Gerard Vaughan was unusual as a minister in that he had practical experience in the field for which he was responsible. He spent two decades as a consultant at Guys Hospital specialising in community affairs and social medicine and only relinquished his appointment when Margaret Thatcher offered him the post of Minister for Health within the Department of Health and Social Security. He was not an enthusiast for the Bevanite model of a National Health Service and instituted studies into the way healthcare was organised in the United States, France and other European countries. He was a very early proponent of the idea that an insurance-based system might have more to offer than a tax-based system and in November 1974 proposed "total insurance cover" as the second stage in the reform of the NHS. Even today, when his ideas would find more favour, the prevailing view within the NHS is still deeply hostile to any attempt to change the basis of its finance even though the French system is widely regarded as offering a better service. His advocacy was almost certainly a factor in Margaret Thatcher's decision to appoint him Opposition spokesman on Health, although the Shadow Cabinet post dealing with Health and Social Services went to Norman Fowler. Ironically in the light of later events, he was instrumental in persuading Fowler to accept demotion to shadow the Ministry of Transport when Margaret Thatcher reshuffled her shadow Cabinet in 1976. Patrick Jenkin, who took Fowler's place, became the Secretary of State in May 1979. Like the Chancellor, Geoffrey Howe, Jenkin was attracted by the idea of a shift to an insurance based system and therefore very open to Vaughan's ideas.
Vaughan had formed the Conservative Medical Society in 1975 and had chaired the opposition working party that called for tax relief on private medical insurance in 1976, an idea that finally became part of the Government's thinking, at least so far as the over 65s were concerned, at the end of the 1980s. Although Vaughan's advocacy of an insurance based system was reflected in the work of the Conservative Health Study Group before the General Election - the Government was to carry the unacceptable risks and support those who could not afford the necessary premium - his ideas fared less well in Government. Jenkin duly set in train an examination of the idea on taking office and Vaughan publicly advocated the move in November 1980. But it was July 1981 before Jenkin announced a working party on alternative finance and after an initial report in November (made public by the Independent seven years later), its work was brought to an end by Jenkin's successor as Secretary of State, Norman Fowler, in February 1982. Vaughan asked for a move and in March 1982 was named Consumer Affairs Minister when Sally Oppenheim left the Government.
Vaughan was ahead of his time in other respects. He believed in a larger role for the private sector and in June 1980, as a preliminary step to securing greater cooperation between the public and private sectors, urged health authorities to contract out more of their work to private clinics. The Regional Health Authorities responded in a manner that at best could be described as tepid. They believed that the solution to the problem of waiting lists was more cash and they argued that making use of expensive private facilities was not the best way to make use of the limited cash at their disposal. It is only fair to add that they had their hands full with a major reorganisation of the Health Service, which the Secretary of State and Vaughan had set in train in 1979. This consigned ninety area health authorities to oblivion and empowered the District Health Authorities; while the move was clearly sensible, it was thought to signal a victory of the health service power groups over the market-oriented reformers and Howe was later to confide to a delegation of Conservative MPs that the attempt to create a responsible lower tier organisation had secured the worst of both worlds, loss of control at the centre, but insufficient independence and responsibility at local level.
Vaughan's ministerial career ended in controversy. While investigating the activities of a CND activist, Joan Ruddock, he announced that he would halve the Government grant to Citizen's Advice Bureaus, a decision that he was forced to reverse after a staggeringly inept Commons performance. After the 1983 election he was not continued in office.
Gerard Folliott Vaughan - the middle name derived from his mother - was the son of Leonard Vaughan DSO, DFC, a sugar planter turned RAF pilot, who died on active service. He was born in Portugese East Africa, where he was educated privately. He studied medicine at Guys, qualifying in 1947, and at the Maudsley. Subsequently he became a member (1949) and fellow (1966) of the Royal College of Physicians. He took a Diploma in Psychological Medicine in 1952 and in 1972 became a Fellow of the Royal College of Psychiatry. From 1958 until 1979 he was a consultant at Guys where he was the physician in charge of the Bloomfield Clinic. However, he was already active in Conservative politics, fighting the 1955 General Election in the safe Labour seat of Poplar, and co-opted subsequently on to the London County Council as an Alderman. He was elected to the LCC for Streatham in 1961 and subsequently secured election to the Greater London Council for Lambeth in 1967, subsequently serving as an Alderman until 1972. He chaired the Strategic Planning Committee 1968-71 and served on the South East Planning Council.
In 1967 he was adopted for Reading, a Labour marginal, and in 1970 turned a Labour majority of 4,133 into a Conservative majority of 1,154. When the constituency was split in two, he chose to fight Reading South, a seat that he held until 1983. After further boundary revisions he was adopted for Reading East, and held that seat until he stood down in 1997. He had campaigned as an anti Common Marketeer in 1970 and was noticeably ambivalent about British entry in 1971. Towards the end of his parliamentary career he was one of the minor rebels against the Maastricht Treaty. Neither his euroscepticism nor his vigorous backing of the Labour MP, Jack Ashley's campaign to secure compensation for the Thalidomide victims prevented Heath from appointing him an assistant Whip in March 1973. He was to serve as chairman of the medical panel to judge compensation for children afflicted by thalidomide 1973-4 and was briefly Francis Pym's PPS before becoming a whip in March 1974.
As Conservative health spokesman from 1975 he promised the restoration of the pay beds phased out by the Labour Government and was sharply critical of the Government's limitations on private practice. He also joined with Ashley again in 1977 to harry the Labour minister of health for his refusal to compensate those children who had been harmed by immunisation, a campaign that forced the Government to make limited compensation available. Ashley hoped for further action from the Conservatives, but once in government Vaughan's evident sympathy for their cause could not prevail against arguments that there were other priorities for limited health budgets. Nor did Vaughan win his fight to make Britain self-sufficient in blood products, although he did secure from the Treasury sufficient funding to double the production of factor 8. He was a keen supporter of fluoridation, but disappointed many who had wanted tougher action on smoking by adhering to the line he had first taken when co-sponsoring the Nabarro bill in 1971 to print health warnings on cigarette packets. He was ready to concede that in certain circumstances contraception should be available to under 16s, a good example of his pragmatism, but equally firmly behind the Corrie bill to put a 24 week ceiling on abortions. When it failed to pass, he made it tougher for surgeons to permit abortions. One of his lifelong enthusiasms was for homoeopathy, and he is widely remembered for his prompt action as a minister to limit the closure of wards at the Royal London Homoeopathic Hospital.
After his departure from Government, he joined one or two private health companies, chairing Private Medical Centres PLC from 1986. But he remained an active backbencher, serving on the select committees on education 1983-93 and science and technology 1993-7. Always a friend and supporter of Margaret Thatcher, he allowed himself the occasional rebellion, most noticeably against charges on dental and eye tests, but also against limits placed on local authorities' ability to spend the profits of council house sales. He favoured a ban on experiment with embryos and as the threat of AIDS became apparent, he not only urged the provision of free needles to drug addicts, but more controversially favoured the screening of visitors and immigrants from Africa, a move that led several voluntary bodies to withdraw from his UK Aids Foundation in 1986. He remained a keen advocate of an insurance based NHS, presiding over a Carlton Club discussion in 1987 that resulted in a report backing that reform, but he lent strong support to Kenneth Clarke's reforms in 1989 despite his disappointment that they did not go further.
Best characterised as a flexible rightwinger, Vaughan was an engaging and congenial figure. His "bedside" manner when speaking was not universally admired, however, and he was known on occasions to boil over. Critics of his ministerial performance thought, a little unfairly, that he could have dome more to get a grip on the health service budget and his ideological commitment to reforming the financial basis of the service was thought misplaced. On that issue, it is only fair to say that the subsequent history of the NHS has perpetuated the debate and he may yet have the best of the argument. He was a man "full of benevolent intent", capable of earning plaudits from political opponents, most notably from Jack Ashley, who paid warm tribute to the wonderful work he did for Thalidomide children and for the courage he showed in opposing the Heath Government's attempts to close the subject down.