2The National Health Service We will learn:What happened before the NHS was createdThe 5 stages leading to the creation of the NHS in 1948What was the NHS designed to doWhy were some people against the NHS being formedRemember, there is a high chance that this will be a question on paper 2!It could also appear on paper 1!
3Towards 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 schemesCharities and churches did often help with the costsbut somebody had to pay for medicines or treatments received.Government did pay medical costs for the military!
45 Stages towards the NHS Pre World War I 1911 National Health Insurance Scheme introduced by a reforming Liberal governmentWorkers 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!
55 Stages towards the NHS World War One The government had to massively expand hospitals and medical care for the millions of soldiers mobilisedSoldiers were promised a “Country fit for heroes” to thank them for their sacrificeHowever, there was little money spare after the costs of war were accounted for.But, women were given the vote in 1918
65 Stages towards the NHS Inter War Years The development of the Labour MovementSocialist ideology wanted to help working class people.It believed in sharing out the resources of the country in an equitable wayThe Labour party gradually gathered in strength throughout the 1920s and 1930sThe Great Depression of the 1930s showed how vulnerable the poor could be.
75 Stages towards the NHS World War 2 Blitz brought the casualties to the civilian populationNot just soldiers getting injured this time around.Coalition government of Labour, Liberals and Conservatives all working together for victory.1942 Beveridge ReportBritain would benefit from a “Cradle to Grave” social security systemHealthy citizens would be needed to rebuild Britain after the war.The report was popular with soldiers fighting and the civilians at home.
85 Stages towards the NHS Post World War 2 Labour Party elected with a huge majority in 1945Socialist ideology1946, they proposed creating a National Health Service available to all paid for through national taxation.July 5th 1948 the NHS is created!
11Available to all according to need Arguments for NHSArguments against NHSAvailable to all according to needSick do not have to worry about paying the bill – less stressEfficientno insurance forms to fill inNHS can set its own prioritiesEg Public Health measures,Immunisations, health checks, cancer screening, family planningStandard contracts?Doctors and nurses have the same pay and conditionsCost –Expensive treatments may have to be rationed/limitedUnlimited demandThe longer you live, the more medical care you need.Waiting times for non-emergency operationsCrowd out charities?Bad for insurance companies
13What does the NHS actually do? Hospital servicePriority for medical emergenciesParamedic serviceMedicines made available by prescriptionDental servicesFamily doctor ServiceAnte-Natal servicesPost-Natal servicesVaccinations & ImmunisationsPhysiotherapyMental Health facilitiesTraining of doctors and nursesConducts researchScreeningHealth EducationHealth warningsFamily Planning
14Opposition to the NHSWho was against the NHS being set up in 1948?
15Opposition 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 costMany 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.
16What 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
20Public Health in the 20th Century Improved HousingUse page 176 to explain how social housing was improved by the government throughout the 20th centuryClean Air Act 1956What was this for? What did it do?Page 177
21Modern challenges to Public Health ProblemHow has it been addressedDifficulties still to faceFresh WaterMost people have access to fresh waterIs there enough clean water?Sewage disposalWaste DisposalAir PollutionHousingSafety at workFood safetyInternational Public Health
23Factors to consider Government Religion War Individuals Luck / Chance CommunicationsScience and TechnologyConservatismCreate a spider diagram for each of the factors. Think of examples of each factor has influenced medicine and health (positively and negatively)
24Factor 1: GovernmentHow have governments influenced health through the ages? p188Give 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?
25Factor 2: ReligionGive 5 examples of how religion has affected medicineAre these examples of change or of conservatismIn which periods was religion particularly importantGive examplessHas religion done more to cause change or to promote continuity?How important has religion been in the history of medicine?
26Factor 3: War Give 5 examples of how warfare has influenced medicine? Give examples of warfare promoting new ideas in medicineWhich civilisations were particularly concerned with the health of its soldiers?