The approach of World War II in 1939 dramatically emphasized the weak­ ness of existing medical facilities and the need for reform, particularly in relation to national and regional planning of hospital and specialist services. Heavy civilian casualties from air raids were expected in the first months of hostilities, and both beds and medical staff would be needed. The existing rapport between the Ministry of Health and the Royal Colleges facilitated such arrangements. The presidents of the Colleges urged doctors to accept the terms of the new Emergency Medical Service (EMS) in 1939,1 and lead­ ing members of the Colleges were influential in ensuring its overall admin­ istration and success. From these wartime arrangements of medical services, and from a number of reports issued during the war and immediately after, came a new National Health Service-catalyzed by the disruption of the war years but built on ideas that had crystallized in the 1930s.