In 1948 an animated public information film called Your Very Good Health explained the benefits of Britain’s soon-to-be-introduced National Health Service (NHS).1 It portrayed two different categories of hospital patient. The central character, Charley, says he is ‘on the panel’ as he cycles through an optimistic impression of a new town.2The narrator asks him to imagine that he fell off his bike: ‘You’d be carted off in an ambulance, which might cost a couple of quid. And then you’d have to pay the hospital, too.’ After he is convinced the new service will benefit him, Charley asks about ‘old George up the road’, who we first see walking past, wearing a bowler hat and carrying a brolly. When Charley asks him what would happen if he fell off a ladder he replies: ‘I should call my doctor and have a private ward at the local hospital.’ After the narrator describes the possibility of a series of spe-cialist referrals and mounting payments, George is relieved and con-vinced that the new health service will benefit him too.Why or how Charley would need to pay the hospital did not need explaining to a 1940s audience. Nor did the difference with the system under which George might incur mounting costs. Perhaps it was so ingrained in the everyday tapestry of British social life that it simply went without saying. The problem is that, looking back from the best part of a century later, we do not really know what went without saying. It is all too easy for those of us who have grown up with the NHS to anachronistically impose our own assumptions, either that things were the same or that they were different, onto the hospital system operating before 1948. We might assume that historians would be wise to this, but too often when they refer to payment in the pre-NHS hospitals they fall into precisely this trap. Although the abolition of payment became he most distinctive and widely recognised feature of the NHS, we never ask, or else take for granted, what the predecessor of a health service free at the point of use was, how it worked, or what it meant to hand over money to the doctor or the hospital.