Set in Great Britain in the inter-war years, A J Cronin's The Citadel is often credited with sparking off the movement that led to the establishment of the National Health Service. The novel begins in 1921 with the arrival of a young doctor, Andrew Manson, to Drineffy, a Welsh mining town. It tells the story of his rise from a young physician's assistant to a successful consultant in London. It is an interesting and enlightening document of the medical system existing at that time. At the same time, it is a romance, beginning with his falling in love with Christine, a primary school teacher, and moving on to their marriage and, then, as he moves up the social ladder, his liaison with Frances, a married woman, who teaches him how to be successful. The novel ends with an idealistic coming together of Andrew, his surgeon friend Denny, and a maverick pharmacist, Hope. The three decide to set up a type of polyclinic in a moffusil town, moving out of avaricious and overcrowded London to deliver medical care where it is most needed and on sound scientific principles.