S2 1 - History of the NHS

Question 1

What was healthcare like before the NHS?

Answer 1

To be healthy was to be rich;
Hospitals and Drs were available but has to be paid for
There were some exceptions; low paid workers – free care
Others relied on home remedies or charity – charitable and voluntary hospitals
Municipal hospitals
Asylums
Workhouse

Question 2

When was the NHS introduced and by whom?

Answer 2

NHS introduced 5th July 1948 by Aneurin Bevan
At the end of World War II
Era of expectation

Question 3

How was the NHS first financed?

Answer 3

Financed from central taxation

Question 4

What was the founding principle of the NHS?

Answer 4

fair and equal access to all, free at the point of delivery

Question 5

What were the first few difficulties of the NHS?

Answer 5

Administration difficulties
High public expectations
Prescription charges
Problem balancing demands

Question 6

What did Bevan say about the NHS from the very start?

Answer 6

expectations will always exceed capacity

Question 7

Who acted as the gatekeepers of the NHS at the start?

Answer 7

GPs

Question 8

What was the first planned major innovation of the NHS?

Answer 8

The development of community health centres (beginnings of MDT?)

Question 9

Which NHS Era lasted from 1988-1997?

Answer 9

Era of ‘the Market’

Question 10

Describe the Era of ‘the Market.’

Answer 10

Introduction of the internal market 1989 (White Paper – Working for Patients) an attempt to resolve problems through competition

Question 11

What were ‘purchasers’ and ‘providers’ in the NHS during the Era of ‘the Market?’

Answer 11

Purchaser - HA and some family Doctors
Providers – acute hospitals and other health organisations money was directly given to hospitals so they could spend as they see fit for patients

Question 12

What did a hospital have to do to become a provider or a purchaser in the NHS during the Era of ‘the Market?’

Answer 12

To become a provider, hospitals had to become NHS Trust (formation of NHS Trusts)
To become a purchaser GPs became GP Fund-holders (GPs managing budgets)

Question 13

Which accusations caused worry in the NHS during the Era of ‘the Market?’

Answer 13

Accusations of two-tier system worry of competition between hospitals

Question 14

Which happen in 1997 and after in the NHS during the Era of ‘the Market?’

Answer 14

1997 – new Government (Labour), abolition of internal market

New White Paper: The New NHS – Modern, Dependable

Question 15

Which NHS Era lasted from 1988-1997?

Answer 15

Era of ‘all change’ 9most change)

Biggest programme of change (until 2010 comes along!) since start of NHS

Question 16

Which changes occurred during the Era of ‘all change?’

Answer 16

Restructuring of NHS not as management-orientated anymore
Putting patients at centre of the NHS
Increased use of IT
NHS Information Highway
NHS Direct 1998 (now known as ringing 111)
Formation of NICE 1999 reviews treatments and medicines and if money should go into them or not
10 Year NHS Plan – July 2000

Question 17

Which 7 things did the 10 Year NHS Plan promise?

Answer 17

more hospitals and beds
more Doctors and nurses
shorter waiting times for hospitals and GP appointments
cleaner wards, better food and facilities in hospitals
improved care for older people
tougher standards for NHS organisations, better rewards for the best; rewards hospitals for good work
greater power and more information for patients and the public

Question 18

What were the 4 principles of NHS founded during the Era of ‘all change?’

Answer 18

1. Patient focused service – patient choice, role of independent sector
2. Competitive providers – payment by results, money following patients
3. Active purchasers – PCTs had purchasing power, practice-based commissioning
4. Cost effectiveness and affordability – tariffs, commissioning

Question 19

What do we call the era of 2010 onwards?

Answer 19

Era of ‘austerity, major reforms and uncertainty!’