State Medical Service Association

The Socialist Medical Association (SMA) has its origins in the meeting in summer 1930 between Dr Charles Brook and Dr Ewald Fabian, Secretary of a German organisation of socialist doctors, who commented on the lack of a similar organisation in Britain, following the demise of the State Medical Service Association. In response Brook convened a meeting in London on 21 September at the National Labour Club which resulted in the formation of the SMA, with Brook as Secretary and Dr Somerville Hastings, Labour MP for Reading, as the first President. A constitution was agreed in early November, incorporating the basic aims of a socialised medical service, free and open to all, and the promotion of a high standard of health for the people of Britain. The association also committed itself to the dissemination of socialism within the medical profession and the support of `medical Members of Parliament'. The SMA was open to all doctors and members of allied professions, such as dentists, nurses and pharmacists, who were socialists and subscribed to its aims. International links were established through the International Socialist Medical Association, based in Prague, of which Dr Fabian was also Secretary.

The appointment of a Research Sub-Committee in November 1930 to address the practical questions of a socialised medical service resulted in the SMA's first major publication in 1931, namely For a healthy London . This document formed the basis of the policy of the London County Council (LCC) after the Labour victory in the 1934 LCC elections. In 1931 the SMA affiliated to the Labour Party and subsequently exerted an important influence on Labour health policy, particularly following the publication of its programme, A socialised medical service, in 1933. At the annual party conference in 1932 a resolution calling for a national health service to be an immediate priority of a Labour government was passed and two years later conference accepted a document entitled The people's health prepared by SMA members.

The association continued to lobby for a national health service throughout the 1930s and 1940s, producing statements of policy on various topics, such as occupational health services, maternity and child health services and dental services. Its official journal, Medicine Today and Tomorrow, was launched in 1937 (and re-named Socialism and Health thirty years later) and a summary of the development of British medicine in comparison with other countries was issued under the title Whither medicine? in 1939, expressing what came to be the basic principles of the National Health Service. Three members of the SMA then participated in the Medical Planning Commission established by the British Medical Association (BMA) in 1941, which issued its draft interim report in 1942. The momentum for change gathered pace in December 1942 following the publication of the Beveridge Report, one of its basic assumptions being a comprehensive health service available to all. The process of discussion subsequently initiated by the Minister of Health included a meeting with a deputation from the SMA in March 1943.

The SMA did not however limit its campaigns to health issues in Britain. The threat of fascism in Europe was clearly illustrated by the Spanish Civil War, prompting the SMA to establish the organisation Spanish Medical Aid and to assist the Republican cause by sending a medical unit to Spain in 1936.

The SMA campaign for a state medical system finally bore fruit in 1944, with the publication by the government of a White Paper on a national health service. The election in 1945 of twelve Labour MPs sponsored by the SMA enabled the association to influence the progress of the National Health Service Bill which was introduced to Parliament in 1946 and which culminated in the foundation of the National Health Service (NHS) on 5 July 1948.

At its height in 1943 membership of the SMA was 1800. However following the establishment of the NHS, the influence of the organisation waned and its role gradually changed. The SMA re-named itself as the Socialist Health Association (SHA) in May 1981 to reflect a shift in emphasis to the prevention of illness through the promotion of good health. The association is still active today, comprising about 25 branches. The SHA now operates as a modern pressure group, with the emphasis on public education and lobbying on health issues, in co-operation with like-minded organisations such as the Labour Party, the Fabian Society and trade unions.