1. The National Health Service
The Welfare State

2. 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!

3. 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!

4. 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!

5. 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

6. 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.

7. 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.

8. 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!

10. Arguments for NHS
Arguments against NHS

11. Available to all according to need
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

13. 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

14. Opposition to the NHS
Who was against the NHS being set up in 1948?

15. 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.

16. 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

17. Public Health in the 20th Century

18. Public Health in the 20th Century

19. Public Health in the 20th Century

20. 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

21. 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

22. Factors that have influenced Medical Advances

23. 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)

24. 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?

25. 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?

26. 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?