Theme 2 b 1 - Health provision, 1918-45 Flashcards

Question 1

Q

In a summary- what was health care provision like during the interwar years?

Answer

A

<ul> <li>It was patchy.</li> <li>Local health authorities had varying responsibilities and operated some hospitals, as did charitable institutions.</li> <li>Many employees were covered by health insurance but their families often were not.</li> <li>Much healthcare was private; one paid to see a doctor and paid for the treatment recommended.</li> <li>Healthcare overall seemed to be improving.</li></ul>

Question 2

Q

What did the Liberal government introduce in 1911?

Who was it for and who did it only apply to?

Answer

A

<ul> <li>Introduced a system of compulsory national health insurance for low-paid employees earning under £160 per year. They and their employees paid into the scheme which provided sick pay and free medical treatment.</li></ul>

<ul> <li>Only applied to wage earners and the unemployed and families of wage earners were not provided for under the scheme.</li></ul>

Question 3

Q

Healthcare- 1918

Who paid for the costs of the healthcare for the poor?

What did the Poor Law do?

Answer

A

<ul> <li>There were numerous private charitable and philanthropic groups that paid the costs of healthcare for the poor.</li></ul>

<ul> <li>Poor Law- provided for some degree of medical care with Poor Law Hospitals.</li></ul>

Question 4

Q

Healthcare- 1918

What did workhouses often have and what were many converted into?

Answer

A

Often had their own infirmiries and many of them converted completely into hospitals once their use as effective prisons for the poor became obsolete.

Question 5

Q

Healthcare, 1918-1939

Why was this period significant for the development of healthcare?

Answer

A

<ul> <li>A consensus emerged between medical professionals and policy makers about what was wrong with the existing system and about the goal of reform.</li></ul>

<ul> <li>Secondly- there were significant government reforms.</li></ul>

Question 6

Q

Healthcare consensus, 1918-1939

In the interwar years, what was the widespread consensus?

Answer

A

Widespread consensus that the government should play a leading role co-ordinating provision and that more money should be spent on healthcare.

Question 7

Q

Healthcare consensus, 1918-1939

It was believed that the government had a role to play in encouraging medical advance.

What did this specifically include?

Answer

A

<ul> <li>Invest in research.</li> <li>Invest in medical training.</li> <li>Organise a national network of hospitals.</li> <li>Play a role in rationing healthcare.</li></ul>

Question 8

Q

Healthcare consensus, 1918-1939

What did the Fabian society advocate before 1918?

What did Fabians believe?

Answer

A

<ul> <li>Advocated centralising healthcare provision.</li></ul>

<ul> <li>Fabians believed that centralised, state-planned healthcare was the only way to significantly improve healthcare for all in Britain</li></ul>

Question 9

Q

Healthcare consensus, 1918-1939

In 1919 what did the Labour party become the first British political party to advocate?

Answer

A

Advocate a free and comprehensive national health service!

Question 10

Q

Healthcare consensus, 1918-1939

What did the British Medical Association (BMA) advocate?

Answer

A

Advocated a regional system of healthcare, co-ordinated by central government.

Question 11

Q

Healthcare consensus, 1918-1939

What did the government commision in 1920 and what happened as a result?

Answer

A

<ul> <li>Commissioned a study into the organisation of the health services.</li></ul>

<ul> <li>The resulting Daweson Report reccomended a network of state-funded and state-organised hospitals.</li></ul>

Question 12

Q

Healthcare consensus, 1918-1939

What did the 1926 Royal Commission on National Health Insurance reccomend?

Answer

A

<ul> <li>Reccomended a regional rather than a national structure for healthcare.</li></ul>

<ul> <li>The commission reccomended a compulsory health insurance scheme to fund a unified national health insurance service.</li></ul>

Question 13

Q

Healthcare consensus, 1918-1939

During the 1930s- what happened to private and voluntary hospitals?

Answer

A

They lobbied unsucessfully for government funding!

Question 14

Q

Healthcare consensus, 1918-1939

What did the Voluntary Hospitals Commission of 1935 argue?

Answer

A

Argued that the government should merge voluntary hospitals and local authority hospitals in order to bring together expertise and finance.

Question 15

Q

Government reforms, 1919-29

What did the government establish in 1919?

What was it responsible for?

Answer

A

<ul> <li>A new ministry of health.</li></ul>

<ul> <li>Responsible for co-ordinating health at a regional level. Additionally it administered funds raised by the national health insurance scheme.</li></ul>

Question 16

Q

Government reforms, 1919-1929

Who was the first minister of health and what was he involved in?

Answer

A

<ul> <li>Christopher Addison, an academic and medical doctor who played an important role organising medical care for troops on the western front in WW1.</li></ul>

<ul> <li>He was a strong advocate of regional health services.</li></ul>

Question 17

Q

What was the most serious public health problem in the immediate aftermath of WW1?

Answer

A

The deadly disease- tuberculosis.

Question 18

Q

Tuberculosis

What had the government set up before the war to slow the spread of the disease?

Answer

A

TB sanatoria funded by national insurance.

Question 19

Q

Tuberculosis

What did the Ministry of health act 1919 create and why was it established?

Answer

A

The Medical Research Council (MRC) which was established in order to research the causes of TB, led by Lord Richard Haldane.

Question 20

Q

What was the Medical research council?

Answer

A

The council was an official, publicly funded body but independent of government control- ministers had no power over the MRC's medical or scientific findings.

Question 21

Q

What did the tuberculosis act of 1921 do?

What happened as a result?

Answer

A

<ul> <li>Made the provision of TB sanatoria by local authorities compulsory.</li></ul>

<ul> <li>As a result of co-ordinated action, the number of cases of TB declined in every year between 1920-1938.</li></ul>

Question 22

Q

Who was the Local Government Act, 1929 steered through parliament by?

Answer

A

Minister of health, Neville Chamberlain!

Question 23

Q

What did the Local Government Act, 1929 do/ pass?

Answer

A

<ul> <li>Passed responsibility for Poor Law hospitals to county and borough councils.</li> <li>Allowed county and borough councils to convert Poor Law infirmaries, which only served the poor, into public hospitals.</li> <li>Gave local authorities responsibility for other areas of public health such as the running of venereal disease clinics, child welfare, dentistry, school medical services and school meals.</li></ul>

Question 24

Q

What did Chamberlains Local Government Act, 1929 lead to and create?

Why was this a vital moment in the history of healthcare in Britain?

Answer

A

<ul> <li>It led to the reorganisation of heathcare on a regional basis. It created a single health authority that co-ordinated healthcare in each county or borough.</li></ul>

<ul> <li>It enabled local authorities to provide medical services to the entire population of the area. However, it didn'tlead to cheap, modern healthcare for all.</li></ul>

Question 25

Q

Healthcare in the depression

In spite of the healthcare reforms of the 1920s, how much of the population was insured against illness in 1929?

Answer

A

Less than half the population!

Question 26

Q

Healthcare in the depression

What health services increased in importance following the onset of the Great Depression?

Answer

A

Affordable health services for the poor!

Question 27

Q

Healthcare in the depression

What were uninsured people forced to rely on?

What happened in the most deprived parts of Britain?

Answer

A

<ul> <li>Forced to rely on private health insurance, which in many cases did not pay out enough to cover medical costs.</li></ul>

<ul> <li>Extreme poverty and hunger led to higher incidences of illness and, in some cases, premature death!</li></ul>

Question 28

Q

Healthcare in the depression

During the 1930s, what was the new consensus?

What did healthcare professionals and ministers continue to favour?

Answer

A

<ul> <li>New consensus that existing provision was inefficient, varied widely in terms of quality, and failed to meet the medical needs of all patients.</li></ul>

<ul> <li>Continued to favour a regional approach to these problems, rather than creating a national service. Nonetheless, at a local level, individual hospitals provided innovative care.</li></ul>

Question 29

Q

Innovations in heathcare

Why were there a number of innovations duringthe 1930s?

What was the ministry of healths priority?

Answer

A

<ul> <li>Partly as a result of what had been learnt about diet and fitness when training troops in the First World War, new advances in preventative healthcare occured.</li></ul>

<ul> <li>Priority was hospital funding, but local authority hospitals began innovative experiments in preventative health, focussing on improving diet and hygiene.</li></ul>

Question 30

Q

Healthcare by 1939

What happened to public health between 1929 and 1939?

What were key indicators?

Answer

A

It seemed to be improving!

<ul> <li>Infant mortality were in decline.</li> <li>Infant mortality in England and Wales dropped from 14.3 in every 1,000 between 1906 and 1910 to 12 per 1,000 between 1936 and 1938.</li></ul>

Question 31

Q

In the 1920s & 1930s, what were maternal mortality rates like in low income groups compared to the middle class?

Answer

A

They were 50% higher in low-income groups!

Question 32

Q

In the 1920s and 1930s, on average, how many more years did middle-class men live compared to working-class men?

Answer

A

12 years longer!!!

Question 33

Q

In the 1920s-1930s, on average, how many more years did middle-class women live in comparison to working-class women?

Answer

A

19 years longer!

Question 34

Q

At the end of the 1930s- Politcial and Economic Planning, a think-tank established in 1931 to monitor health policy argued what?

Answer

A

<ul> <li>Argued that British healthcare lagged behind other developing countries. Compared to healthcare in parts of the British Empire such as Australia and New Zealand, it argued that overall British healthcare provision was inefficient, poorly co-ordinated and badly regulated!</li></ul>

<ul> <li>It pointed to the failure to organise a co-ordinated response to a typhoid outbreak in Croydon in 1937, which led to the deaths of almost 50 people!</li></ul>

Question 35

Q

The impact of WW2

What did WW2 result in the establishment of?

What did the threat of air raids result in?

Answer

A

<ul> <li>A nationwide emergency healthcare system & the emergence of a new consensus.</li></ul>

<ul> <li>Threat- which planners in the mid 1930s predicted would lead to millions of casualties, resulted in detailed planning before the war about how to care for the wounded.</li></ul>

Question 36

Q

The Emergency Medical Service

When was it founded?

Answer

A

1939

Question 37

Q

The Emergency Medical Service

What was it founded to do?

Answer

A

Provide first aid & casualty clearing stations for people wounded in air raids.

Question 38

Q

The Emergency Medical Service

What did it allow the government to do?

What had been created between 1939 & 1940?

Answer

A

<ul> <li>Dictate a hospitals activities - a power it had previously never possessed.</li></ul>

<ul> <li>An entire national service had been created in anticipation of German attacks.</li></ul>

Question 39

Q

The Emergency Medical Service

What did it result in a pooling of?

Answer

A

<ul> <li>Resources, skills and expertise and the creation of a national system!</li></ul>

<ul> <li>Very quickly- government planners adopted the national framework as the basis for plans for a post-war healthcare system.</li></ul>

Question 40

Q

The Emergency Medical Service

How did the war lead to a change in within the medical profession?

Answer

A

Previously- many doctors & hospital administrators had preferred to stay independent of government.

However- the central organising power of the state - along with additional funding proved attractive!

Question 41

Q

The Emergency Medical Service

Did consensus in favour of a national state run system emerge immediately?

What happened in 1941?

Answer

A

No!

1941- Medical Planning Research, a group of 200 doctors, endorsed provisional plans for a nationwide health service.

Question 42

Q

Negotiations 1942-44

The creation of a post-war health system required intense negotiation between who?

Were the groups willing to collaborate? What were they concerned about?

Answer

A

<ul> <li>Doctors represented by the British Medical Association (BMA), and managers of local authority, private and voluntary hospitals.</li></ul>

<ul> <li>Were willing to collaborate but were also concerned about the loss of autonomy that a national state-run health system required.</li></ul>

Question 43

Q

The Emergency Medical Service

What did the government publish in 1944 & what did it reccomend?

Answer

A

<ul> <li>Published a White Paper on health- reccomending a new national system paid for from general taxation.</li></ul>

<ul> <li>By end of WW2- huge shift in thinking about healthcare. All 3 main parties committed to state-provided, centrally funded healthcare.</li></ul>

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Theme 2 b 1 - Health provision, 1918-45 Flashcards

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