2 Creating A Welfare State Flashcards
what was unemployment like 1918-39
-peaked at 3 million at the end of the 30s
-1911 national insurance act, a self funding national insurance scheme with benefits paid from a fund generated by members’ contributions whilst employed
-the poor laws 1500s - 1948, system of relief for the poor, made a clear distinction between deserving poor and undeserving poor. the war undermined this scheme, many of the returning troops were not legible for the benefits it provided
-the government said the only alternative solution was to hand out dole money which was to be paid out of general taxation
-what did the unemployment insurance act of 1920, idea was that the number of increasing workers covered by insurance would make the scheme self funding, but instead the greater number of eligible claimants quickly drained the funds
-the 1918-20 out of work donation, issued to returning troops and the civilian unemployed - set out that the government accepted the duty to help the unemployed
- in 1921, the government was forced to make extended payments, dole payments disguised as insurance
-1929 local government act, county and borough councils had to set up Public Assistance Committees which replaced poor law guardians . Pacs given the power to means test claimants. by 1931, 400,000 rejected
-1934 unemployment act, part one provided 26 weeks of benefit payments to the 14.5 million workers who paid into the scheme, part two created a national unemployment assistance board to help those with no entitlement to insurance benefits
-by 1937, the UAB had helped 1 million, and poor law provision had shrunk to just a few groups not covered by the UAB such as widows and deserted wives
-it was only when huge state spending was poured into rearmament after 1939 that persistent unemployment was finally tackled
what were pensions like 1918-39
- state pensions had been introduced by the 1908 pensions act, hugely popular with eligible over 70s, criticism that they were means tested and did not support widows and children of the deceased
-chamberlain addressed these concerns with the 1925 widows orphans and old age contributory pensions act, 10 shillings a week 65-70. self employed workers of both sexes allowed to join in 1937
what was housing like 1918-39
-concern that slums promoted crime and disease and lots of slum clearance had been undertaken before 1918
-introduction of mains water and sewage to homes, as late as 1899, one quarter of houses in Manchester had flushing toilets compared to 98% in 1914
-returning soldiers ‘home for heroes and the 1919 housing and town planning act aimed to empower local authorities to use central government funds to meet housing needs
– only 213,000 built, 600,000 needed before the onset of the recession led to the Geddes axe, the drive for public economy and retrenchment n UK government expenditure, housing shortages grew worse
Impact of total war
-ww2 led to wide consensus
-total war, affected rich and poor, prompted total solutions such as universal rationing
-forces britain to borrow large sums of money
-forced a coalition government
What did the beverage report 1942 do
Key recommendations: 5 giants :
WANT, through national insurance
DISEASE through NHS
IGNORANCE through better education
SQUALOR through rehousing
IDLENESS maintenance of full employment
-provision of welfare to be centralised, regulated and systematic
-state welfare funded entirely by a compulsory single insurance payment
-sold 635,000 copies
Impact of beverage report
-Labour rejected his call for welfare payments to be met solely by universal insurance
-it was felt that a higher rate would penalise the poor
-social security was therefore not introduced on a self funding basis
-higher taxation was used to supplement higher pension and unemployment benefits
-labour did implement these ideas from beverridge:
-family allowances act 1945, mothers with a non means testes payment of 5 shillings a week for every child part from her first
-national insurance act 1946, created a compulsory universal contributory system to help pay for pensions
-national assistance act 1949, provide financial help to the most vulnerable poor such as single mothers, the blind and deaf who had not been covered by the 1946 act
Why was welfare provision being challenged by 1979
-cost of unemployment benefits rose 0.6% of GNP in 1939 to 8.8% in 1970
-baby boom 1940s-50, mire cost for baby and education
-an increase in life expectancy, more care for elderly
-thatcher opposed increase in benefit payments because they encourage a culture of dependence
Health provision 1918-45
-healthcare emerged as an off hybrid of state and private provision, state healthcare was provided by a range of different agencies including the poor law
-first world war exposed the inadequacies of healthcare: 41% rated unfit for combat roles, 10% unusable in any military roles
-ministry of health 1919, lacked authority and political will required to radically change the system
-1926, conservative government failed to act on a royal commission recommendation to either scrap or reform health insurance system, minister for health, Neville chamberlain advised that insurance companies were too powerful a group to take on at a time of financial instability
-a few big insurance companies such as prudential, dealt with around 75% of health insurance
-some of the friendly societies were so small that they couldn’t afford to pay for members with no insurance whatsoever
-lots of duplication of roles due to the large number of societies operating in each region
-the 1911 act only insured workers - the wives, widows and children of poor workers remained without a safety net and relied on family, local community or a sympathetic GP
-gps were the first option for most medical care. However patients would not only have to pay for a consolation and usually the medicines as well
-in rich areas, gps would earn a good living
-1929 local government act, empowered pacs to tale over and develop infirmaries into proper hospitals however there was no timetable or compulsion for action and, with a few exceptions, uptake was slow outside of London
-in 1939, half of all public hospitals were still poor law infirmaries
-1938, national survey, revealed a shortage of beds, n building, equipment, trained consultants and poor patients accessibility due to the poor distribution of good hospitals
What happened when the nhs was launched in 1948
-doctors were shocked by the sorts of medical issues that poor people had put up with rather than than pay for treatment, such as untreated hernias and skin diseases, most commonly toothache
-12 prestigious voluntary hospitals in London and ten in the provinces. Hospitals such as guys in lodnon had a long independent history and trained top specialists and consultants, attracted generous donations from wealthy donors
-the majority of the other 1,000 voluntary hospitals were smaller, staffed by visiting consultants or gps and les financially secure where charity fees and local authority grants did not cover costs, the hospital declared itself bankrupt. Needed a quick turnover of patients, for this reason they did not admit the elderly or those with chronic illnesses, who were forced to rely on public hospitals
The impact of the second world war on healthcare
- led to the creation of nationally funded organisation to deal with expected casualties, a national system of blood transfusion depots was established in 1938 near hospitals but far way enough to avoid bombing, which continued after 1946
-an emergency medical service was set up in 1939 to treat military personnel and as the war progressed, a wider range of civilian casualties. National funding for the service led to an impressive growth in the number of beds, operating theatres and specialist treatments available , such as the treatment of burns by plastic surgery
-the successful state response to adversity inspired beveridge to call for an NHS
-despite thr deaths and injuries from fighting and bombing, the health of thr average Briton improved during the war thanks to rationing, the rich ate less and the poor ate more,and increased government propaganda to educate people about healthy habits
Getting the doctors onside 1945-79
-Bevin, minister for health, create a centrality rather that locally run system, funded by taxation rather than insurance, which succeeded
-the 1946 national health service act
-the approved societies were forced to rely on private clients for business and the voluntary hospitals apart from the teaching hospitals, were nationalised
-February 1948, 90% of the British medical association voted against working within the nhs and argued that it would undermine their clinic independence, when in reality most doctors were more concerned about losing income
-bevan overcome this opposition by granting doctors a few for each patient on their books, rather than paying them a direct salary and by allowing consultants to retain private patients
- on 5 July 1948, 90% of doctors joined the NHS
-bevan was angry that he had gained doctors support by stuffing their mouths with gold
Was the nhs a healthy change?
-first 10 years of NHS, new antibiotic drugs were developed in the USA caused the number of deaths from tuberculosis to fall from 25,000 to 5,000 a year
-a programme of mass immunisation led to a huge drop in causes of polio and diphtheria in the mid 1950s
-90% drop ion whooping cough cases by 1970
=the MMR vaccine was developed in 1971 in the USA, which the nhs offered free of changes in 1988
-over 300 inadequate cottage hospitals were closed in the 1960s and new centres of excellence with close ties to universities were funded for larger towns
-increased life expectancy, men 66-70, women 71, 75
-however a range of diseases associated ith olds age people increased due to the greater nu,her prof people surviving past 80
-heart disease and cancer increased through the 1950s and 60s before lowering in the 70s due to better diets, more exercise and fewer smokers
-arthritis continued being the largest health problem
Challenges to healthvare 1945-79
-bevan had expected the cost of healthcare to fall after 1948. As the nhs was so large it would be able to take advantage of economies of scale (buoying things more cheaply in bulk)
- nhs cost 4.1% of GNP in 1950 to 14% in 1990
-advances in medical science , treatments available, sometimes for illnesses that were incurable or had not been recognised in 1948, 33 antibiotics available in 1968
-higher public demands, as people came to demand on NHS, a dandruff syndrome emerged, people took up valuable time and resources with complaints about the most trivial problems
-backlog of cases, difficult to dedicate the necessary time and funds to planning and the full reorganisation of the old system,
-number of staff employed doiubled from 500,000 in 1948 to over a million n 1979
-1951, charges introduced for dentures spectacles,which was felt by bevan that this undermined the key principles, the charge was a fixed sum so penalised the poor
Medical advances in the 1960s and 70s
-first kidney transplant took place at Edinburgh royal infirmary in 1960, so the demand for kidney transplants quickly overtook supply and kidney failures services reached 2%of the NHS budget in the 1930s
-introduction of contraceptive pill in 1961
-women taking the pill 1962-69 increased from 100,000t to over a million, resulting in smaller families
-abortion act 1967, post war baby boom was over
-first hip replacement 1962, and first heart transplant 1968. As the first patient died of complications, only 6 transplants were carried out out 1968-78
-CT scanner was invented in 1972 and became standard equipment
Education in the early 20th century
-where schools existed, they were provided by churches,c charities and private foundations
-1870s board schools, provided funding for. Older, failing grammar and church schools, new enfranchised voters needed some education to vote responsibly
-vast majority of schools only provided an elementary education to the age of 11 or 12 after 1902 - children left school with the basic tools of reading, writing and arithmetic and religious instruction
-1902 education act increased the chances of a grammar school education for able working class children by returning state funding, over 1000 grammar schools offered a quarter of their places to non fee paying children who did sufficiently well in exams.
-1914, only 56 out of every 1,000 elementary school students gained such places and secondary education remained for the upper and middle
classes
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