Public health Flashcards
What steps had been taken in order to provide healthcare to Britain 1914
Compulsory national health insurance
Numerous private charitable groups that paid for healthcare costs
The poor law
Workhouses had infirmaries which eventually became hospitals
How did the 1911 liberal system of national health insurance work
Compulsory system
Employees earning under £160 a year paid into a scheme which provided sick pay
What were some drawbacks to the 1911 healthcare system
Act only applied to wage-earners and the unemployed
Did not include families of wage earners
What was the poor law
Created new administrative systems to oversee the relief provided to those in need
What was the consensus of what the government should do in healthcare during the interwar years
Invest in research and medical training
Organise a national network of hospitals
Ration healthcare
When was the ministry of health established
1919
What was the ministry of health initially responsible for
Co-ordinating health at a regional level
Administering funds raised by the NH insurance scheme
Who was the first minister of health
Christopher Addison
What did Christopher Addison the first minister of health do
Organised medical care for troops on the front lines
A strong advocate for regional health services
Arthur Morgan
What was the most serious health problem post-WW1
Tuberculosis
What did the 1919 Ministry of health act create
The Medical Research Council MRC
Why was MRC established
in order to research causes of TB
What did the Tuberculosis act of 1921 do
Made the provision of TB sanatoria by local authorities compulsory
Who formed the local government act 1929
Minister of Health Neville Chamberlain
What did the 1929 government act do for healthcare
Passed responsibility for poor law hospitals to county and borough councils
Allowed the conversion of poor law infirmaries into public hospitals
Gave local authorities responsibility for other areas of public health
(6)
What areas of responsibility for public health were local governments given
venereal disease
clinics
child welfare
dentistry
school medical services
school meals
What did Chamberlain’s local gov act lead to
Reorganisation of healthcare on a regional scale
What amount of population was insured against illness in 1929
Less than half the country’s total population
What consensus on bringing out healthcare was reached in the 1930s
Current system was inefficient, varied in quality and failed to meet needs
Why were there innovations in healthcare during the 1930s
Because of what the first world war had taught the country about diet and fitness
What was the ministry of healths priority in the 1930s
Hospital funding
What did local authority hospitals start to focus on in the 1930s
Improving peoples diet and hygiene
What was a key indicator in improving healthcare by the end of the 1930s
Infant mortality had declined
How much did infant mortality decline by 1939 in England and Wales
1906-1910: 14.3 in every 1000 infants died
1936-1939: 12 in every 1000 infants died
What areas didn’t see a decline in infant mortality rates in 1930s
Areas affililiated by extreme poverty
What was healthcare established for WW2
Nationwide emergency healthcare system
When was the emergency medical service founded
1939
Why was the emergency medical service founded
Provide first aid and casualty clearing for people in air raids
What resulted due to the emergency medical service
Resulted in pooling of resources, skills and expertise
Allowed gov to dictate a hospitals activites
How did WW2 lead to a change in the attitudes to medicine
Doctors no longer preferred to stay independent
New funding and gov organisation made state work attractive
What did the 1944 white paper on health declare
a new national system paid for from general taxation
Why was the NHS confirmed to happen after the war
Both the tories and labour promised to make it in their manifesto
When was the national health service act
1946
What was established in the national health service act
Healthcare was universal
Healthcare would be comprehensive
Healthcare would be free
What would NHS offer in terms of comprehensive healthcare initially
curative and preventive care
mental and physical care
hospital care
dental care
general surgeries
specialist areas
How did Bevan create a nationalised but regionalised healthcare system
All existing hospitals were nationalised
NHS hospitals would be run by regional health boards
What compromises did Bevan make in order to get doctors on board with the NHS
Consultants allowed to continue working privately
GPs able to avoid becoming local authority employees
Regional health boards appointed not elected
What type of system was the NHS initially
Tripartite system
What 3 tiers was the NHS comprised of
Hospital services
Primary care
Community services
How did Macmillan reform the NHS
introduced hospital plan in 1962
What was hospital plan 1962
Created 90 new hospitals
Modernised 134 hospitals
Refurbished 356 new hospitals
How did Keith Joseph reorganise the NHS
Introduced the NHS reorganisation act 1972
What did the NHS reorganisation act 1972 do
introduced a new management structure to the NHS
Was the NHS effective
Proved to be remarkably effective at improving physical health
How did the NHS reflect the inequalities in society
middle classes received better treatment than working class people
Men received a better deal than women
How much did life expectancy increase for men between 1948 and 1979
65.8 years - 71 years
How much did life expectancy increase for women between 1948 and 1979
60.1 years - 77 years
What did the 1979 Merrison report argue
Hospitals received around 70% of NHS funding
Other areas received much less
How did the middle class benefit more than the working class
Investment in WC areas lagged behind
Budget allocations favoured more MC areas in
What did the 1980 Black report reveal
Gap between MC and WC grew
By 1970s WC women twice as likely to die in childbirth than MC
Unskilled working men twice as likely to die before the age of 65
What areas did the NHS have an impact on women
Reproduction
Abortion
Childbirth
Work
How did the NHS help women in terms of reproduction
Gave them greater control over their fertility
Led to a decline in birth rates
When was the contraceptive pill introduced
1961
When did contraception become free from the NHS
From the 1970s
What were some drawbacks to the availability of the contraceptive pill
Early contraceptive pills increased stroke and cancer risks
Men tended to take less responsibility for contraception
When was the abortions act
1967
What did the 1967 abortions act do
Gave women the right to terminate a pregnancy
What were some drawbacks to the 1967 abortions act
Dependent on the approval of two typically male doctors
Medical staff had the legal right to refuse participation in terminations
How many abortions occurred 1968-1978
1.5 million
What percentage of abortions were carried out privately 1968-1978 and how much did it cost
58% were performed privately
Cost around £200 per procedure
How many people died of legal abortions 1968-1978
86
How many women gave birth in hospitals in 1950
60% of women
How many women gave birth in hospitals in 1978
97%
How many women were given an episiotomy during hospital births
70-90% of women
What were some issues of episiotomy
Led to pain whilst sitting for 68% of women
Often done without the woman’s consent
Longer recovery times during childbirth
How did the NHS help women in work
Created a a state-funded caring profession allowing women to become the majority in care work -nursing
What were some challenges of medical advances 1945-1979
NHS effectiveness led to higher expectations
Longer lives led to an elderly population with its own health needs
Increasing pressure to deliver more services
What was the increase in prescriptions at chemist pre and post NHS
6.8 million given pre
13.6 million given post
What did the pharmacological revolution mean 1949-1964
more medicines available
Increase in NHS drug costs
NHS spent 250% more on drugs 1964 vs 1951
What vaccines were given out in 1964
TB
Diphtheria
Poliomyelitis
Whooping cough
tetanus
What did the 1959 Younghusband report mean
The NHS started offering chiropody services
How did patients feel about the NHS compared to pre-ww2 health
Far superior
Prepared to tolerate any issues in the NHS
What were issues in investment for NHS 1940-1968
very little investing in hospitals
How much did NHS spending increase annually in the 1960s
Increased an average of 4.5%
What did the greater funding in the NHS reflect
The greater demands on the NHS
In the 1960s what were some areas the NHS could offer
Kidney dialysis
Catheters
Organ transplants
Why did new treatments in the 1960s lead to more staffing
Required expensive technologies and specially trained staff
How much did the number of nursing staff and consultants increase 1964-1979
66%
How much did the number of technical staff increase 1964-1979
300%
How many staff members did the NHS have 1951
407000
How many staff members did the NHS have 1979
1 million
How many people were of retirement age 1951
7 million
How many people were of retirement age 1971
9 million
How many hip replacements were formed in 1979
24,000
What did the 1967 family plannings act do for the NHS
made family planning advice available to all women
What happened to the 1967 family plannings act
Reversed by Tories in 1972
Reinstated by labour om 1974
