Theme 2 b 3 - The impact of the NHS to 1979 Flashcards
Impact on public health
What happened to life expectancy of men & women between 1948-1979?
Women : 70.1 years (1948) - 77 years (1979)
Men : 65.8 years (1948) - 71 years (1979)
Impact on public health
What caused the increase in life expectancy?
Combination- better healthcare & increased affluence.
What did the Merrison Report 1979 argue?
- Hospitals recieved around 70% of NHS funding, whereas other services including GP services & preventative health programmes recieved much less.
- Within hospitals- surgery and general medecine recieved much more money than services dealing with mental illness & geriatric medecine.
- Investment in hospitals tended to create regional inequalities. e.g. A lot of the investment in hospitals introduced in the 1962 Hospital Plan was spent in London.
Health & class
Who benefitted more from the NHS?
Why was this?
- The middle class tended to benefit more than the working class.
- Investment in working- class areas lagged behind investment in middle-class areas.
Health & class
Research in the 1950s indicated what about budget allocations?
Give an example of what a study found?
When did this problem persist into?
- Budget allocations favoured middle class areas.
- Hospitals in some middle-class areas recieved an annual budget of £4.98 per head - whereas in working- class areas, busgets were set at £3.19 per head.
- 1970s- similar study conducted 1972 found that middle class areas tended to have per capita budgets that were 24% higher than working-class areas.
Health & class
What did the Black Report, published by the Department of Health and Social Security in 1980 indicate about the gap between working class & middle-class healthcare?
It grew between 1949 & 1972.
Health & Class
By the 1970s- what did the gap between the richest and the poorest mean that?
- Working class women - twice as likely to die in childbirth compared to middle-class women.
- Unskilled working men- twice as likely to die before reaching the age of 65 as middle-class professionals.
Impact on women- reproduction
What did the NHS give women greater control over?
What did this lead to?
Control over their fertility!
Led to a decline in birth rates!
Impact on women- reproduction
Women born in 1920 had how many children on average?
How is this different to a woman born in 1966?
1920- Two children (average)
1966 - 1.3 children (average)
Impact on women- reproduction
What contributed to women having fewer babies?
- Free contraception from NHS- only available from 1970s.
- Education provided by the NHS.
- Contraceptive pill- introduced 1961.
Impact on women- reproduction
What were the drawbacks of the availability of the contraceptive pill?
- Early contraceptive pills had side effects such as an increased risk of a stroke & some types of cancer.
- The availability of the pill meant that men tended to take less responsibility for contraception.
Abortion
How did the 1967 Abortion Act have a mixed impact on women’s reproductive rights?
- The right to terminate a pregnancy was dependent on the approval of two - typically male doctors.
- Medical staff were given the legal right to refuse to participate in terminations.
- Access to abortions were controlled by medical professionals - and therefore provisions reflected the beliefs and prejudices of doctors.
Abortion
Between 1968 & 1978, how many terminations were carried out?
1.5 million terminations.
Abortion
How were abortions more easily available to middle class women?
Around 58% were performed in the private sector, to women who paid around £200 for the procedure.
How was medical supervision of abortion regulated?
What did this result in between 1968 & 1978?
Poorly regulated in the NHS.
86 people died during a legal abortion between 1968& 1978, and 72 died as a result of NHS surgery!
Childbirth
In the 1950s- what % of women gave birth in hospital?
60%
Childbirth
By 1978, what % of women gave birth in hospitals?
97%
Childbirth
How did the number of women giving birth in hospital change from the 1950s to 1978?
Changed from 60% (1950s) to 97% (1978)
Childbirth
How far women benefitted from hospitalisation during this period is disputed. What did one survey record?
What did this lead to?
- Between 70-90% of women who gave birth in hospitals were given an episiotomy in order to assist the birth.
- Procedure led to pain when sitting in 68% of cases and longer recovery times. The procedure- often carried out without the consent or knowledge of the woman.
Childbirth
What have many feminist writers argued about the medicalisation of childbirth?
- Shifted away power from women to men.
- Doctors - who between 1948 & 1979 were predominantly men and controlled childbirth.
Women and work
What did the NHS create for women & why was this?
- Greater opportunities for women in the workplace.
- The expansion of health & social services created a state-funded ‘caring profession’.
- According to traditional stereotypes- women were naturally more caring than men- so were able to find jobs in these new professions.
Women & work
In 1948- how many female nurses did the government try to recruit?
54,000 female nurses.
Women & work
Where were a significant minority of female nurses recruited from?
The Caribbean
Women & work
What were the limiting factors for women within job opportunites?
- Women in general- restricted to the lower paid and lower status jobs in the 1950s & 1960s.
- Experience of black women = even worse. Promotion was extremely rare and they were subjected to racial harassment.
Impact on mental health
By what year was there a concern at the top of the government that the NHS was not treating mental illnessess effectively?
1957
Impact on mental health
What did the 1957 Royal Commission on Mental Illness and Mental Deficiency argue?
- Patients with mental illnesses were routinely stigmatised.
- Their personal rights were not respected.
- Mental hospitals operated more like prisons than hospitals.
Impact on mental health
How did the 1959 Mental Health Act address the previous problems surrounding mental health care?
- Introducing new terminology. Patients were referred to as ‘ mentally ill’ rather than insane.
- Removing judges from the process. Decisions to force treatment on people with serious mental health problems made- by mental health tribunals rather than judges. These tribunals had responsibility to protect liberty of patients.
- Introducing an open doors policy, so most patients could attend voluntary treatment sessions in daycare centres- rather than being compelled to stay in hospital long term.
Impact on mental health
The 1959 Mental Health Act- what care did it move away from and to?
What plan was it confirmed by & what did it propose?
Move away from residential care towards out-patient or drop-in care.
Confirmed by 1962 Hospital Plan- proposed a 50% reduction in hospital beds for people with mental illnesses by 1975.
Impact on mental health
The 1959 Mental Health Act- How did the act not have the impact that was hoped for?
By 1974:
- Only 15% of the daycare places needed were available.
- Only 33% of the hospital places needed were available.
As a result - patients with mental illnesses tended to be admitted to non-specialist hospitals.
Impact on mental health
What happened as a result of a report into the abuse commissioned -along with a much wider enquiry into all of Britains NHS mental hospitals?
- Long- stay psychiatric hospitals where people had been incarcerated often for decades began to close.
- Report recommended the practise of introducing hospital inspections.
Impact on mental health
How many enquiries had there been into the misconduct and abuse at psychiatric hospitals across the UK had there been between 1967 &1981?
What did this demonstrate about the provision of healthcare for the mentally ill?
25 seperate enquiries.
It was in need of improvement!
Impact on mental health
When were the Two White Papers published?
What did the recognise?
1971 & 1975
Recognised ongoing problems but no major reform happened until the early 1980s.
