How to look for records of... Public health and social policy in the 20th century

2. Key changes to central health administration

The Ministry of Health, following its creation in 1919, took on the powers and duties of the health functions of the government, which were previously fragmented across departments, most notably from the following:

• Local Government Board
• The National Health Insurance Commissions of England and Wales
• Privy Council
• The Home Office
• The Board of Education

For papers relating to the formation of the Ministry of Health search within MH 78, RECO 1, CAB 21/72 and PC 8/854.

The principal purpose of the new ministry was to consolidate under a single authority the medical and public health functions of the central government and the co-ordination and supervision of local health services in England and Wales. Revisions to the administration came throughout the 20th century; notably, the co-ordination of local medical services was greatly extended in connection with emergency and wartime services from 1938 to 1945, and these developments culminated in the establishment of the National Health Service in 1948.

The Department of Health and Social Security (DHSS) was created in November 1968, merging the Ministry of Health and the Ministry of Social Security. Responsibility for a number of its functions was transferred into and out of DHSS during the twenty years of its existence. In 1988 the department was divided once more and the Department of Health was formed, separate to the Department of Social Security.

Throughout the 20th century there was a rise in lobbying of central government by groups with an interest in health and social welfare issues, and policy on health care provision was affected by the economic events, crises, and developments of the period such as:

• unemployment
• poverty
• maternal and infant mortality
• health insurance
• mental health
• preventative medicine

For information on public health before this period, see our guide, Public health and social policy in the 19th century.

3. How to search for records

Records of the ministry are arranged largely in file series broadly reflecting the functions of its specialised divisions. Due to the complex system of registration each record series can contain very broad topics; for example, MH 148 is a series that contains policy review relating to food hygiene, fluoridation of water supplies, medical examinations of Commonwealth immigrants, and the 1962 survey of children born with congenital deformities due to thalidomide. You can browse each series using the browse function from the catalogue description page.

The MH 148 catalogue description page in our catalogue. The search boxes allow you to search for records within this specific series, as is the case with the catalogue description pages for all National Archives records series.

4. Online records

Some useful resources relating to health policy are available online.

4.1 Parliamentary Papers (1715-present)

Search Parliamentary papers for reports relevant to health, unemployment and poverty. These are available online at The National Archives and many libraries and academic institutions with a ProQuest account. You can:

• search for papers using the paper number and the year
• browse by century, year and volume
• browse the 20th century collection by department

4.2 Legislation

Search legislation.gov.uk for relevant legislation.

4.3 Government datasets

Search Discovery, our catalogue, for information and statistics related to health policy held in digital datasets. See our research guide on government datasets for detailed advice on how to do this.

4.4 The King’s Fund Digital Archive

Search the King’s Fund Digital Archive for King’s Fund publications and documents from 1898 onwards.

4.5 The Wellcome Library’s Digital Collections

The digital collections of the Wellcome Library cover wide-ranging topics, including public health.

4.6 The UK Government Web Archive

Browse archived websites to view snapshots of the Department of Health and NHS departmental websites. You can also use keywords to search the whole of the UK Government Web Archive..

5. The National Health Service and hospitals

Draft of the Coalition Government’s White Paper on a National Health Service, February 1944 (catalogue reference CAB 66/46/24).

With some minor exceptions The National Archives does not hold records of hospital patients. We do, however, provide guidance on where you can find Historical NHS patient records.

Many hospital records are held at local archives and the records we hold mainly relate to high-level administrative matters. For more information see our research guidance on Hospitals.

Prior to the NHS, joint hospital boards were authorised to establish and maintain local hospitals. Search for their records in:

• Local Government Board correspondence (1868-1935), organised by County and District Councils, in MH 48
• Joint hospital boards’ correspondence and minutes (1903-1961) in MH 67

You should also search for related records in local archives.

After the inception of the NHS in 1948, regional hospital boards (RHBs) were established to administer hospitals in specific regions. You can browse representative correspondence between the RHBs and the ministry (1941-1969) in MH 90.

Target the following key series:

• Committee on Reconstruction Problems and Nuffield College Reconstruction Survey (1940-1945) in CAB 117.
• General policy files relating to the implementation of the National Health Service Act 1946 (1935-1965) in MH 137. Specialist services (1923-1977) are in MH 135.
• Search by region and date the correspondence between the department and selected local regional bodies (North Western, Northern, and Yorkshire) leading up to the 1974 reorganisation of the NHS (1947-1974).
• Search by broad topics and date publicity material on various aspects of the National Health Service (1939-1944) in BN 10.
• Records relating to the Royal Commission on the National Health Service (Merrison Commission 1976-1979) in BS 6 are organised by subject’s name or organisation giving evidence as well as by sub-committee.

6. Public assistance and health insurance

In 1911 the National Insurance Act was passed, which created a system of health insurance for workers based on contributions from individuals, employers and the government.

Search the following key series:

• Papers and correspondence relating to the administration of health insurance (1911-1960) in PIN 4.
• Papers relating to insurance regulations and legislation (1912-1997) in PIN 19.
• Files relating to the introduction and administration of social insurance schemes and allied services under the Ministry of National Insurance (1912-1965) in MH 62.

A main function of the ministry was the supervision of public assistance services. In 1930 the old poor law boards of guardians were replaced, under the Local Government Act 1929, by public assistance committees and county borough councils. High unemployment levels between the wars were a major influence on economic, social and political practice and theory; successive governments sought new ways to address the problems of widespread poverty.

To find relevant records, use the advanced search option in our catalogue and search within department reference MH, PIN, or AST, or click on the following series references to search for records within each respective series, using keywords such as ‘public assistance’, ‘casual poor’, ‘medical relief’, ‘care of the aged’ and ‘welfare’, or try browsing:

• General files relating to public assistance and poor law outdoor relief covering children’s training and employment, pensions in respect of relief, medical relief for paupers and vagrancy (1907-1970), organised by topic in MH 57.
• Social welfare files, including records concerning the care of the aged in Public Assistance Homes and Institutions (1938-1965) in MH 130, organised by topic, with some files organised by area.
• Correspondence of the Ministry of Health with local authorities (1913-1973), organised by county council, topic, and date in MH 52.

The following series are best searched by browsing by date and/or area or county council:

• Circular letters issued by the Poor Law Commission, the Poor Law Board, the Local Government Board and the Ministry of Health (1834-1962), organised by date in MH 10.
• Correspondence of the Local Government Board and Ministry of Health with poor law authorities, including the transfer of poor law functions to local authorities in 1929 (1904-1933), organised by area and date in MH 68.
• Files of the Ministry of Health, with a few earlier ones of the Local Government Board, relating mainly to the administration of casual wards and reception centres in various parts of England (1894-1950) in AST 8 are organised broadly by county or committee with some files catalogued by date only.

7. Food, diet and nutrition

The key records relating to food, diet and nutrition are in record series MH 56, which includes papers from various food and nutrition committees (1850-1967). Use the advanced search option in our catalogue to identify specific records from this series or from across all the records in MH, AST, JV (Milk Marketing Board) and MAF (Ministry of Food).

Search using keywords such as ‘food’, ‘diet’, ‘nutrition’, ‘malnutrition’, ‘children’, ‘families’, ‘welfare’, ‘milk’ – or combinations of these.

• Browse the papers of the Committee on Medical and Nutritional Aspects of Food Policy and Food and Nutrition Surveys (1948-1992), including files relating to imported meat, food hygiene and food additives in MH 148.

Search by keyword or browse the following key series:

• Files of the Milk Marketing Board (1930-1994) relating to the promotion of sales of milk including publicity and advertising campaigns in JV 7.
• General reports and technical information of the Scientific Advisor’s Division of the Ministry of Food on foodstuffs, rations and nutrition (1936-1959) in MAF 98 -some of the committee minutes are organised by date only.

8. Family planning and mother and child welfare

With the rise of the welfare state in Britain and the inception of the National Health Service, educational campaigns on birth control were launched and the provision of mother and child welfare services increased.

The records consist of internal correspondence between officials and correspondence with organisations lobbying for reform, covering issues such as:

• whether ante-natal clinics should be provided by the local authority or the voluntary sector
• moral and social questions relating to birth control including abortion
• religious opinion on the provision of such clinics

To find specific records, use the advanced search option in our catalogue and search across all records within MH and JA, using keywords such as: ‘birth control’, ‘abortion’, ‘birth clinic’, and ‘maternity clinic’ or ‘child welfare’.

Browse the following key series:

• Files covering medical services and public health relating to areas designated as distressed under The Special Areas Acts of 1934 and 1937 (1934-1960) in MH 61/4-10.
• Health Education Council files on Sex Education and Prevention of Unwanted Teenage Pregnancies (1980-1992) in JA 630.
• Files covering Confidential Enquiries into Maternal Deaths in England and Wales (1947-1994) in MH 156. Search this series by keyword for other files relating to local authority services, including child welfare and welfare foods.

9. Mental health

The Lunacy Commission and Board of Control had responsibility over admission, detention and discharge of psychiatric patients and had powers to inspect asylums.

• Browse by date the Correspondence, papers and minutes from the Lunacy Commission (1845-1913) and Board of Control (1913-1960) in MH 50.
• Search by asylum or gaol the correspondence and reports from the Lunacy Commission and Board of Control (1798-1971) in MH 51. Some files can be searched by patient name.
• Browse the policy files relating to the implementation of the Mental Health Act 1959 (1958-1966) in MH 140.

For more information about the Lunacy Commission, Board of Control and related record series, read the administrative background to MH Division 14 in our catalogue.

See our separate guide to lunatic asylums, psychiatric hospitals and mental health for how to search records on this topic.

10. Public health: diseases, epidemics, sanitation and health education

Public health is complex and can cover environmental health and the provision of adequate sanitation, responses to infectious, chronic, and epidemic diseases, as well as the introduction of public health services and campaigns.

Advances in medicine reduced levels of infectious diseases, but serious outbreaks of smallpox, typhoid, poliomyelitis, diphtheria, tuberculosis, and measles were not unusual through the inter-war period, although epidemics were increasingly rare.

By the end of the 20th century, authorities dealing with public health tended to focus on chronic conditions, such as diabetes or obesity, or on health education about lifestyle choices. There were also responses to the appearance of new infectious diseases like HIV/ AIDS.

To identify specific records from the catalogue use the the advanced search option in our catalogue and search by name of a disease, sanitary measure, and/or a place name.

Browse or search by keyword the following main record series:

• Correspondence between the Ministry of Health and local authorities (1913-1973) in MH 52.
• Files relating to public health services, including tuberculosis, medical inspection of aliens, midwifery, propaganda and vaccination, as well as port health authority case files, and reports of medical officers of health (1853-1970) in MH 55.
• Welsh public health and environment matters (1854-1985) in BD 11.
• Committee meetings, papers and correspondence of the Expert Advisory Group on Acquired Immune Deficiency Syndrome (AIDS) (1985-2000), including files relating to the interdepartmental group on AIDS and the nationwide advertising campaign, in JA 235.

Browse by date the following series:

• The Public Health Laboratory Board was established in 1961 to provide a continuous picture of the communicable microbial diseases of England and Wales. Public Health Laboratory Service Board minutes and papers (1961-1983) are found in DN 1 and the Public Health Laboratory Service yearbooks (1962-1982) in DN 2.
• Sir George Newman’s diaries (1907-1946), relating to his role as Medical Officer of the Board of Education and Chief Medical Officer at the Ministry of Health in MH 139. Covers subjects such as tuberculosis, medical research, milk, dental registration, medical education and maternal mortality.
• Central Council for Health Education: Minutes and Papers (1927-1969) in MH 82.
• General Register Officer Circulars (1910-1940), containing annual reports of the Medical Officer of Health and mental health statistics (limited years) in RG 41.

A more comprehensive list of key series relating to public health can be found in the catalogue description of the Records of the Health Divisions.

11. Sterilization and eugenics

Physical and mental degenerative diseases were of interest to eugenicists both in Britain and abroad.

Whilst no legislation for legalising sterilization and euthanasia was introduced in Britain, the government corresponded with groups who favoured legislation on sequestration, sterilisation and euthanasia of people suffering degenerative diseases. A report on the illegal sterilisation undertaken in Britain at the Gateshead School is found in MH 79/291.

Search by the key words ‘mental defective’, ‘euthanasia’, ‘sterilisation’ and ‘heredity’ in Discovery or browse the following key series:

• Papers of the Departmental Committee on Sterilisation (1932-1933) in MH 51/208-211 and the proceedings of the Departmental Committee on Sterilisation (1932-1933) in MH 51/212-235, organised by date.
• Papers of the Departmental Committee on Sterilisation (1928-1935), including discussions about sterilising ‘mental defectives’ in MH 58/100-105.
• Papers of the Special Operations Executive’s intelligence reports on euthanasia and genocide in Germany in the 1930s and 1940s in HS 6.

The Foreign Office’s General Correspondence printed indexes, available at The National Archives in Kew also include mention of cases for sequestration of people with mental diseases and also some general reports on genocide. Many papers referred to in the printed indexes do not survive, but those that do are in FO 371. See our guide to Foreign Office correspondence for detailed advice on searching for these records.

12. The pharmaceutical industry

Regulation of pharmaceutical products was limited at the beginning of the 20th century. Throughout the period the industry became increasingly regulated, particularly in the wake of the introduction of thalidomide to the market, which resulted in the births of children with congenital deformities.

The Committee on Safety of Drugs was set up in 1963 to advise government health ministers on the quality, efficacy and safety of medicines and was replaced in 1968 by the Committee on Safety of Medicines following the Medicines Act, 1968. It provides advice to the Licensing Authority on whether new products should be granted a marketing authorisation and it also monitors the safety of marketed medicines.

To identify specific records from the catalogue use the advanced search option in our catalogue and search by name of a Pharmacy Act, poison, and/or drug.

You can target the following series to narrow your search:

• Minutes, papers and reports of the Committee of Inquiry into the Pharmaceutical Industry (Sainsbury Committee) (1964-1967) in MH 104.
• Files relating to regulation of pharmaceutical products (1926-1972) in MH 58.

The following committee minutes are arranged by date and may not include names of drugs or specifics of regulations in the catalogue description:

• Minutes and papers of the Committee on Safety of Drugs and the Committee on Safety of Medicines (1963-1976) in MH 171.
• Minutes and papers of the Committee on Safety of Medicines together with the minutes and papers of its three sub-committees (1970-1988) in BN 116 and minutes of the Committee on Safety of Medicine’s sub-committees (1964-1975) in MH 148.

13. Doctor and nurse recruitment

Nursing shortages throughout the 20th century led to various nursing workforce policies and planning. Ministries dealing with nurse recruitment policy and planning include:

• The Ministry of Labour and National Service
• The Ministry of Health
• Colonial Office

The Ministry of Health took over the recruitment of nurses from the Ministry of Labour from 1957.

Search the following key series using keywords such as ‘doctor shortage’, ‘nurse recruitment’, ‘overseas nurse’, ‘foreign nurse’, ‘recruitment of doctors’ – or combinations of these. You can, alternatively, search across the whole of LAB, MH and CO series using the

• Files relating to nurse recruitment in Department of Employment records in LAB 12 (1915-1978).
• General subject files relating to health, including nurse recruitment (1853-1970) in MH 55.
• Browse the files of the Colonial Nursing Service (1940-1955) in CO 850.

See our guide on Doctors and Nurses for information on other records we hold.

14. Further reading

14.1 Online resources

• The National Archives blogs
• BBC archive Birth of the National Health Service
• National Health Service history from an archived version of the NHS website
• Nuffield Trust NHS timeline
• Search archived data from the Hospital Records Database to find information on the location of hospital records, including those about staff and patients, in the UK
• The King’s Fund’s audio and visual animation of how the NHS works
• Digital resources at the King’s Fund’s library
• The Health Foundation’s ‘Policy Navigator’ time-line of health care reform

14.2 Online journals

Online journals available via our e-library:

Jane Lewis, ‘ Gender, the Family and Women’s Agency in the Building of ‘Welfare States’: The British Case’, Social History, 19 (1994). Access via the e-library on-site at Kew.

14.3 Printed resources

The following recommended publications are available in The National Archives’ Library.

• Christopher Ham, ‘Health Policy in Britain: the politics and organisation of the National Health Service’ (Macmillan, 2004).
• Bryan Rayner, ‘History of the Department of Health’ (DoH, 1994).
• Geoffrey Rivett, ‘From cradle to grave: fifty years of the NHS’. Revised editions of Rivett’s book are available at history.net.
• Sally Sheard and Sir Liam Donaldson, ‘The Nation’s Doctor: the role of the Chief Medical Officer 1855-1998’ (The Nuffield Trust, 1998).
• Pat Thane, ‘Foundations of the Welfare State’ (Longman, 1996).
• Charles Webster, ‘The National Health Service: a political history’ (Oxford Univeristy Press, 1998).