Development of Health Care Policy in Great Britain

The growth of healthcare policy in the last century has been shaped by numerous factors. These aspects include social, economic, and political elements: poverty, de-industrialization, and various political ideologies. Social attitudes changing over the nineteenth and twentieth centuries were the major driving force for the advancement of healthcare policies.

In the early 1900s, attitudes were changing and people were becoming more knowledgeable about social issues within the country. The Boer War and both World Wars had shown politicians that the country was poor, unfit, and extremely unhealthy.

Unemployment was rising, and a growing number of people were becoming dependent on assistance from the state. At this time, we had the political influence of a Liberal Government whose ideals, described as social democratic, would shape the health service. Social democratic ideals concerning healthcare were that treatment should be available on a needs basis rather than for those who could afford it and should be provided by the state. They believed that all people should be free from poverty. The social democrats believed that it was the government's duty to care for its citizens. This ideology led to the establishment of Labour exchanges and National Insurance in 1911 to help those who were sick and out of work. Women were given the vote and they helped to highlight the social conditions of the nation. Poverty was rife and was a drain on the economy. It was one of the primary reasons the population was so unfit and unhealthy, as we will see later.

In 1942, Beveridge penned a report aimed to address the five social 'giants': want, disease, ignorance, squalor, and idleness. The report was comprehensive and considered the whole question of social security, arguing that want could be eliminated by a system of social insurance organised for the individual by the state. Beveridge proposed the establishment of a national health service, national insurance, aid, and family allowances. He also emphasized the importance of full employment. Although not exactly as Beveridge had originally hoped, a newly-elected Labour government adopted measures that formed the basis of the British Welfare State. The measures that were introduced included an all-encompassing government insurance program that covered unemployment, sickness, maternity, and widow's benefits.

Pensions, children's and guardians' allowances were also available. A free national health service, training, and industrial injuries schemes were introduced. Full employment became a government policy. Collectively, these advancements created the welfare state, a system of social security ensuring a minimum level of health and social services. Ideally, the welfare state aimed to relieve poverty, reduce inequality, and achieve greater social integration. In many respects, this has had a tremendous effect on people's lives: people are living longer, are healthier, and standards of living have improved. However, the welfare state has fallen short in providing full employment or eradicating poverty.

Poverty is still prevalent in Britain today, a significant drain on the Welfare State. Destitution has evolved over the years, shifting from absolute poverty to relative deprivation. In the early 1900s, many people lived without proper shelter, often unable to feed or clothe themselves, a stark illustration of absolute poverty. The establishment of the welfare state has played a significant role in alleviating absolute poverty; today, it is mostly confined to the homeless. Relative deprivation, however, remains extremely prevalent in today's society. It is more about social exclusion and the inability to afford what the nation as a whole deems necessary, like not owning a television or being unable to socialize.

The primary contributors to poverty in modern society are diverse, including low-paid employment, high levels of unemployment, inadequate benefits for the sick and disabled and a rise in single-parent families. A survey conducted in 1992/93 revealed that 25% of the population, around 14.1 million people, were living in poverty, predominantly from ethnic minority groups, women or the lower classes. The majority of this group were unemployed, dependant on a state pension, or engaged in low-paid part-time jobs. This led to a conclusion that the main contributors to poverty are three-fold: limited access to the job market, the high cost of living, and poor strategies for tackling poverty. Poverty has far-reaching impacts on the nation's health, a fact that became acutely apparent during wartime.

The links between destitution and health are incontrovertible. Not only are the impoverished more likely to endure disease and premature death, but poor health and disability are commonly cited as triggers for poverty. Research has suggested that most people blame the poor for their own financial situation, displaying skepticism towards those who live off government subsidies. The common belief is that those reliant on welfare could find work if they were motivated to do so. Income is a vital resource for families, and those earning less are least able to afford good housing, often living in poor areas devoid of children's play facilities and struggling to access health, education, and recreational services.

Insufficient income restricts these families' ability to purchase foods recognized as essential to health, such as fresh fruit and vegetables, or to maintain warm, dry homes. Poverty affects people's health from birth to old age. At nearly every stage of life, individuals in poorer social classes have higher rates of illness and death than those in wealthier social classes. Studies focusing on child mortality reveal a disparity in the causes of death across social classes. Lower birth weights in infants have been linked to social class, often attributed to parental poverty and poor maternal environments rather than health care quality.

Childhood years death prices from accidents (the biggest solitary cause of death in childhood years) are a clear example of just how living in an inadequate area, without safe backyard has a major effect on the health and wellness of kids. The poorer social classes are ill greater than their richer equivalents and make use of the health services regularly. Almost all significant awesome conditions influence hand-operated classes greater than non-manual courses and in some circumstances are twice as high. There are 2 major descriptions for this, which can be seen, as social and also material. Social descriptions consider how health and wellness inequalities are rooted in the behavior and way of lives of the individual and that those suffering bad health and wellness have different mindsets, worths and way of livings which indicate they do not look after themselves.

Insufficient diet plan, cigarette smoking, alcohol consumption and absence of exercise all have direct results on the health and wellness of a person. Reduced earnings boundaries the kind of food that inadequate individuals can get as well as for that reason the amount of nutrients a person can consume. These adults in low-income families continue to smoke as well as consume alcohol exceedingly or take drugs. Although these adults know the damaging influences it will certainly carry their health, they proceed with this lifestyle since to them it is a means of handling the everyday stress that living in poverty carries them. III health and wellness caused by poverty is consequently a drain on the welfare state in costs to the NHS and also benefits paid with illness and impairment.

Society has actually altered over the centaury and also has impacted on wellness plan. Family structure has transformed from the nuclear 2 parent as well as youngsters to stepparent family members (reconstituted) and also only moms and dad households. Relations are less as individuals relocate away to find job. Separation prices have likewise climbed up because females have actually ended up being extra independent as well as have a lot more legal rights. More women are functioning and also have higher assumptions of marital relationship with much less spiritual meaning behind them. The modification in family structure has likewise had an effect on demographics. As even more ladies pick careers less and also less infants are being birthed and also therefore the birth price is decreasing. The welfare state has actually boosted living problems and also as a result individuals are living much longer. These 2 facts will result in an aging population that has far reaching ramifications. An aging populace will certainly result in a better percentage of state dependant people with much less young people to spend for the solutions. This is a problem, which the Conventional government started to attend to in the 1980s, and is proceeding for the Labour government today.

Financial changes have also contributed to social plans. Since the establishment of the welfare state, Britain has undergone significant alterations in the types of jobs available. Britain has lost many of its national industries, e.g., shipbuilding, mining, manufacturing, and almost all of our fishing industry. These have been replaced by service industries such as care, retail, finance, and leisure sectors--a process referred to as de-industrialisation. During the industrial age, men earned fair wages and had secure jobs. Today, working within the service sector, people work longer hours for less pay, contributing to an increase in poverty. Many jobs are part time, therefore social insurance contributions supporting the welfare state are insufficient. The costs of the expanding health service are constantly increasing. As previously mentioned, poverty leads to poor health with diseases such as heart conditions, cancers and more recently, diabetes, all draining resources from the National Health Service (NHS).

The ageing population also imposes higher costs on the health service; more senior citizens will need care with fewer people to fund it. Other costs to the health sector include expenses incurred from administering and researching medications. The greater the NHS usage, the more medications need to be paid for. The cost of drugs can range from a few cents per pill to tens of thousands per pill. The increased usage of complex treatments and devices, like scanners, also adds to these costs. Staff costs are the largest strain on resources for the health sector, and as more people require services, this will increase. This cost issue is compounded by the fact that there won't be enough younger people to cover the ever-increasing NHS costs. This has led to changes in the health service over the years, with the most extreme adjustments taking place in the 1980s.

The 1980s saw Britain's first female Prime Minister, Margaret Thatcher, leading the Conservative government. The Conservatives were the first party to reform the welfare state when it was established in the 1940s. The Liberal Government of the early 1900s had laid the groundwork for the welfare state, including the principles of free care for all and their vision of a poverty-free nation. The Conservatives' beliefs diverged significantly and were categorized as right-wing. They trusted market forces and capitalism and believed that the state should not interfere in business and that people were responsible for themselves. This led to privatisation and de-industrialisation, resulting in high unemployment rates and increasing poverty, both placing a strain on resources. This eventually led Thatcher's government to consider NHS privatisation. However, this was deemed too radical a step, so free-market principles were implemented instead. The Conservatives believed that only those truly in need, such as the disabled and chronically ill, should receive free care while everyone else should pay for their care. This resulted in the formation of hospital trusts and private medicine, an attempt at reducing NHS costs funded by tax.

In 1989, the white paper "Helping Individuals" was presented and transformed the financing structure of the NHS. It still upheld the liberal ideology by providing primarily free services at the point of delivery, with universal care still funded via general tax. The paper introduced competition and market pressures, which included both providers and buyers. General practitioners, insurance providers, and wellness boards were the buyers who purchased services for their clients, while hospitals and clinics served as service providers and competed for clientele. It was expected this competition would motivate hospitals to elevate their standards of care in order to attract business. Contracts would be created between buyers and providers, with the money (or expense) following the patient from one service to another. General practitioners were encouraged to take control of their own budgets, allowing them to dictate how their funds were spent and granting them the freedom to enhance and expand services within their practices.

Hospitals were allowed to become Trusts, meaning they had opted out of the system and could now own their own assets and set their own pay and staff levels. Essentially, hospital trusts became businesses similar to any other commercial entity. The idea was that this would improve patient care delivery, as underperforming hospitals would fall by the wayside while those offering superior care and services would prosper. The white paper also outlined specific improvements to patient care, including friendlier waiting areas, a simpler complaints system, individual appointments, and clearer information for patients. The conservatives hoped that by introducing a patient-regulated health service with increased control over its funds, performance and accountability would improve, resulting in better services to the nation. These changes allowed patients to choose their care and gave rise to a new industry.

Private medical insurance proliferated, growing from 4% to 25% of the population within a year. The three main companies in this sector are BUPA, PPP, and Norwich Union. Critics argue this system has led to a dual-tier healthcare structure in which the wealthy can bypass waiting lists. The principle is simple: an individual insures themselves against accident, injury, or illness, paying monthly premiums to secure immediate treatment and financial compensation for loss of work. Naturally, this option is only available to individuals with significant income and individual insurance constitutes the smallest portion of this business. Conversely, companies comprise the largest users of private medical insurance. For them, it's beneficial as insurance can be offered as a job perk, justifying a lower wage. It also expedites the return of employees to work. The insurance companies also assist in interfacing with the multitude of sectors that provide care, saving companies time. This is why businesses have embraced private medical insurance.

Various markets are involved in the arrangement of treatment. The state industry, i.e. healthcare facilities, GPS, social workers, and also property treatment provide care to all and are funded by the state. The private sector, i.e. private hospitals, property, and assisted living homes, provide care to those who can afford to pay for it or are insured. Volunteer agencies such as Age Concern or WRVS rely on charity to exist and provide access to transportation, services, and equipment, among others. Family, friends, and neighbours also offer care; this is known as the informal sector. This is dependent on the individual being close to family who are in a position to assist. The state sector carries the majority of healthcare provision, supported by the voluntary agencies. The private sector handles a smaller percentage of the care provision and occasionally relies on the state to fill gaps in their services. This mixture of care providers is called the mixed economy of care and has arisen from the policies adopted by the Conservatives and passed with the "Benefiting People" paper in 1992. Today, we have a Labour government who are looking to change the health service once again with policies that still align with the far-right beliefs of a free market and state funding via taxes. Only time will tell how this will affect the welfare state as it stands today.

The development of healthcare policy over the last 100 years has shaped the welfare state as we know it today. The social, economic, and political influences stem from the national needs for a healthier, more educated society for protection and advancement in a modern world. The improvement of women's rights and the right to vote was instrumental in social policy becoming a major concern of governments. The Beveridge Report highlighted the state of the nation and gave its recommendations on how to eradicate poverty. The welfare state was established to achieve this and was quite successful in helping to improve living standards. However, the welfare state did not eliminate poverty, as many individuals today still live day to day in impoverished conditions.

Poverty has changed as now there is less absolute poverty and more relative poverty than before. Social attitudes have changed, with people having higher expectations in all aspects of life. This has led to changes in family structure, with more families being reconstituted than nuclear. The demographics of the nation have also changed, with fewer women having children and those who do, having fewer children. People are also living longer due to medical intervention and advancements. This has massive implications to the welfare state, with more people becoming dependent on it and fewer people to pay for it. De-industrialisation has resulted in more people living in relative poverty as job security has disappeared and people are working longer hours for low wages. This leads to more ill health in the poorer sectors of society who are dependent on the state for care. This costs the NHS more money in staff, medicine, and equipment.

The liberal and traditionalist ideologies had a significant impact on the welfare state. Liberals advocated for free care for all, while conservatives believed that those who could afford it should pay. Nonetheless, conservatives also provided free care when necessary. The traditionalists introduced market pressures and created the mixed economy of care that exists today. Each of these policies has its advantages and disadvantages. The welfare state is costly, and its funding is now a major issue to contend with as our population ages. The government today must find a way to fund the care sector, which is spiraling out of control as individuals expect shorter waiting lists and excellent service without raising taxes. Healthcare is a complex issue to tackle as many other aspects of life impact the health of our nation, including poverty, demographics, the economy, and politics.

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