The National Health Service

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The National Health Service

• The Welfare State

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The National Health Service

• We will learn
• What happened before the NHS was created
• The 5 stages leading to the creation of the NHS
  in 1948
• What was the NHS designed to do
• Why were some people against the NHS being formed
• Remember, there is a high chance that this will
  be a question on paper 2!
• It could also appear on paper 1!

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Towards the welfare state

• Before 1948 all health care was the
  responsibility of private individuals to pay for
  the care they received.
• Some paid into insurance schemes
• Charities and churches did often help with the
  costs
• but somebody had to pay for medicines or
  treatments received.
• Government did pay medical costs for the
  military!

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5 Stages towards the NHS

• Pre World War I
• 1911 National Health Insurance Scheme introduced
  by a reforming Liberal government
• Workers were forced to contribute to a special
  fund that would help pay if they got sick or were
  unable to work.
• Although only available to workers!
• Not their wives or children!

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5 Stages towards the NHS

• World War One
• The government had to massively expand hospitals
  and medical care for the millions of soldiers
  mobilised
• Soldiers were promised a Country fit for heroes
  to thank them for their sacrifice
• However, there was little money spare after the
  costs of war were accounted for.
• But, women were given the vote in 1918

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5 Stages towards the NHS

• Inter War Years
• The development of the Labour Movement
• Socialist ideology wanted to help working class
  people.
• It believed in sharing out the resources of the
  country in an equitable way
• The Labour party gradually gathered in strength
  throughout the 1920s and 1930s
• The Great Depression of the 1930s showed how
  vulnerable the poor could be.

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5 Stages towards the NHS

• World War 2
• Blitz brought the casualties to the civilian
  population
• Not just soldiers getting injured this time
  around.
• Coalition government of Labour, Liberals and
  Conservatives all working together for victory.
• 1942 Beveridge Report
• Britain would benefit from a Cradle to Grave
  social security system
• Healthy citizens would be needed to rebuild
  Britain after the war.
• The report was popular with soldiers fighting and
  the civilians at home.

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5 Stages towards the NHS

• Post World War 2
• Labour Party elected with a huge majority in 1945
• Socialist ideology
• 1946, they proposed creating a National Health
  Service available to all paid for through
  national taxation.
• July 5th 1948 the NHS is created!

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Arguments for NHS Arguments against NHS

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Arguments for NHS Arguments against NHS
Available to all according to need Sick do not have to worry about paying the bill less stress Efficient no insurance forms to fill in NHS can set its own priorities Eg Public Health measures, Immunisations, health checks, cancer screening, family planning Standard contracts? Doctors and nurses have the same pay and conditions Cost Expensive treatments may have to be rationed/limited Unlimited demand The longer you live, the more medical care you need. Waiting times for non-emergency operations Crowd out charities? Bad for insurance companies Standard contracts? Doctors and nurses have the same pay and conditions
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What does the NHS actually do?

• Hospital service
• Priority for medical emergencies
• Paramedic service
• Medicines made available by prescription
• Dental services
• Family doctor Service
• Ante-Natal services
• Post-Natal services

• Vaccinations Immunisations
• Physiotherapy
• Mental Health facilities
• Training of doctors and nurses
• Conducts research
• Screening
• Health Education
• Health warnings
• Family Planning

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Opposition to the NHS

• Who was against the NHS being set up in 1948?

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Opposition to the NHS

• Who was against the NHS being set up in 1948?
• Opposition tended to come from the right ie
  Conservatives who believed that the free market
  was the best way of allocating resources. They
  were mostly worried about the cost
• Many GPs and doctors were also against he idea of
  standardised contracts (BMA)
• Local authorities were not keen to lose control
  over local health provision.
• Bevan conceded generous contracts to win over the
  BMA.

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What kills people today?

• What were the biggest killers a century ago?
• What are the two biggest killers of the modern
  era?
• How come these two are so serious now compared to
  80 years ago?
• Page 170

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Public Health in the 20th Century
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Public Health in the 20th Century
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Public Health in the 20th Century
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Public Health in the 20th Century

• Improved Housing
• Use page 176 to explain how social housing was
  improved by the government throughout the 20th
  century
• Clean Air Act 1956
• What was this for? What did it do?
• Page 177

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Modern challenges to Public Health
Problem How has it been addressed Difficulties still to face
Fresh Water Most people have access to fresh water Is there enough clean water?
Sewage disposal
Waste Disposal
Air Pollution
Housing
Safety at work
Food safety
International Public Health
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Factors that have influenced Medical Advances
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Factors to consider

• Government
• Religion
• War
• Individuals
• Luck / Chance
• Communications
• Science and Technology
• Conservatism

• Create a spider diagram for each of the factors.
  Think of examples of each factor has influenced
  medicine and health (positively and negatively)

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Factor 1 Government

• How have governments influenced health through
  the ages? p188
• Give examples of governments who have become
  involved in health matters.
• Give examples of governments who have tried not
  to get involved in health matters.
• What methods have governments used to change
  medicine and health.
• How important have governments been in improving
  medicine and health?

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Factor 2 Religion

• Give 5 examples of how religion has affected
  medicine
• Are these examples of change or of conservatism
• In which periods was religion particularly
  important
• Give exampless
• Has religion done more to cause change or to
  promote continuity?
• How important has religion been in the history of
  medicine?

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Factor 3 War

• Give 5 examples of how warfare has influenced
  medicine?
• Give examples of warfare promoting new ideas in
  medicine
• Which civilisations were particularly concerned
  with the health of its soldiers?