Reflections on the 1944 National Health Services Commission: A Response to Bill Freund and Anne Digby on the Gluckman Commission

Abstract

This article is a critique of and comment on two revisionist articles by Bill Freund and Anne Digby, which appeared in the SAHJ in June 2012. The authors maintain – from different standpoints – that the National Health Services Commission (NHSC or Gluckman Report) was doomed to failure, largely because of the failings of its Chairman, but for opposite reasons: Freund because he was not radical enough, Digby because he was too radical, and failed to carry the medical profession and the politicians with him. After outlining their arguments, this article contends that paradoxically these assessments both overemphasise and underestimate Gluckman, by failing to examine the role of Smuts, the Commissioners, the Department of Public Health, the views of leading members of the medical profession and the radicalism of many in the profession during the war. It highlights the international influences, especially ‘social medicine’, on the Commission, and explains why it selected the health centre at Pholela as the model for the health centres it envisaged as the foundation of a national health service. Finally it suggests that the Gluckman Commission's recommendations are still relevant to South Africa and the wider world.