public health Flashcards
what was the Healthcare Consensus in early 20th century?
agreement that the government should be involved with coordinating healthcare.
- investing in research
- invest in medical training
- rationing healthcare
- organise national network of hospitals
what were the disagreements about government involvement in healthcare in early 20th century
- Fabian Society - advocated for centralised healthcare
-1919 Labour party advocated for free comprehensive healthcare - BMA advocated for regional healthcare coordinated by central government.
consensus on government involvement in regional healthcare although some advocated for national health service
what important government department was introduced in 1919
and what did it do
Ministry of Health
first minister of health (chris
coordinated health on a regional scale
first minister (christopher Addison) advated for regional health services
how was turburculosis dealt with in the 20s-30s
Ministry of Health Act / Medical Research Council (1919)
Turburculosis Act 1921
researched TB led by Robert Haldane
- independant of gvernment as they had no power over MCR’s research or findings
- number of cases of TB decline after provisions for TB were made compulsory for local authorities
what was the Local Government Act 1929?
regards to medical reforms (pos. + neg.)
- allowed country councils to convert Poor Law infirmaries into public hiospitals
- gave local authorities reposnisbilies for other areas of healthcare (school medicine / meals, dentistry adn child welfare)
put in by Minister of Health Neville Chamberlain
pos.
* reorganisation of regional healthcare
* created single health authority.
* enable healthcare for entire county populations
neg.
* didnt lead to cheap healthcare for all
what were the Pioneer Health centre and the Finsbury Health centre
why were they introduced
examplesof experimental preventative health centres
offered anual health checkups for a small weekly entrance fee.
they addressed problems in the local areas
what did Finsbury Health Centre offer to its local community?
extra research not in textbook
innovative healthcare, most technologically advanced public health.
opened in 1938
Finsbury was found to be one of the poorest places in England for health
the centre was built as an early prototype for the NHS
it adressed the problems of the local community such as lice / TB
what was an inidcator of class differences in public health
between 1929 and 1939
- maternal mortality was higher amoungst WC women 50%
- MC men lived 12 yrs longer than WC men
what was the Emergency Medical Service?
post second world war (impact)
what was its impact
1939
provided medical care for those wounded in air raids
pooling of medical resources to form a national health service in response to german attacks
change in attitudes towards national medical health.
what was the impact of WW2?
- 1944 White paper supporting a new tax funded health service
- change in thnking about national health ( all 3 parties comitted to state funded healthcare
what did the National Health Service Act introduce?
not the NHS differnet thing
1946 bevan minister for health
* all hospitals nationalised but run by local hospital boards
* intorduction of the nhs in 1948
conpromises made to please private doctors - could continue privatley and appoint their own regional health boards
NHS run by priveledged groups.
what was the impact of the nhs
1948-1979
- life expetancy increased (65.8 m, 70.1 f 1948 to 71m and 77f 1979)
- changed attitudes to state intervention on public health
what was the class difference in the NHS?
- MC benefitted more as more budget was allocated to those areas
- £4.98 pp in MC areas
- £3.19 pp in WC areas
- class healthcare gap grew between 1948-79 (Black Report)
what were the challenges the NHS faced?
1948-64
overall public judgement at the time
- increased expectations
- aging population due to longer lives (required more care)
- increased emand for medical care
- increased drug cost as it covered more medicines (250% more spent in ‘64 than ‘51 medicne more expensive)
victim of its own success
overall seen as cost effective and good provider of healthcare in this period
what were the challenges the NHS faced?
1964-79
overall judgement
- spending increased in a weaker economy (predicted to be 3% increase between ‘60 and ‘75 but actually 4.5%)
- new medicines needed more specialist staff staff increased to 1mil by 1979 (expensive)
- increased lives, elderly neede more care 9mil by ‘71
- 1979 24,000 hip replacements.
still seen as indispensible
was growing faster than the economy so was on track to fall in effciency and enter crisis
