Brian Abel-Smith, who has died aged 69, first rose to prominence thanks to a memorandum to the 1953 Guillebaud inquiry into the costs of the National Health Service. Written with his mentor Richard Titmuss, whom he was eventually to succeed as professor of social administration at the London School of Economics, it showed that spending on the still infant NHS, far from spiralling out of control as the Treasure feared, was actually falling as a percentage of gross national product; and that the pressures in demography and advances in medical science meant that more needed to be spent on it, not less.
The memorandum set the tone of the eventual report; it removed any threat to the continued existence of the NHS, and instead firmly located it in the cross-party consensus.
During the 1950s, Abel-Smith continued his work on health policy in Britain, producing histories of pre-NHS hospitals and of the nursing profession that remain classics to this day. In the 1970s and 1980s, his interests became more international, with cross-national studies of value-for-money in health services and on the containment of health costs that are still essential reading. He visited more than 60 countries as a consultant for the World Health Organisation and other international organisations; in consequence, there is hardly a national health system in the developing world that does not bear the stamp of his advice.
But his contribution was not only to health services. He worked on various aspects of housing and social security policy; in particular, as special adviser on pensions to the then Secretary of State for Social Services, Richard Crossman, from 1968 to 1970, he contributed to what was probably the best work that the Labour Party ever produced on the subject.
The work of his that arguably made the most political impact was not on health, but on poverty: The Poor and the Poorest, written with Peter Townsend and published in 1965. By demonstrating that despite 20 years of a welfare state, poverty still persisted, especially among children and the elderly, it challenged the social and political complacency of the day.
It led directly to the formation of the Child Poverty Action Group and, more broadly, to an awareness that a coalition of politically aware academics and welfare activists with a single cause to fight for could lead to change.
Indeed, he was always active politically. He acted as a senior adviser to both the 1964-70 and 1974-79 Labour governments; he served as both the treasurer and vice-president of the Fabian Society. However, he never let his politics dominate his academic commitment to what he perceived to be the truth. One of his last acts was to co-author a controversial article in Fabian News that drew attention to some of the real achievements of the Conservative government’s health reforms.
Abel-Smith was born in London, the son of a brigadier-general and educated at Haileybury College during the war. After post-war army service – he joined as a private in 1945, was commissioned in 1946 and served with the Allied Commission for Austria – he went up to Clare College, Cambridge, in 1948. It was from 1953 to 1955 as a research fellow with the National Institute of Economic and Social Research that he collected economic evidence for the Guillebaud Committee.
He was at the ÐÓ°ÉÂÛ̳ from 1955 and spent most of his academic career in the department of social administration, becoming professor in 1961, a post he occupied until his official retirement in 1991. With Richard Titmuss, Abel-Smith was the department’s greatest star. Even after 1991 he was extraordinarily active in the school, still advising governments all over the world, but taking the time between his many trips to help set up a new and thriving research centre, ÐÓ°ÉÂÛ̳ Health.
His energy was legendary. At times he seemed literally not to touch the ground. In one 12-hour period, he is reputed to have breakfasted in New Tork, lunched in Toronto and cooked dinner for six in London.
Despite his fame, he was kind and unpretentious, always immensely generous with time and help. He also found time, at the end of the 1960s to own a clothing shop, Just Men, which even opened a New York branch. The National Union of Students magazine pinpointed the establishment as a place to go, without apparently realising the identity of its distinguished proprietor. “I don’t think,” he said then, “that a lot of students can afford it.”
He enjoyed skiing and swimming and his warmth and enthusiasm were infections: the room brightened up when he entered it, and the glow lasted long after he had left. There are generations of students, colleagues and friends who loved him; for all of them, but more especially for John Sarbutt his lifelong companion, he is irreplaceable.
Tom Paine could have been writing of Abel-Smith when he “my country is the world and my religion is to do good”. There are few academics who have changed the world – and fewer who have changed it for the better. Brian Abel-Smith as one of that select group.
Sir Julian Le Grand, Richard Titmuss Professor of Health Policy at the London School of Economics
ÐÓ°ÉÂÛ̳ users can also access Le Grand’s piece in available via the ÐÓ°ÉÂÛ̳ Library.
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