So in England there has been some form of state funded health and social care before the NHS for 400 years. However, the fundamental roots of the National Health Service can be traced back to the nineteenth century, when legislation in the Public Health Act 1848 addressed poor sanitation and living conditions. At the beginning of the 20th century, the state health service began to develop more systematically. Inspired by the findings of those who were recruited to fight in the Boer War and were found unfit. In 1919 the Ministry of Health was established and national health insurance was developed. Free access to GPs was provided to some groups of workers; in the 1940s, approximately 21 million, half the population, were covered, and two-thirds of family doctors participated in the program (Ham 2009). In the nineteenth century institutional healthcare had been dominated by workhouses and Poor Law infirmaries, in 1929 these were transferred to the Local Authorities (LAS) to be developed into a local hospital service, alongside commercial and voluntary hospitals who had also grown up since then, and because of the mental disorders that had developed since 1800. Getting healthcare in Britain in the 1930s and 1940s was difficult, life expectancy was very low and thousands of people died every year from infectious diseases such as pneumonia, tuberculosis, polio, meningitis and diphtheria. The poor never had access to medical care and relied on doctors who provided their service for free, hospitals charged for treatment and although the poor were reimbursed, but before receiving treatment they had to pay. In the 1930s a series of reports, including studies by the British Medical Association, the collective voice of GPs and hospitals