This booklet contains the background papers prepared for a discussion meeting at Cumberland Lodge in Windsor Great Park on 7 and 8 June 1984.

The idea for the meeting came from the late Lord Vaizey, who was Principal of St Catherine’s Foundation at Cumberland Lodge. It followed on from the discussion in his recent book ‘National Health’.

His belief, which is shared by the Office of Health Economics, was that the principles of the Beveridge Report need to be fundamentally re-appraised in the light of the changes in British society since the 1940s. It is not too soon to be looking at how Britain’s National Health Service should be developed to cater for the situation which can be expected in the 1990s, half a century after the NHS was introduced. An NHS conceived to deal with the medical and social problems which existed in the 1930s and 1940s cannot be expected to cater for the problems of the 1990s.

As my own background paper explains, the arguments in favour of the solutions which have been discussed in the past – a reversion to ‘private’ care, or the introduction of competing insurance-based sources of finance – have not stood the test of time. Much more subtle and imaginative changes are required to meet fully the present and future health care expectations of the British public. And those expectations, in turn, need to be both more realistic and more critical than they have been so far.

These are some of the issues raised in these eight papers, and in the digest of the discussion of them which makes up the ninth chapter of this booklet. As this last chapter points out, the meeting at Cumberland Lodge can been seen as the start of a new phase of discussion about the future of health care in Britain.

Many of the ideas which it introduces would have been unthinkable a few years ago. The fact that a totally constructive and uninhibited discussion of these issues was possible is immensely encouraging for the prospect for a realistic and positive ‘New NHS Act for 1996’.

The untimely death of Lord Vaizey since the meeting has been a sad blow to all of those of us who were present. However even without the continued benefit of his driving energy the discussion which he stimulated must be encouraged to continue.