The NHS at 70: The founding of the RCGP

When the NHS was founded in 1948, most GPs were barred from full participation in the existing royal colleges. Dr Christopher Timmis explains how a group of pioneering family doctors established a college of GPs in an effort to raise standards and boost morale.

Drs John Hunt (left) and Fraser Rose first proposed a College of General Practitioners (Photos: RCGP Archives)
Drs John Hunt (left) and Fraser Rose first proposed a College of General Practitioners (Photos: RCGP Archives)

The College of General Practitioners, later to become the Royal College of General Practitioners (RCGP), was founded in 1952 by a small group of ten GPs. There had been calls to create a college for many years. An attempt in the 1840s had only narrowly failed, but nothing had been done since then. Why did this all change in the 1950s?

The arrival of the NHS in 1948 had resulted in a significant increase in GP workload. Conflicts with the government over pay further angered GPs until eventually (though temporarily) resolved in their favour by Judge Danckwerts in 1952.

This was a time of increasing specialisation. The Royal College of Obstetricians and Gynaecologists had recently been founded. Most GPs were barred from full participation in the three royal colleges (of Physicians, Surgeons, and Obstetricians and Gynaecologists), and were widely regarded as second-rate doctors who had fallen off the hospital career ladder.

However, during the war many GPs had worked in the armed forces on a more equal footing with specialist colleagues and they were little inclined to accept second class status.

Before the NHS many GPs held part time posts as specialists in their local hospitals. When the NHS was introduced the staffing of hospitals was reviewed and almost all GPs without specialist qualifications lost their hospital posts. This caused much resentment.

Into this atmosphere of discontent, the 1950 report into UK general practice by Joseph Collings described a deplorable situation with widespread poor standards. It sparked a furore. Many felt it was unfair, but there was a general feeling that there was also an uncomfortable element of truth in it and something more had to be done.

A new college

Two GPs, Drs John Hunt and Fraser Rose, independently became convinced that a college would help to restore GP morale, improve standards and raise the status of general practice. They met late in 1951 at the BMA and wrote a joint letter to the medical press proposing a college.

They were overwhelmed with the encouraging replies they received from GPs up and down the country.

The two pioneers gathered a nucleus of experienced GPs from all parts of the UK, together with some supportive specialists and legal advisers. They were fortunate to enlist an excellent chairman in Henry Willink, ex-minister of health. This ‘steering group’ met in London eight times through 1952 and thrashed out a constitution for a new college.

It was far from plain sailing because there was intense and widespread opposition from the establishment, especially the royal colleges, and the discussions effectively had to be carried out in secret. The Memoranda and Articles of Association were signed by all ten GP members of the steering committee in November 1952 and the new College of General Practitioners was announced a month later.

Supporting research

The fostering of research in general practice was one of the founders’ key aims and a research committee was set up in January 1953. An early success was the quarterly Research Newsletter which reported on research work by college members.

In 1958 the newsletter developed into the Journal of the College of General Practitioners. The editors courageously maintained the focus of the journal on original research in general practice, rather than the more lucrative educational review articles. Articles were peer reviewed before being accepted and in 1961 the Journal was included in the American Index Medicus, the first time in the world that a journal from general practice was recognised in the scientific literature.

As well as gradually building an evidence base for General Practice these researchers were starting to define the work of the GP and the special skills that were required.

In 1972 the college’s publication The Future General Practitioner – Learning and Teaching comprehensively described the scope of GP work and set out educational aims for vocational training. General Practice was now presented as a distinct discipline which could and should be taught largely in the GP setting. Three-year Vocational Training for new GP principals became compulsory in 1981.

A royal college

Early in 1967 the college approached His Royal Highness Prince Philip, Duke of Edinburgh, with regard to royal patronage of the college. Prince Philip responded favourably but suggested that the college ‘would get more out of him(!)’ if he was involved as part of some special anniversary year.

As an interim measure in 1967 Her Majesty the Queen graciously commanded that the college should henceforth be known as the Royal College of General Practitioners. In 1971 the college successfully petitioned Her Majesty for the grant of a Royal Charter and this was formally handed over by The Duke of Edinburgh on 1 November 1972 when he was appointed an honorary fellow and elected as president –  twenty years to the month after the college’s founding.

Possessing a royal charter provided a major boost to the prestige of the college and put it on a level footing with the other royal colleges. In 1967 after the ‘Royal’ prefix had been granted the GMC and the Editor of the Medical Directory both recognised the qualifications of MRCGP and FRCGP.

The royal charter is also regarded as one factor in increasing the numbers of universities willing to set up chairs of general practice during the early 1970s. The college has continued to pursue its aims of supporting general practice and maintaining high standards and is today the largest UK medical college with over 50,000 members.

  • Dr Christopher Timmis is a retired GP from Middlesex and  a member of the RCGP Heritage Committee.            

Read more about the NHS at 70

Further reading

  • Pereira Gray, D (ed.)  Forty Years On – The Story of the First Forty Years of the Royal College of General Practitioners.  London: Atalink Ltd, 1992.
  • Fry J et al (ed.)  A History of the Royal College of General Practitioners – The First 25 Years. Lancaster: MTP Press, 1983. 

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