ID cards and the NHS: separated soon after birth

It was only two years, one month and eight days ago that Damian Green fed the last pieces of Labour’s ID card scheme into a giant industrial shredder in Witham. The coalition, on getting into power, promised to destroy ID cards and protect the NHS. Although some think the government is putting the NHS through a metaphorical shredder with the changes that take effect on 1 April, that is overdoing it. In general, the coalition has kept its promises on these two issues.

What is not widely know is that, on its foundation in 1948, the NHS was completely tied to ID cards – you had to use a card to get treatment. Furthermore, the link survives to this day.

By the start of the First World War, Britain had introduced biometric passports. To put it another way, passports included a photograph; a biometric is simply a measure of the body. In 1915, the government issued the first modern passport, a folded piece of cardboard with two years’ validity, and in 1920, a League of Nations international conference on passports agreed the book design that is still used today.

What Britain didn’t have was an identity card system – until the Second World War. The government passed the National Registration Act on 5 September 1939, just two days after war was declared – a piece of emergency legislation that was retained by the Labour government that followed when the war was won. The paper database required was established through a slimmed-down Census, carried out on 29 September 1939, which asked just seven questions: name, sex, age, occupation, residence, marriage status and membership of military reserve, auxiliary forces or civil defence services or reserves. The resulting National Register, which did not cover members of the armed forces, was used for security and planning, and to run rationing. […]

The Labour government elected in 1945 did not abolish identity cards, but did establish the welfare state: 5 July 1948 saw the formation of the National Health Service, for example. The NHS is an example of state paternalism, if of the most benign character. An identity card can be seen as a reasonable flip-side to such paternalism: if the government is going to look after its citizen children, it is going to want to keep tabs on them. Indeed, one argument in favour of ID cards’ most recent incarnation was to stop foreigners taking advantage of the NHS.

The 1940s are Britain’s refoundation myth: the Second World War and the welfare state established in its aftermath have enormous resonance to this day, as the warmly-welcomed tribute to the NHS in the opening of London’s 2012 Olympics showed. The health service is one of several institutions enacted in the war’s aftermath to have taken on a permanent, unchallengeable quality; while several governments have reformed the NHS, welfare and other parts of the post-war settlement, none has abandoned them.

But initially, identity cards were part of that post-war settlement. The 1945 government’s stated reason for keeping the wartime identity card law in place was to prevent 20,000 deserters from claiming rations, and there was an expectation that they would be abolished when this particular problem had subsided. But in an example of what is now called ‘function creep’, where something introduced for one purpose is employed for others, their use expanded instead. A British citizen needed an ID card to obtain a new passport, to withdraw money from the Post Office and for medical treatment under the new NHS.

Also, the police could demand to see someone’s card. This supposedly applied only when they suspected a serious crime, but in practice many officers demanded to see the card of anyone they dealt with. By 1950 the Labour government was arguing that cards should be retained permanently for administrative purposes.

The wartime identity card scheme was abolished by an alliance of Conservatives and Liberals – in 1952, as in 2010 – while the NHS lives on. But the wartime ID system survives to this day, because the ID numbering system required to access the NHS was retained… as the NHS number. As so often, that estimable civil servant Sir Bonar Neville-Kingdom speaks with a sense of history:

The extract is from my new book, Card declined: how Britain said no to ID cards, three times over, available here.