Evidence, Encounters and Effects of South Africa's Reforming Gluckman National Health Services Commission, 1942–1944

The progressive recommendations of the National Health Service Commission of 1942–1944 have attracted historical attention but the three and a half million words of evidence given to it have hardly done so. This article reviews this testimony, which gave unrivalled detail on the fragmented state of South Africa's healthcare structures and on the variety of its personnel. In addition it supplied insights into social attitudes and prejudices related to health and medicine in a racially segregated society on the eve of apartheid. The paper analyses the problems that this ground-breaking commission encountered, and explores whether there were ‘lions in the way’ of its reforms, as was suggested in an encounter with an influential witness. The article probes whether there was a tangential relationship between the evidence, and the commission's conclusions on new health centres as the basis of a radical new national health system. In evaluating whether these reforms were stultified by the election of an apartheid government in 1948 (as others have argued), it concludes that the Gluckman recommendations had already failed before this because they ignored political and professional interest groups. The article also assesses reasons for the contrast between the commission's grandiose recommendations and its modest effects.