honorary Secretary and Professor John A. Ryle as President, asking SMA members to support the Medical Peace Committee.

But the work of the SMA was still chiefly to advocate a new form of medical care and we find it putting forward to the Labour Party Annual Conference a resolution to ‘reaffirm the Party’s previous decisions to make a Socialist Medical Service part of its programme and policy’. Branches of the SMA had now been formed in South Wales, Sheffield and Birmingham. The latter owed its origin to Dr C. C. Bradsworth who had returned from two years service in Spain. The branch he formed has remained among the most active in the country. Other changes were taking place as Dr Buckle had to return to Australia and his place as Honorary Secretary was taken by Dr Brian H. Kirman. It will be recalled that the political situation at the end of 1939 was exceedingly confused and the SMA like all political organizations was divided in its attitude to the war, and especially to the position taken up by Russia.

However, Medicine Today and Tomorrow sought to keep the aim of the SMA firmly on its principal goal, ‘a new system of medical care’. For this, it declared in December, 1939 ‘both the profession and the public are clamouring as to the lines along which it is suggested medicine should develop’. A committee of the SMA had been working on a document for some time which would provide ‘a précis of the development of British medicine, of the most important changes taking place in other countries and of the most important schemes for the future’. This document, Whither Medicine? began with concepts still being argued over thirty years later. ‘The family doctor,’ it said, ‘must always remain the most important link in the medical chain as the person whose business it is to recognize disease in its earliest form and to act as friend and adviser in all matters of health.’ This he could do only if he was active in the prevention of disease and if he had ‘available all hospital and specialist facilities’. Those who are still arguing about how the health service should be administered would be interested in the solution offered in Whither Medicine? , ‘that the country should be divided into regions, which may include a number of local authorities and in which all hospitals, personnel etc, will be pooled for the common use of the whole region’ .

It is doubtful if any better statement of the principles of a National Health Service was ever given than in this document: and in practice the departures from these principles proved to be minor. The writers claimed ‘substantial agreement that:

  1. The Service must be complete, domiciliary, institutional and specialist.

  2. The patient must be freed from every economic barrier between himself and health.

  3. The doctor must be given security; opportunity for advancement, for study and for leisure, and must be able to command for his patient complete medical care irrespective of his financial position.

  4. The family doctor must be closely associated with the hospitals, and so far as possible be part of the same service as his consultant colleagues.

  5. The hospitals and medical services generally must be regionally organized according to the density of population.

  6. To ensure uniformity administration must be under the control, direct or via the local authorities, of the Minister of Health, but the doctor must be given the maximum amount of freedom in his purely clinical work.’

War now engulfed Europe and sometimes the plea for, and the advocacy of, a national health service seemed a little remote from the events of the day. Yet the membership of the SMA was growing rapidly, young doctors serving in the armed forces were developing new ideas about the kind of health services they wanted and politicians were thinking about health as one of the things they could promise ‘after the war’. The next five years were to be the busiest in the existence of the Socialist Medical Association but also the most triumphant.

The Annual Conference of the SMA for 1940 was held at the end of May and among the officers a new Vice-President was appointed, Dr Horace Joules, who was to be a great source of strength for the next twenty years. As Medical Superintendent, a title he thought inadequate to describe his duties, at one of the largest and most progressive County Council Hospitals he was to give the SMA many new ideas on health service administration and above all on aspects of occupational health and air pollution. At the same meeting Dr Charles Brook, who had now become a member of the London County Council, was guest speaker with a lecture on ‘Post-War Problems of the GP’. At this time no one ever accused the SMA of putting forward schemes that were not completely practical, for many of its members were not only working in the health services but actually on controlling committees. It was, for example, announced just at the time of this annual meeting that Mr Somerville Hastings and Miss Esther Rickards had again been appointed chairman and vice-chairman respectively of the Hospital and Medical Services Committee of the London County Council.

This 1940 Annual Conference was very sharply divided on the general political situation, as distinct from its unity on all matters concerned with health. The relationship of the Soviet Union to Germany, and the actions the USSR had taken, were argued over in a resolution which sought to support the Russian position and in amendments which took the view that German Fascism had to be opposed. The Editor of Medicine Today and Tomorrow supported the latter view as he had already done in an editorial in which he quoted Litvinov as saying ‘No international principle can ever justify aggression, armed intervention, the invasion of other states and the violation of international treaties.’ The Annual Conference first voted in favour of the resolution, which would have meant the SMA opposing the official view of the Labour Party on a non medical matter, but later decided that this was something on which a postal ballot of all members should be held. As a result the resolution was heavily defeated.

The Summer of 1940 was busy with a great variety of events. Refugee doctors were entertained at a Garden Party at Richmond and funds for many purposes were raised. The aerial attacks on London showed that the SMA had been right in demanding a better policy for shelters and medical services and these matters were the subject of leaflets that had a wide distribution and of a well attended meeting at Conway Hall. Mr Ritchie Calder, (later Lord Ritchie Calder) strongly supported the SMA point of view on Casualty Services in the Daily Herald, and later in his book, The Lesson of London. At this time the SMA began to find support for its ideas from a very wide range of the best political and scientific brains in the country.

The concept of a socialized health service captured many imaginations and so great was the demand for ideas that Medicine Today and Tomorrow once again, September, 1940, summarized SMA views in a pamphlet, Medicine Tomorrow. This recognized that ‘a completely socialized medical service will be possible only in a completely socialized community, yet there is no reason why medicine should not be in the vanguard of the march forward, based as it is on service and imbued with altruism and no reason why it should not be an example of the benefits to be derived from State organization’ .

From the start of 1941 that march forward was to accelerate. The SMA members felt that in addition to the policy discussions in MTT they wanted more details of the Association’s activities and it was decided that the Bulletin should now appear as a printed document. The Editor, Dr Elizabeth Bunbury, opened the first edition of the new series with a remark that the war was bringing fresh problems but ‘courage rises with occasion’. It took some courage to start printing even four pages of printed material in war time but the SMA membership was rising rapidly and the whole political atmosphere was changing in favour of changes in the medical services, and somehow funds were found for this purpose.

The change in atmosphere was so great that in February 1941 the British Medical Association decided that it needed guidance as to the future and set up a Medical Planning Commission. The BMA sought to make this widely representative and so included three well known members of the SMA, Mr Somerville Hastings, Dr D. Stark Murray and Dr H. H. MacWilliam. All were at that time active also in the BMA, and Dr Murray was President of the Surrey Branch. Their appointment was a measure of the support the SMA had within the profession and a recognition that some changes were inevitable and that the BMA should be aware of what the Labour Party was likely. to plan. Medicine Today and Tomorrow also claimed some credit since it had always said that ‘planning should be done as a whole and should be done by the medical profession’. The Editor who was. to be a member. of the Commission had nothing but welcome for a body ‘to study wartime developments and their effects on the country’s medical services’ which, while it indicated the BMA did not want to push ‘planning’ to its logical conclusion would still give an opportunity for others to put forward new ideas.

It is true that the Medical Planning Commission was from the start solely medical and so almost solely concerned with things as seen through doctors’ eyes. MTT would have liked it to include ‘students, the newly qualified, the young men in the Services and the EMS and GPs who were not members of the BMA’. It included, in addition to those mentioned above, Dr Haden-Guest MP, and Dr Harry Boyde who were also members but better known in other capacities, the former in Parliament, and the latter as a vocal member of the Stratford Division of the BMA. There were seven or eight other members, appointed as nominees of various bodies, who were active supporters of the idea of an organized national service of some kind. The Commission was a very large body, nearly seventy members, and was to do most of its work through subcommittees, on which the SMA members were all exceedingly active. The Editor of MTT expected much more from this body than was ever to appear. ‘The Commission will also have to consider the cost of our medical services. . . and make a calculation as to how much we might reasonably expect to spend per head of the population.’ It was suggested that the whole question of both rebuilding hospitals and rehousing people would need to be tackled and that farming policy and the use of the land would be included in a discussion of nutrition. ‘A medical commission,’ an article went on, ‘cannot take any other view than that an optimum diet must be guaranteed by the State.’ This was deliberately naive and doomed to disappointment: but it was surely quite realistic to hope that the Commission would in the end support or even recommend for all citizens ‘a simple and easily controlled service which will preserve health and place at their ready disposal all that modern medical science offers for the treatment of disease’.

Had the Commission been allowed to go on to its own conclusion it would certainly have worked out such a scheme, and a minority report backed up by twelve to fifteen influential signatures would have stated the case for a fully socialized and salaried service. As it was it had met only a few times when it was obvious that it was proceeding very much further than its terms of reference suggested and would, whatever its conclusions, face the BMA with the alternative of accepting an advanced political view or of repudiating its own Commission. So a ‘Draft Interim Report’ was published in the BMJ of June 20, 1942 and presented to the profession at a conference, with the suggestion that the Commission might re-examine its views ‘in the light of discussion and criticism’. The British Medical Journal recognized that there might have been at least one minority report if conclusions had been final and thought that ‘divergencies can be revealed without the presentation of reservations by one or more signatories’. The SMA members had accepted that position, for the time being, and in expectation of renewed battles before the final reports appeared: but the BMA could not face up to that and the Commission never met to finalize its work. In a brief discussion at the Council of the BMA on June 10, 1942, Professor R. M. F. Picken, who was a member of the Commission, urged that the BMA must reach solid conclusions on basic principles for if, he said, ‘the Association took a merely non-possumus attitude towards changes, then it would be in the same position in which it had unfortunately been before, of fighting rearguard actions against what other people regarded as progress’. This was a prophetic utterance which was to be true many times over in the next twenty-five years.

Meantime the SMA had continued its work of propaganda in public and inside the Labour Party. Medicine Today and Tomorrow carried many articles that clarified the question of what kind of health service should be planned to follow the war. One pinpointed the question of cost and was to have repercussions when the national health service bill was finally put before Parliament. If the Medical Services are Free, what will be the cost? was the first real attempt to set out the subject and reach positive conclusions; and so well did L. T. Hilliard and L. C.J. McNae make the calculations that they became the basis of the financial memorandum which was presented to Parliament. By the time the first year’s actual cost of the NHS was ascertained in 1949 there was quite an outcry at the enormous increase, as it was forgotten that Hilliard and McNae had given their figures at 1938-39 values which bore little relation to the inflated values of 1948-49. It was estimated that just before World War II England and Wales were spending £140 million a year on a variety of health and medical services. ‘For the same expenditure’, the authors said, ‘the existing medical services could be reorganized and coordinated to provide a better average service for the country as a whole.’ Naturally they were thinking of a salaried service and thought GPs would average £1,000 a year but a net income as they would ‘not have to provide their own secretaries, dispensers, surgeries, cars, or instruments’. As buying of practices would cease to be legal doctors would not need to borrow capital and would also earn a very good pension. The authors were ready to admit that some items of their budget might prove a little inaccurate but on the whole were satisfied that the same £140 million could be spent to far greater advantage: and an end made to the frequent remark that a national service was impossible because ‘it would be too expensive’.

War problems still occupied a great deal of SMA time. At the Annual Conference of May 1941 Ritchie Calder gave the main address on ‘The Effects of War on the Medical Service’, foreshadowing some of the changes that could be expected. At this same meeting Dr Brian Kirman resigned and Mr Aleck Bourne was appointed Honorary Secretary in his place. Dr Bunbury reported that the Bulletin was not only fulfilling its primary purpose but attracting so much attention that she proposed it should be doubled in size; one part, the original Bulletin continuing for members only and the second to be distributed to interested laymen outside the Association. This arrangement continued until 1950 and both publications need to be consulted. for details of the work that was done during those years. In spite of war the activities were constant and of great variety. We note two garden parties in 1941, at the homes of Dr D. Stark Murray in Richmond, and Dr P. A. Gover at Highgate. The first of these coincided with the entry of the USSR into the war against Hitler. The Association at once sent a telegram to Mr Maisky then Ambassador in London asking him to convey fraternal good wishes to the health workers of the Soviet Union. In a reply thanking the SMA for its good wishes Mr Maisky spoke of the need to ‘strengthen and increase the cooperation between our two countries’.

Two problems on which the SMA had particular influence were those of nutrition and of tuberculosis. Medicine Today and Tomorrow in June 1941 published a report prepared by a special sub-committee on ‘The War, Tuberculosis and the Workers’, which was revised and reprinted in 1942. Drawing on the figures for World War I, from Britain and from Germany, it very clearly made the point that industrial conditions caused an increase in tuberculosis and in war the increase might be disastrous. The document called for the use of mass radiography among industrial workers but also recognized that the social and financial problems had to be tackled at the same time. A deputation led by Mr Hastings put these views to Sir William Jameson, Chief Medical Officer at the Ministry of Health.

A long memorandum on the whole subject of Nutrition was sent to the Minister of Food, outlining the dangers of malnutrition but calling especially for guarantees of adequate animal proteins and supportive foods for pregnant women, children and adolescents and for all who were sick. But close attention was also paid to the needs of industrial workers: and in MTT Dr Jurgen Kuczynski argued that ‘Better food for the workers means increased man-power’. He argued that it was not a case of guns instead of butter but of more guns out of providing butter and other foods to those in industry. He gave some very convincing figures from scientific sources in many countries.

Public propaganda was intensified during this period in a series of monthly meetings at the Conway Hall. In February, Dr D. Stark Murray spoke on ‘An Approach to Socialized Medicine’, in March Professor J. R. Marrack took ‘Nutrition in Wartime’ as his topic, and in April ‘Medical Education and Research’ was the subject to a symposium addressed by Professor A. St G. Huggett, Dr P. A. Gover and Mr J. H. T. Lawton.

The SMA membership was now 500 and the lay half of the Bulletin was proving so popular that it was renamed Medical News and Views. The August issue carried a long article on the medical services of the Soviet Union, the war effort of which was now creating interest in the way of living of the Russian people. Members of the SMA were now involved in schemes for medical aid and appeals went out not only for money, chiefly used by Mrs Churchill’s Committee for Russian Medical Aid, but for instruments and other useful material.

The year 1942 began with further pressure on the authorities to give more attention to the nutrition of special groups. A memorandum was published at the request of the Parliamentary Labour Party Food Committee on the need for extra nourishment in illness, pregnancy and lactation. Particular attention was paid to tuberculosis, which in the first year of the war had increased instead of decreasing as it had been doing annually up to 1939. But 1942 was to be the year when the issue of a national health service, in principle, was to be settled once and for all. The BMA did not want its members to be faced with the report of its own Medical Planning Commission, which might be revolutionary and which it was intended should be presented to a BMA conference (as we have seen earlier in this chapter), in complete ignorance of the many proposals that were being made. So BMA Study Groups had been set up over the whole country and part of the literature sent to them for discussion was Medicine Tomorrow originally printed in the September, 1940, issue of MTT but now enlarged and revised.

The Association now found that industrial health questions were of increasing importance and held a conference on the subject when the speakers were Dr L. Fieldman, Dr T. O. Garland and Professor Hermann Levy, the former German economist. In April a new name appeared among SMA speakers when Dr Barnet Stross spoke and later wrote on the subject of health in the Potteries. He was Medical Adviser to the National Society of Pottery Workers and to the North Staffordshire Miners’ Federation and was to prove invaluable to the SMA in this field. Social, historical and philosophical aspects of medicine were presented to SMA members in lectures by such authorities as Professor J. D. Bernal, Professor Hyman Levy and Professor Arnold Sorsby and many others. Social services were for the first time clearly brought to the notice of members by a valuable memorandum prepared by the Association of Socialist Social Workers, which was virtually a sub-committee of the SMA.

Paper shortages now made it difficult to maintain all the Association’s publications. MTT had to be cut in size and Medical News and Views became an occasional instead of a monthly publication. The membership was now over 900 and the Annual Conference asked the EC to consider appointing a full time Organizing Secretary. In July, Mrs Thora Sinclair-Loutit SRN . was appointed. As Thora Silverthorne she had gone to Spain in the first ambulance unit and so met Dr Sinclair-Loutit, the medical officer who commanded that unit. Both were now active members of the SMA and the EC considered itself fortunate to find, in war time, so experienced an organizer. She found the SMA now had a dozen active branches, some in unexpected places. This was because evacuation of hospitals from London had produced concentrations of doctors in areas that previously had known little political activity in the medical field, in Brighton and, notably, in Ashford, Middlesex. Now everybody was talking medical politics and the SMA continued to grow. By October 1942 the membership was one thousand and Bulletin 48 recorded the fact with a summary of SMA history and activities. The issue of MTT of the same date carried an up-to-the-minute restatement of SMA policy The Socialist Programme for Health, the whole organization standing poised for the publication of the Report on Social Security to be known as the Beveridge Report. That appeared at the end of November 1942 and will be a suitable starting point for our next chapter.

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