<P> The National Health Service in England was created by the National Health Service Act 1946 . Responsibility for the NHS in Wales was passed to the Secretary of State for Wales in 1969, leaving the Secretary of State for Social Services responsible for the NHS in England alone . </P> <P> Dr Benjamin Moore, a Liverpool physician, in 1910 in The Dawn of the Health Age was probably the first to use the words' National Health Service' . He established the State Medical Service Association which held its first meeting in 1912 and continued to exist until it was replaced by the Socialist Medical Association in 1930 . </P> <P> Before the National Health Service was created in 1948, patients were generally required to pay for their health care . Free treatment was sometimes available from Voluntary Hospitals . Some local authorities operated hospitals for local ratepayers (under a system originating with the Poor Law). The London County Council (LCC) on 1 April 1930 took over from the abolished Metropolitan Asylums Board responsibility for 140 hospitals, medical schools and other medical institutions . The Local Government Act 1929 allowed local authorities to run services over and above those authorised by the Poor Law and in effect to provide medical treatment for everyone . By the outbreak of the Second World War, the LCC was running the largest public health service in Britain . </P> <P> Dr A.J. Cronin's controversial novel The Citadel, published in 1937, had fomented extensive criticism about the severe inadequacies of health care . The author's innovative ideas were not only essential to the conception of the NHS, but in fact, his best - selling novels are said to have greatly contributed to the Labour Party's victory in 1945 . </P>

What was before the nhs and welfare system