NHS in crisis: 80 years after William Beveridge's report, our own 'revolutionary moment' feels far off – Martyn McLaughlin

In the spirit of the party season, let’s play a game of ‘who said that’ by identifying the following quotation: “A revolutionary moment in the world's history is a time for revolutions, not patching.”

It is an arresting statement. Concise, impactful, and direct, it satisfies on the page and when spoken aloud. But who is its author? Emiliano Zapata? Ernesto ‘Che’ Guevara? What about an outside bet? Nelson Mandela?

The answer is an eccentric economist and eugenicist in his 60s. Few people in his lifetime would have regarded him as a socialist, let alone a revolutionary, but in that one phrase, he convinced the country of the need for seismic change.

It is 80 years since Sir William Beveridge took his place as the unlikely architect of the British welfare state with the publication of a report which set in motion a transformational shift in the role of government. Arguably the defining policy document of 20th century British politics, it was conceived during a time of strife and uncertainty.

Yet it recognised that even while Britain dealt with the threat of Adolf Hitler, other dangers preyed close to home. They were, in Beveridge’s words, “five giants” that posed major obstacles if, and when, the country embarked on the long road to post-war reconstruction: want, disease, ignorance, squalor, and idleness.

The precise terms seem archaic today, and little wonder, given how they were coined by a patrician who was prone to Victorian moralising. Even so, their meaning shone through, and captured the imagination of a country hoping for better days ahead.

Despite its dry official title – Social Insurance and Allied Services – there was an insatiable public appetite for Beveridge’s 299-page report. On the day of its publication, people queued for hours outside HM Stationery Office to hand over a shilling and secure their own copy. In the first month, sales topped 100,000. Before long, the total exceeded 600,000.

More importantly, his text served as a catalyst for radical change. Prior to his report, there was no universal healthcare service, free at the point of use, and nothing even resembling a social care system. Beveridge’s vision changed that, with Clement Atlee’s reforming government seizing on its proposals to create the NHS, a contributory system of National Insurance, and with it, the concept of universal social security from the cradle to the grave.