The Original Concept of the NHS in 1948 - Essay Example

?The original concept of the NHS in 1948 was to improve the health of the nation. It was perceived that this would result in a reduction in future need for provision. Discuss these statements, refering to existing models of health. The World Health Organization currently defines health as a ‘state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO, 1948). This is known as the biopsychosocial model and encourages health practicioners to look at health as a whole, ensuring that individuals are well-equipped to lead a full life in the physical, mental and economic spheres. This has not always been the predominant measure of health, however. Prior to this report, the biomedical definition of health held precidence, and this suggested that health need only be the absence of disease. This is not always the case, however, as an individual may state that they are healthy in biomedical terms, but their social class or lifestyle may cause them to be more susceptible to certain diseases or even just to have a lower quality of life than another individual. The aim of this essay is to discuss the effect that the NHS has had on the health of the UK and how these definitions of health have helped shape the British awareness of health and how it is to be maintained. This essay aims to explain how the success of the NHS has caused it to have more problems – the successful nature of the service has allowed people to live for such a long time that they now require more epensive medical care for longer than ever before. The NHS believed that it would reduce the need for provision, but instead has enhanced it. There are several aspects of an individual that determine the standard of health he/she can enjoy. These range from the unalterable – age, sex and genetic factors, for example – to the areas which health promotion aims to improve and which should not be an issue in the sphere of health – lifestyle, housing and social class. Age is evidently a determinant of health, in that the chronic diseases (cancer, diabetes, Alzheimer’s, heart disease) that have come to define the modern West occur increasingly with age . Age is also generally associated with being slower and weaker and as such the elderly may believe themselves to be in ‘suboptimal health’ (Ubel et al., 2005, p1054) and be more inclined to seek healthcare. Sex is another obvious determinant of health, with various diseases affecting either sex more than others. Autism, for example, affects men more than women , but depression affects more women than men (Nolen-Hoeksema, 2001, p173). The same can be said for various cancers that simply cannot occur in a certain sex because of the missing anatomical parts. Hereditary factors such as genetic disease (Huntington’s, Fragile X) or genetic predispositions (posession of the BRC1 gene [Xu, 2008, p460], susceptibility to early-onset Alzheimer’s) also affect our health. However, it is those things that health promotion can have an effect over, such as lifestyle, housing and social class. Lifestyle is probably the biggest killer, with smoking, lack of exercise and over-eating still being common in the UK (Office for National Statistics, 2009) and the resulting diseases associated with these conditions being more deadly than ever. Housing and social class have less of an effect than in the past, with benefits and, of course, the NHS providing an equality of care for all people in the UK. Unemployment is also considered dangerous in the health stakes. This is due to the fact that it reduces longevity and health, particularly amongst men (Carvel, 2002, p1). It is also reported that the NHS could help reduce unemployment by recruiting in the local area and thus save costs to itself. However, unemployment used to be a much bigger worry than it is today, with healthcare having to be paid for up front, making it particularly inaccessible to the masses of people on low income. However, this all changed with the start of the NHS and the availability of the free at the point of access healthcare that it provided. David Lloyd George had attempted to set up an approximation to a National Health Service with the National Insurance Act of 1911, but this had many flaws and was still unavailable to those in certain trades, and became increasingly difficult to maintain in light of the cuts of the 1930s (Mulholland, 2009, p39). It also did not extend to the dependants of the wage earner. However, during and immediately prior to the Second World War, the need to introduce a health insurance that would cover all trades and dependants was becoming increasingly recognised (Webster, 2002, p111), but no action could be taken due to the crisis. A Labour government headed by Clement Attlee came into power shortly after the war, and Aneurin Bevan took over the task of persuading doctors and the British Medical Association (BMA) to join the health service planned during the war . Despite the fact the BMA refused to join the service (Talbot-Smith & Pollock, 2006, p32), the new NHS was launched on the 5th July, 1948 and vowed to take funding from taxation rather than the National Insurance (Mulholland, 2009, p78). The services continued as before, but were free at the point of use and everyone was eligible for care (Webster, 2002, p20). However, by the 1950s the NHS was requiring increasingly large amounts of funding and a charge for prescriptions was introduced to help cover some costs and dental treatment also became chargable at a rate of ?1 per treatment (Webster, 2002, p89). However, services within the NHS were improving – there were more trained medical staff and more outposts of treatment included under the umbrella than ever before. The Mental Health Act of 1959 also improved standards of care for those with mental illnesses (Pilgrim, 2009, p23), meaning that the NHS was now enccompassing more elements of the WHO definition of health. In the later parts of the 20th century, it became clear that the NHS could not generate the resources needed to deal with an increasing aging population and major reforms became necessary (Mulholland, 2009, p382). These reforms are still continuing today, as is the increase in numbers of elderly patients. The increasing aging population is in part due to the success of the NHS. There have been substantial improvements in the health of the British nation since 1948, and as such people are living longer than ever before and becoming more and more likely to develop a chronic illness (costing more due to the long-term nature of the problem) rather than the cheaper to heal acute illnesses more common in the past. Life expectancy for males has increased by over 6 years for a newborn since 1980 (Office for National Statistics, 2009), and those aged 65 can expect to live a further 17-20 years (Office for National Statistics, 2009). This is a huge increase in longevity in such a short period of time, but it comes at a price – those over 65 are more likely to require long-term health care (Office for National Statistics, 2009). Health Protection Scotland (2007) has provided information on the number of infectious diseases that were diagnosed, with infectious diseases showing a downward trend over the last century. This is due to an increase in vaccinations and increasing precautions taken, such as the NHS directive to encourage people to wash their hands. It is also a significant cause of the increasing aging population. There have been other significant improvements to the health service. These include genetic discoveries such as that of the BRC1 gene that can help identify those who need to be more cautious with their health (Xu, 2008, p460) and improvements in technology. Diagnostic technology, for example, has improved dramatically, with the humble x-ray being relegated to the realms of broken bones and nMRI, CT scans and ultrascans being used for more compex problems. This can help diagnose illnesses far before they would have been traditionally, but the trade-offs here are the increased price burden on the NHS and the increase in elderly population, which in turn provokes an additional financial burden. Having mentioned this, it is worth discussing how much demand on the NHS has increased. It is reported that the number of prescriptons per person per year has doubled in the last two decades. This means that in the 1980s, an individual would generally have had 8 prescriptions per year, whereas in 2010, an individual would have 16 (Busield, 2010). It is evident that the general increase in longevity would cause not only more prescriptions per year to be issued due to an increase in chronic illness, but to raise the number of years that these prescriptions would be needed for. If we were to take the statistics from the Office for National Statistics mentioned above, then the combined doubling of prescriptions and additional 6 years of life, the NHS can expect to provide 40 more prescriptions per person than it would have 20 years ago. There is also the issue of the spend on health promotion. The NHS currently spends money on several health inititives, such as the smoke free scheme which distributes free packs to help people stop smoking (Talbot-Smith & Pollock, 2006, p100) and various advertisements placed to encourage people to eat more fruit and do more exercise in an attempt to combat obesity. Obesity and lung cancer are two diseases that are in the most part preventable, but cost the NHS billions of pounds every year (Carvel, 2002, p1) to deal with. It is suggested that the NHS spend more on health education in an attempt to save money on other preventable or semi-preventable diseases. However, some people believe that spending money on health promotion is a waste and should be paid for by the education budget. The conclusion here is that the NHS has dramatically improved the health of the nation. Having looked at various statistics, it is evident that longevity has increased to such a level that the UK now enjoys some of the longest lives in the world, and infectious disease rates are increasingly low. However, there are some issues with stating this fact blindly. This increase in health has also caused more problems which fall within the sphere of both the biomedical and the biopsychosocial models of health, with mental disease and chronic disease causing more problems than ever before. Lung cancer and obesity rates are at an all-time high (Talbot-Smith & Pollock, p210), with children becoming increasingly likely to suffer from illnesses related to obesity such as diabetes (Secrest et al., 2011, p376). This means that the longevity that the NHS has played such a large part in creating has also caused some problems, and the nature of the British people today means that this life expectancy may not last and may not be applicable to the current living generations. This improvement of the health of the nature on some levels has reduced the need for care for infectious diseases such as mumps and measles down to the cost of vaccination, saving the NHS millions of pounds each year. However, it is too simplistic to say that this has resulted in a reduction in the need for provision. As stated several times, the NHS has had such a success that it has caused itself more problems, although there is hope. If the NHS has played a part in so dramatically increasing the health of the nation since 1948, there is no reason that further medical advances and increasing awareness of the public through health education could not help the NHS to continue to improve the health of the UK in the biopsychosocial model of health. Bibliography Busield, 2010. Prescriptions Per Person Double. Nursing Times. Available at: http://www.nursingtimes.net/prescriptions-per-person-double/5013070.article [Accessed April 16, 2011]. Carvel, J., 2002. 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