Public Health: Phase 5 Advances in Public Health 1920-1948

Question 1

What problems in public health remained by the 1930s?

Answer 1

Unemployment was still over (over 3m). All the unemployed were outside of the National Insurance Scheme

Those in work could not afford to pay and so they could not get free medical help

The death rate for under 1 year olds was high

In most areas affected by the depression, infant mortality was increasing again

In 1934, there were 4m insurance policies on which people owed payments

Question 2

When was the Beveridge Report?

Answer 2

1942

Question 3

Who was the Beveridge Report written by?

Answer 3

William Beveridge

Question 4

What were the 5 giants that Beveridge wanted to tackle?

Answer 4

Want

Disease

Ignorance

Squalor

Idleness

Question 5

What did the Beveridge Report suggest?

Answer 5

Setting up the NHS (healthcare from the cradle to grave), free for all, paid from taxes, staff were government employees and so they were paid through them.

All people in work would pay National Insurance out of their wages (this would pay benefits when needed)

Question 6

What did the government do during WWII to intervene in public health?

Answer 6

The Emergency Medical Service was set up with central control over hospitals and medical staff

Food was rationed to ensure that people got food to eat

Evacuation meant that the government took a major role in keeping the population safe. The Middle Classes were shocked at the poor conditions of the children they received from big cities.

Question 7

How did Attlee’s Labour government lead to the NHS

Answer 7

In 1945, Labour won a landslide victory.

Clement Attlee, the new Prime Minister announced that a welfare state would be set up to protect people

The welfare state would be paid for through National Insurance contributions by employers and employees.

The 1946 National Insurance Act provided old age pensions, maternity benefits and payments to the sick and unemployed

Question 8

What was the 1946 National Health Act?

Answer 8

Aneurin ‘Nye’ Bevan proposed the National Health Act.

This included:
1. All hospitals would be taken over and put under thirteen regional health boards. These in turn would be controlled by the Ministry of Health

2. All doctors would be paid a salary, instead of receiving fees for each of their patients
3. Doctors would not be allowed to buy and sell practices and with them, lists of patients
4. Doctors would not be allowed to set up new practices in areas where there were already enough doctors

Question 9

What was the opposition to the NHS Bill?

Answer 9

• The BMA (representing 51,000 GPs) thrweatened to boycott the NHS if Bevan’s plans went through unchanged
• The BMA likened Bevan to Hitler because he was trying to enforce change
• Bevan’s responde was to take a more moderate line and he made a number of compromises

Question 10

What compromises did Bevan make to the NHS Bill?

Answer 10

• Consultants would be able to work part-time for the NHS and continue with private patients too. They would also be allowed to use private beds in NHS hospitals to treat their private patients
• He agreed that doctors would not be paid solely by a salary and would also receive a fee for every patient on their list.
• He also agreed that doctors who joined the NHS would be able to retain private patients and the fees they got and the fees they received for treating them

Question 11

How did the NHS improve health?

Answer 11

• Everyone in Britain was entitled to free medical care. This included visits to the doctor, perscriptions, hospital treatment and operations, emergency services, dental treatment and false teeth, opticians and free spectacles, vaccinations, and clinics

All hospitals in the country (about 3,000) were taken over by the government and GPs were paid by the state

Question 12

What was the impact of the NHS?

Answer 12

By October 1949:

• 187 million perscriptions had been provided
• 5,250,000 pairs of glasses had been perscripted
• 8.5 million people had been treated at dentists
• The GP soon became the ‘family doctor’
• The first charges were introduced for dental and optical treatment in 1951 (Bevan resigned in protest)
• People no longer had to worry about treatment
• Life expectancy increased from the year 1919 to 1992
• The NHS offered many services: midwifery, after-care, dentists, hospitals, medical research, teaching hosptials, vaccination, and ambulances