History of the 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. 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
Rail transport in Great Britain international services including the Channel Tunnel and Port of Felixstowe, which is containerised. Nevertheless, network bottlenecks and insufficient investment in catering for 9' 6" high shipping containers restrict growth. A symbolic loss to the rail freight industry in Great Britain was the custom of the Royal Mail, which from 2004 discontinued use of its 49-train fleet, and switching to road haulage after a near 170-year-preference for trains. Mail trains had long been part of the tradition of the railways in Great Britain, famously celebrated in the film "Night Mail", for which W. H. Auden wrote the poem of the same