In July of 2001, the British government loaned President George W. Bush a bust of Winston Churchill, which was prominently displayed in the Oval Office for the remainder of his presidency. After the September 11 attacks that year, many saw the sculpture as a symbol of unity between these two countries in the aftermath of tragedy—and as a reminder of their special relationship stretching back decades. Bush may also have derived some inspiration from the visage of Churchill, who led his country through its darkest hours, most notably during the Battle of Britain.
What the president probably did not know was that his hero, the iconic prime minister and leader of the Conservative Party, played a significant role in the expansion of the British welfare state and, in particular, in the creation of a universal healthcare system. A Burkean conservative who always sought a balance between tradition and change, Churchill understood the necessity of using state power to solve social problems. Conventional wisdom suggests—in the United States anyway—that such efforts are anathema to conservatives, whose chief aim is to cut taxes and social spending. But Churchill presents an alternative portrait of conservatism.
A nobleman by birth, Churchill was raised as a Tory. But fairly early in his parliamentary career he began to criticize his own party for embracing plutocracy. He feared that the Tories were becoming too much like America’s Republican Party, which supported laissez faire capitalism, giving large industries free rein in the relentless pursuit of profit, and only deviating from this ideological position in support of protective tariffs. In the spirit of his Tory predecessor, Prime Minister Benjamin Disraeli, Churchill wanted to revive the alliance between nobles and workers so as to curb the power and dominance of the bourgeoisie. Heeding the dictates of his conscience, Churchill crossed the aisle to join the Liberal Party in 1904, whereupon he worked with David Lloyd George and others to enact policies that would provide economic security and improve conditions for the working class.
Churchill began to see the advantages of the welfare state when he served as President of the Board of Trade under Prime Minister Herbert Henry Asquith. In 1908 he studied the workings and benefits of various government programs in Germany, even spending time there to collect information and gain firsthand knowledge. The following year he published a collection of speeches, Liberalism and the Social Problem, in which he argued that state welfare was an essential corrective to the excesses of capitalism.
Churchill later worked alongside his peers in the Liberal Party, including Lloyd George, to pass the National Insurance Act of 1911. In particular, Churchill was responsible for spearheading the provision on unemployment insurance, but he also enthusiastically embraced the act’s section that created National Health Insurance for British workers. In a letter to George V, Churchill praised the act as a vital instrument for political and social stability. He called it “far more important to the prosperity contentment & security of Your Majesty’s Kingdom, than any other measure of our times.”
Ardent in his belief that the National Insurance Act bolstered Britain’s market economy and militated against the dreaded socialist alternative, Churchill continued to support modest expansions of the welfare state during the interwar period. He pushed for laws that funded family allowances, school milk, public education, and pensions for widows and orphans. Though he returned to the Conservative Party in 1924, he never abandoned his commitment to such compassionate policies.
But Churchill’s motives were not progressive; they were conservative. He wanted to root workers in the traditional British economic and social framework by satisfying their needs—thus blunting prospects for socialist revolution. The idea was to tame capitalism and make it more humane so the fabric of British society would not be torn asunder by class warfare. He believed this could only be accomplished by protecting—and providing for—those people who were most likely to suffer from the ravages of free markets.
Although Churchill celebrated these early legislative achievements, he considered them incomplete when he became prime minister in May 1940. Most striking were the huge gaps in health insurance. Mainly covering male workers, National Health Insurance excluded most women and children, and even eligible beneficiaries of the scheme did not receive coverage for more costly medical treatments, including consultations with specialists, complicated diagnostic procedures, hospital stays, and major surgeries.
In 1942, Churchill’s coalition government asked Sir William Beveridge to review the existing systems of social insurance in the United Kingdom and make recommendations for postwar reform. A Liberal economist who had worked for Churchill during the creation of the National Insurance Act, Beveridge called for a dramatic expansion of national insurance that would offer every British citizen comprehensive protection from the vagaries of life, including poverty, unemployment, and illness. Published in November of 1942, the Beveridge report stirred widespread support from the British people, who hoped to be repaid for their wartime sacrifices.
The report also received Churchill’s endorsement. “I personally am very keen that a scheme for the amalgamation and extension of our present incomparable insurance system should have a leading place in our Four Years’ Plan,” the prime minister said in a radio broadcast on March 21, 1943. “[Y]ou must rank me and my colleagues as strong partisans of national compulsory insurance for all classes for all purposes from the cradle to the grave.” Churchill particularly emphasized healthcare. “We must establish on broad and solid foundations a National Health Service,” he declared. “Here let me say that there is no finer investment for any community than putting milk into babies. Healthy citizens are the greatest asset any country can have.”
A year later Churchill expressed more explicitly his support for universal health insurance. “The discoveries of healing science must be the inheritance of all. That is clear. Disease must be attacked, whether it occurs in the poorest or the richest man or woman, simply on the ground that it is the enemy,” he said in an address to the Royal College of Physicians. “Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.” While the war remained Churchill’s highest priority in 1944, he clearly intended to place comprehensive healthcare reform at the top of the postwar agenda.
Although he supported in principle a generous welfare state that provided comprehensive social insurance and guaranteed equality of opportunity, Churchill cautioned against promising too much too fast. In a note to his cabinet in January 1943, he warned of a “dangerous optimism” about what could be accomplished in the immediate postwar years. He believed that visions of the postwar future, especially those propagated by Labour Party socialists, were becoming downright utopian. He thought it prudent to manage expectations about the future by reminding people of the challenges ahead. In the years immediately after the war, he said, the United Kingdom would likely have to finance and maintain a large military, occupy the countries of its defeated enemies, improve conditions in its remaining colonies, and endure a lengthy period of rationing.
These challenges did not foreclose the possibility of making significant postwar improvements, but they cast doubt on the “false hopes and airy visions of Utopia and Eldorado” with which the British people were being regaled. Churchill believed that responsible leadership required striking a balance between pessimism and optimism, between despair and fantasy. “While not disheartening our people by dwelling on the dark side of things,” he said, “Ministers should, in my view, be careful not to raise false hopes.” Churchill insisted that the aspirations of the British people should always remain tethered to reality.
But the British people weren’t interested in Tory realism, as they demonstrated by ousting Churchill and his party in the 1945 general election. Over the next six years, as leader of the opposition, Churchill attacked the ruling Labour Party’s economic policies. He accused Labour of subscribing to “doctrinaire Socialism,” which, in his view, hampered economic growth and created a national fiscal crisis. As his wartime speeches and memos demonstrate, Churchill favored a more active state that would provide cradle-to-grave social insurance and equality of opportunity. But he stood firmly against the socialist impulse to nationalize significant portions of the economy. “We reject entirely the Socialist doctrine that the State should own and manage all the industry and commerce of the country,” he said at a Conservative Party fête in 1948. While he acknowledged that the state had an important role to play in the economy, he castigated Labour for failing to see the benefits of a market economy. “[W]e hold that the mainspring of our industrial life must still be that free competition upon which our commercial greatness has been founded.”
He accused the Labourites of managing to contribute to civic discourse only one new idea. “Only one,” he declared. “You know the one I have in mind. Nationalization.What an awful flop! Show me the nationalized industry which has not become a burden on the public either as taxpayers or consumers or both.” Furthermore, having dramatically expanded the size and scope of government, the Labour Party found it necessary to raise revenue by way of “crushing taxation,” which not only led the British government down the road to “financial bankruptcy” but also undermined individual initiative and enterprise.
Especially with respect to the pitfalls of large-scale nationalization, Churchill proved prescient. The Labour Government under Clement Attlee turned several major industries—including coal, iron and steel, electricity and gas, railways, civil aviation, and healthcare—into state-owned enterprises. Although the British had enjoyed robust economic growth during the 1950s and 1960s, with an average unemployment rate of 2 percent and a 40 percent increase in real wages, the tides of fortune shifted by the early 1970s. Economic stagnation and growing unemployment, which sparked widespread discontent and ushered in the Thatcher revolution, can be attributed, at least in part, to the fact that many of these industries had become woefully inefficient and lethargic.
Churchill may have bemoaned the design of many new Labour initiatives and warned his countrymen about the scourge of socialism, but he supported, at least in theory, much of what his opponents were trying to achieve. He had always supported social insurance and poverty assistance programs for which the Labour Government received so much worker acclaim. In fact, he bitterly resented the credit given to Labour for policy achievements that had been conceived by his coalition government during the war years. “When we turn to the field of social legislation, we are confronted with ridiculous boastings,” he complained. “The Socialists dilate upon the National Insurance Scheme, Family Allowances, improved education, welfare foods, food subsidies, and so forth.” But, he added, “these schemes were devised and set in motion [by]…the National Coalition Government” of which he was the head. In order to drive home the point that an expanded welfare state did not originate with the Labour Party, he resorted to a little boasting: “I have worked at National insurance schemes almost all my life and am responsible for some of the largest measures ever passed.” This was no lie.
It was actually because of his commitment to social insurance that Churchill opposed the National Health Service Act of 1946 and rallied his party to vote against it. The problem, as the Tories saw it, was that it involved state control and ownership of the medical industry, turning doctors, nurses, and other health workers into civil servants. Instead of socialized medicine, Churchill and many of his fellow Tories favored expanding the existing National Health Insurance program to bring about universal coverage—that is, creating what today we call a single-payer system. But it should be noted that the Tories’ resistance was tepid, certainly never reaching the heated level of Republican opposition to the Affordable Care Act in the United States. They knew that a full-scale onslaught against such a popular bill was politically imprudent. Besides, many Tories, as Churchill put it, “supported in principle” what the NHS was trying to accomplish.
So it should not come as a surprise that, after its passage, Churchill liked to claim credit for the creation of the NHS, insisting that the “main principles of the new Health Schemes were hammered out in the days of the Coalition Government.” But he was quick also to blame the Labour Government, especially Minister of Health Aneurin Bevan, for having “plunged health policy into its present confusion.” The NHS suffered from cost overruns, according to Churchill, because of poor planning and administration. Thus did the Tory leader shrewdly take credit for the successes of the NHS while blaming others for its failures. But it was not merely a Machiavellian ruse. Churchill openly supported universal healthcare; he just had reservations about the NHS as it had emerged under Labour. Further, he wanted the British people to know that, despite Conservative opposition to the NHS and other schemes passed after the war, Labour did not have a monopoly on compassion for the working and middle classes, and Labour’s recent achievements had a lineage that could be traced back to both Conservative and Liberal policies.
When the Tories returned to power in 1951, Churchill was given the opportunity to prove that his rhetoric was more than just cheap political opportunism. Restored as prime minister, he now led a government controlled by the Conservatives outright. Without having to work directly with other party leaders, as he had done under the coalition government, Churchill could have slashed or even repealed many of the programs for which Labour had worked so hard, including its crown jewel, the National Health Service. Along with the British Medical Association, many Conservatives were eager to make that happen. But Churchill was not interested in answering to interest groups, especially the BMA, to which he was already quite hostile because of its earlier resistance to the National Insurance Act of 1911. Nor did he succumb to the ideological rigidity that characterized many Conservatives. It was clear even before the election that Churchill was not interested in killing the NHS. “I trust however that no one will in any way relax his or her efforts to make a success of the new Health scheme,” he said at a constituency meeting in July of 1948. “It may be that there has been great carelessness and lack of foresight in its preparation…but no one should allow a great national scheme to suffer through the misbehavior of the Minister in charge.” To Churchill, the NHS was a “great national scheme” whose failures—including poor planning and wretched leadership—necessitated not its demise but reform.
In 1953, Churchill asked Cambridge economist Claude Guillebaud to head a committee that would assess the effectiveness of the NHS. The committee concluded that the NHS was generally successful but needed more funding to ensure that it would remain so. Churchill embraced the recommendation. Thus did the Tories under Churchill make peace with the NHS and, per the recommendations of the Guillebaud committee, increase funding to build more clinics and hospitals. Under his watch Parliament also passed the National Insurance Act of 1954, which increased pensions for retirees and veterans and social insurance benefits by 23 percent across the board. These generous increases benefited roughly six million people. In the end, Winston Churchill can be remembered for bolstering the National Health Service and, more generally, helping create and expand the modern welfare state in the United Kingdom.
Many American conservatives today may not want to face this truth about the hero whose bust graced the Oval Office of George W. Bush. Seeking a balance between tradition and reform, Churchill was an ideological descendant of Edmund Burke. In his address to the Royal College of Physicians he located his call for universal healthcare in the context of tradition. “As between the old and the new, you have undoubtedly the advantage of antiquity,” he said.
This College must play its part in keeping alive the historic tradition of the medical profession, and must ever foster those high standards of professional behavior which distinguish a profession from a trade. This is what you have tried to do as an institution, for nearly 400 years. I confess myself to be a great admirer of tradition. The longer you can look back, the farther you can look forward. This is not a philosophical or political argument—any oculist will tell you this is true. The wider the span, the longer the continuity, the greater is the sense of duty in individual men and women, each contributing their brief life’s work to the preservation and progress of the land in which they live, the society of which they are members, and the world of which they are the servants.
Like Edmund Burke and Benjamin Disraeli, Winston Churchill recognized that policy must be guided by experience, both past and present. Throughout his life he eschewed abstract doctrine and fought ideological extremism. Nowhere can one find in his words or actions the tropes of modern American conservatism, such as small government, low taxes, and absolute property rights. As opposition leader in the postwar years, he expressed his dismay about bloated government and excessive taxation and regulation, but only on practical grounds. He believed that these measures, while necessary in time of war, had outlived their usefulness. But he never turned his practical recommendations into absolute principles. He never insisted that small or limited government was always better.
As Churchill understood, conservative ends sometimes can only be achieved through progressive means. American conservatives today might learn something from Churchill’s storied career, not just as a wartime leader but also as a preserver of domestic tranquility.
Robert J. Lacey is professor of political science at Iona College. Significant portions of this article are excerpted, sometimes in slightly altered form, from his recent book, Pragmatic Conservatism: Edmund Burke and His American Heirs.