By Nygaire Bevan
The NHS is not just one of Britain’s greatest achievements—it is the beating heart of our
nation. In Wales, it is our sacred duty to protect it. My great uncle Aneurin Bevan built this
service on the principle of fairness, determined that good quality healthcare should be
available to all, free at the point of need. He overcame adversity in his own life with
resilience and vision, and it was that same determination which drove him to create a system
that transformed the lives of millions.
Today, as we look ahead to the Senedd elections, we must ask ourselves: are we prepared
to show the same courage and imagination to ensure the NHS not only survives but thrives
for generations to come? Because make no mistake, health matters, and without bold
action, Bevan’s legacy is at risk.
Aneurin Bevan’s story is one of grit and conviction. A boy who struggled at school, who
battled a stammer, who taught himself to speak by reading complex literature aloud while
walking the mountains of his home. That resilience carried him into public life, first as a
councillor and then as an MP. His politics was rooted in fairness and equity, and his vision
for the NHS was simple but radical: healthcare should be universal, high quality, and free at
the point of delivery.
He faced fierce opposition, but he never wavered. With passion and determination, he
pushed the legislation through, and the NHS was born. It was his gift to the people—a
service built not on privilege or policy alone, but on principle. As Nye said: “No society can
legitimately call itself civilized if a sick person is denied medical aid because of lack of
means.”
So, what would Nye think of the NHS today? He would still see a service loved and
cherished (though too often taken for granted by the public), that meets the needs of millions
every single day. But he would also see the cracks widening. An overreliance on ‘medical
solutions’ where once people and communities filled the space. Waste that is invisible to
most but drains precious resources and must be eliminated. Misuse and inefficiency of
services that weaken the system and must be confronted head‑on. And above all, the urgent
need for a new culture of shared responsibility for health and well‑being.
Wales, with its relatively small number of NHS health boards and trusts, has the capacity to
act decisively and to lead by example. Yet too often we are paralysed by centralised control,
by risk aversion, by timidity masquerading as caution, and by a lack of political courage and
bold leadership. This is not the moment for hesitation. It is the moment to prove that ‘health
matters’, that Bevan’s vision was not just a historic achievement but a living and thriving
mandate. If we fail to act now, we risk betraying his legacy and denying future generations
the service he fought so hard to build.
We already know what needs to be done. The Bevan Commission has already set out its
thinking alongside supporting more than 800 Bevan Exemplar initiatives across Wales, to
help find practical, innovative solutions to the challenges. This has shown that change is
possible building upon the knowledge, ideas, passion and commitment of those who work in
the system. But innovation alone is not enough. We must work together to urgently adopt,
spread, and embed these transformations across every health board, ‘pinching with pride’
and ensuring best practice is rolled out consistently. Only then can we deliver the best
possible outcomes for people while creating a more prudent, efficient, and effective NHS.
This is the moment to be bold. We must rekindle Bevan’s energy and drive. Politicians and
health leaders must be brave enough to act, not just talk.
And here lies the crux: we must move from words and rhetoric to doing and delivering.
Speeches and promises will not heal patients, reduce waiting lists, or eliminate inefficiency.
What will make the difference is action—rolling out proven innovations, tackling waste
head‑on, empowering communities to take responsibility for health, and holding leaders
accountable for delivery.
The NHS cannot survive on sentiment alone. It must adapt, innovate, and evolve. Protecting
Bevan’s legacy means defending its founding principles whilst being open and receptive to
change. That requires vision, and courageous leadership translated into tangible outcomes
that make a real difference to people.
As the Senedd elections approach, the challenge is clear: will we honour Bevan’s legacy not
just in words, but in deeds? The NHS was built on bravery and conviction. As my great uncle
said: “The NHS will last as long as there are folk left with faith to fight for it”. It will only
survive if we show the same conviction and determination today – not through rhetoric but
through urgent action. Only then will we have an NHS that is both sustainable and fit for the
future.
Nygaire Bevan is a Bevan Commissioner and the great niece of Aneurin Bevan, founder of
the NHS. She began her career as a nurse before qualifying as a social worker in the
1980s.She has more than 40 years’ experience in health and social care.
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