The National Health Service was born on July 5, 1948. It had been some time in the coming. Four decades earlier Beatrice Webb, co-founder of the Fabian Society, pressed for a national health service. She called it a state medical service, in a minority report to the Royal Commission on the Poor Law.

Even as she set out her idea of universal health care the Liberal Prime Minister, Llloyd George, was setting up the country's first state-organised insurance scheme labelled ''Ninepence for Fourpence''.

In return for a worker's fourpence a week in national insurance contributions employers would pay in three pence and the state a further two pence.

This would provide the services of a doctor for all male workers earning under #160 a year, a sum equal to just a little bit more than average manual earnings.

But hospital care was not included, nor did the scheme cover wives or children.

The ''Ninepence for Fourpence'' scheme, which took effect in 1911, was administeed by so-called approved societies, some of which, in return for additional contributions, provided such things as spectacles and dental care and even looked after other family members. For those who could chip in enough, even hospital care was available. In all, some 21 million people were covered by Lloyd George's insurance scheme.

But the nation wanted more, and in the next 20 years a Ministry of Health Committee, a Royal Commission, and a study by the British Medical Association all called for reform.

But it was not until 1942 that economist William Beveridge, Indian-born of Scottish descent, rallied widespread support - from political parties as well as the electorate - for the establishment of a national health service.

Beveridge's clarion call came in his ''Report on Social Insurance and Allied Services'' - the so-called Beveridge Report - a comprehensive scheme of social reform for the whole community regardless of income.

Published at the height of the Second World War it led, in 1946, to the passing of the NHS Act. But it was a further two years before the Labour Government's Minister of Health, Aneurin Bevan, used Beveridge's blueprint to set up the NHS.

Not without considerable struggle Bevan nationalised some 1540 hospitals. Skilfully he avoided conflict with consultants by allowing them private practice alongside their NHS duties. But he ran head-on into determined opposition from the nation's general practitioners.

With the British Medical Association speaking for them they dug their heels in against many aspects of the NHS proposal that would affect their independence and remuneration, their arguments generally presented as resisting a threat - less real than imagined - to the freeedom of patients to choose their own doctor and of the right of doctors to practise their craft free from interference.

The dispute was noisy and bitter and, when it seemed that BMA opposition would prevent the NHS from setting up on the appointed day, Bevan found it possible to assure family doctors that it was no part of his intention to create a whole-time, salaried service - doctors would continue to be paid on the basis of a capitation fee.

So Bevan won through, overcoming also stiff opposition from the Conservatives who, although approving the principles of Bevan's NHS, none the less repeatedly voted against the Bill in parliament, siding with the reluctant hospitals and outraged GPs unwilling to be conscripted to the new deal.

But the NHS was an idea whose time had come, the opening statement of the foundation stone White Paper of 1944 setting out its aims and ideals, stated: ''Everybody, irrespective of means, age, sex, or occupation, shall have equal opportunity to benefit from the best and most up-to-date medical and allied services available.''

The service was to be ''comprehensive'' for all who wished to take advantage of it, was to be ''free of charge'', and was to promote good health ''rather than only the treatment of bad''. Only now, half a century on, is the last plank in NHS policy receiving more than just lip service.

But what did July 5, 1948, actually mean to the millions of patients for whom the NHS was intended? Would they make good use of it, take full advantage of something for nothing without embarrassment?

Bevan said the NHS would ''lift the shadow from millions of homes'': the heartache of not being able to afford to have a sick child tended by a doctor, the indignity of means testing by hospital almoners, the fear of the middle classes faced with substantial bills they could not easily meet.

Dr John Marks, past secretary of the BMA, has lived with the NHS every day of his working life. For it was on July 5, 1948, that he saw his finals results posted on a notice board at Edinburgh University's medical school, the very same day that the National Health Service was, to use the official phrase of the time, ''vested''.

''Before the arrival of the NHS, health care was piecemeal - a patchwork of friendly societies, doctors' clubs, and panel systems for workers only. Frankly, it wasn't much cop. A lot of people simply had no health care at all because they couldn't afford it,'' says Dr Marks

''Also, the hospitals were all bankrupt. The setting up of the NHS was the greatest social experiment of all time. People talk about the good-old days - they were the bloody awful bad-old days.''

Dr Marks, who worked first as a hospital doctor before moving to general practice, adds: ''When the NHS began there was very real need. When I started working in a hospital in the summer that the NHS came into being I saw the lot, hernias, prolapses, osteomyelitis, hip dislocations. Also, it was obvious that what many patients needed was good food and fresh air - not a doctor.

'' Now, of course, if you have a sore finger . . .''

Dr Andrew Doig came into the NHS five years after it began. Now retired, he became a consultant physician at Edinburgh Royal Infirmary. He recalls boyhood memories of the days when medicine cost money, and many could not afford it.

''There were often difficulties in meeting a doctor's bill - a visit cost 2/6d - and delays in calling for medical help did result in the occasional tragedy.

It was a worry, but I know that in many cases doctors simply did not send in a bill - for example, if they had attended a widow or a child. Also, where there was what might be called a mixed practice, a poor area and a rich one side by side, the rich subsidised the poor.

'' But the poor were often very proud, they felt they had a duty to pay the doctor even if they were unemployed. And consultants would often give advice wondering if the patient could afford it. The result of the NHS was that we could get on with doctoring and forget the financial side.''

The benefits of the NHS were appreciated on a wide front, says Dr Doig, recalling a hospital encounter.

''I was looking after a number of mental patients and the charge nurse, a man, was delighted with the new system. For the first time, he told me, he was able to feed the patients with good food instead of simply broth and bread.''

One of Bevan's beliefs, says Dr Doig, was that if the sick and injured could get speedy treatment and be got back to work as soon as possible the resultant benefit to the nation would make the treatment self-financing.

''But, as we now know, the more services provided the more people stay off work. Today they expect more.''

Dr Marks, too, points to an early misconception in government about how the health service might work in its early days. ''The idea was that if we could improve the standard of living and health the calls on the NHS would drop - the pressure would be taken off the service after, say, five years when everything was put right.''

But it never was put right. New medicines, new technologies and treatments, and ever greater expectation by the public have ensured that in setting up the NHS politicians had created a machine for generating new demands, invented a financial treadmill for themselves.

Whatever their political investmentthey would, in the words of one academic: ''Forever be chasing a metaphysical, ever-elusive concept of adequacy. They could never do enough.''

But in recent years, while demand on the NHS remains unrelenting, there has been a political shift in attitude apparently light years removed from the early-days idea that a pool of ill health could be mopped up and the nation left healthy. Or is it all that different? Where once the language of the NHS concentrated on ''illness'' there is now increasing emphasis on ''health''. Likewise ''treatment'' is losing ground to ''prevention'' and ''cure'' to ''care''. Most significantly, ''disease'' is now thought of as ''behaviour-producing disease''. Where illness was once held to be the concern of the medical profession, today health is seen as the business of everybody.

That is now, but then was then, and from the outset, as the NHS - in Bevan's phrase - sought to ''universalise the best'', it was obvious that a rich seam of unmet need had been tapped, a backlog of poverty and neglected treatment that would not easily be satisfied.

GPs' surgeries filled with patients, mothers with sick babies, labourers with hernias, every ill and ailment imaginable.

Soon reports of abuse of the system began to appear in the press: patients demanding cotton wool, surgical spirit, and aspirin, all free. Some waiting-room queues were swelled, it was claimed, by British nationals who had emigrated, then come home for medical attention: a holiday to the homeland combined with a physical refit - spectacles, false teeth, even surgery.

As demand increased Bevan said: ''I shudder to think of the ceaseless cascade of medicine which is pouring down British throats.''

It was not just patients who gained from the new service. One Clydeside GP recalled that he used to charge one shilling and sixpence for a consultation. ''They laid the money on the desk as they came in. It was all rather embarrassing.''

Visits to the patient's home came dearer. Fees ranged from two-shillings-and-sixpence to seven-shillings-and-sixpence . . . the higher rate reserved for foremen and under-managers from the Clyde's heavy industries.

According to the Clydeside GP: ''We would send out the bills but about one-quarter would be bad debts. Some you simply didn't bill because you knew they couldn't pay. The NHS, thankfully, got rid of all that.''

With a vengeance. But the taxpayer paid, and has been paying ever since. From the outset the NHS has been funded from the public purse and essentially no other source. It is a system that has put health care in this country in a straitjacket.

But with politicians mindful of voter discontent with higher taxes the popular prejudice is to underfund the service, throwing in extra payment only in an emergemncy.

It was ever thus. Just four months after the NHS had been launched Bevan told his parliamentary colleagues: ''The rush for spectacles, as for dental treatment, has exceeded all expectations.

''Part of what has happened has been a natural first flush of the new scheme, with the feeling that everything is free now and it does not matter what is charged up to the Exchequer.

''But there is also, without doubt, a sheer increase due to people getting things they need but could not afford before, and this the scheme intended.''

The bald fact of the matter was that within just 100 days of the arrival of the NHS the disparity between demand and funding that persists to this day had become very evident. Bevan had learned that the original estimate of #176m for the year 1948/49 would be exceeded by one-third and some #225m was required by the end of the first 12 months.

To help it out of its financial bind a supplementary estimate of #59m was voted for the NHS that first year, with #98m extra over estimate needed in 1949/50.

Bevan, as usual, had an answer, delivered even before the launching of the NHS. ''We shall never have all we need,'' he said.

''Expectations will always exceed capacity. The NHS must always be changing, growing, and improving: it must always appear inadequate.''

Bevan hit out at abuse in the system - ''whether by health professionals or by the public'' - and full value for money became the battle cry. But something had to give. In 1949 the Government passed legislation giving it power to impose a shilling (5p) prescription charge with the aim both of raising #10m in revenue and reducing the cascade of medicine going down British throats that was causing Bevan such concern.

Proposals were put forward to scrap the NHS dental service and to introduce a ''hotel'' charge for hospital beds.

After a stiff rearguard action by Bevan these proposals were confined to charges for dental work and optical services, the aim being to contain NHS expenditure within the #400m budget settled on just three years after the service was born.

On the tenth anniversary of the NHS Bevan was to claim that what he regarded as the greatest achievement of his political life was '' regarded all over the world as the most civilised achievement of modern government''.

Almost 5500 non-psychiatric hospital cases due to alcohol abuse were dealt with in Scotland in 1966, 1466 of the patients suffering from chronic liver disease. A further 3734 admissions were made to mental illness hospitals and psychiatirc units as a result of alcohol abuse in the same year.

That may have been the case 40 years ago. But today the political football that is the NHS is not delivering to nationwide acclaim. Waiting lists lengthen, the private sector of health care separates those with money from those who have none, and there is an acute shortage of doctors.

For more than four decades the NHS has been not so much an instrument for meeting needs, as conceived by its founding fathers, but an institutional device for rationing scarce resources.