Contribution of Beveridge Report to Creation of National Health Service and Development of the Welfare State - Term Paper Example

How The Beveridge Report Of 1942 Made Such A Significant Contribution To The Creation Of The NHS And General Development Of The Welfare State Beveridge report (1942) is known after its author Sir William Beveridge. He had been the Director of the London School of Economics during 1919-37. He was the President of the Royal Statistical Society at the time of his well known report which laid the foundation of a welfare State for the United Kingdom. The report of 1942 is titled Social Insurance and Services. It has become a public health classic although it had no mention of medical care or disease. It is rather a literary classic typical of a British civil servant style advocating improvement of health services in the U.K. which had been poor in the pre-Second World War period and inferior to other social protection measures in the U.K. at that time. The report had no recommendation of how health services should be organized except that provision and finance should be welded together and that cost of service and financial viability of the service providers depended on the manner in which the services are organised. His was a detailed scheme aimed at maintenance of employment and income treating health interventions as one of the allied services instead of dealing with the health interventions as public health specialists might have expected. This came at a time when Depression had set in and economic collapse was about to occur after the war time rhetoric ended. This report primarily was concerned with the health care as the means restoring people’s capacity to work and hence largely emphasised on post-medical and rehabilitative care (Musgrove) The World War had its heavy toll on the British people that the resultant rationing and evacuation prompted a determination for creation of a new society in which the British people received protection from poverty and ill health. The Second Rowntree report of 1936 had already highlighted the miseries of British poor families. In his previous report, Seebobm Rowntree had reported on the status of poverty thirty years earlier. In the second report, he stated that many families in the U.K. had been living in poverty and could not help themselves and therefore urged the Government for remedial action for freeing the people from the ill effects of poverty. As a follow-up action during the middle and second world war, British government appointed Beveridge as the head of a Royal Commission to advice on rebuilding of Britain after the war. Beveridge gave his report in 1942. In his report, he identified Five Giant evils of Squalor, Ignorance, Want, Idleness and Disease and advocated that they should be tackled. He insisted that the government should be responsible for its citizens “from the cradle to the grave” and therefore recommended the formation of a welfare state in Britain. He had already been involved in the Liberal reforms set in motion in the years from 1906 to 1914 which helped only minority people. The wage earning families were ignored and they were not eligible for the automatic entitlement to health care. Mothers had to forego their own medical treatment in order to meet expenditure for the treatment of their children. The Second Rowntree report of 1936 had already announced that the poverty had still existed in Britain and that about ten percent of the population had been undergoing hardship. Besides, the wartime sufferings prompted many leaders of the country to think that some action must be taken. The evacuation activities revealed that people evacuated were in poor health and rationing of food items highlighted the need for government’s intervention (Chandler, 25). The two pillars of social security system namely Lloyd George’s National Insurance Act of 1911 and Workmen’s Compensation Act 1897 had become complex in administration (Bartrip). The other forms of national insurance for unemployment and medical expenses and pension schemes for the retired and for widows also became more important and more complex. The Great Depression that began in 1929 destroyed the national unemployment insurance system as it was impossible to maintain 2 million unemployed people from out of the contributions received under the scheme. The inflation as an aftermath of second word war also diminished the benefits being received under other national insurance and workers’ compensation schemes. It was with this background that the Beveridge report was submitted in 1942. Beveridge recommended a streamlined national insurance system backed by six basic principles of flat-rate subsistence benefits, flat-rate contributions, unification of administrative responsibility, adequacy of benefits, comprehensiveness and classification of people according to their needs. Beveridge found the workers’ compensation system had become unpopular among the employees and trade unions although the system of national insurance against sickness proved to be robust. He found that in the former, the claims were being settled between parties with unequal bargaining power and as such he proposed the integration of both the systems of workers’ compensation and national insurance (Cane and Atiyah ,331). Beveridge looked at the world in personal perspective that even a tooth infection was considered a medical crisis. As he was not popular among his contemporaries, his report did not attract the attention of Mr Churchill and his colleagues. That all parties were committed to Beveridge report was far from the truth. His report was not found favour with the Coalition government in 1943. The then prime minister, deputy prime minister and the leader of the Labour party all who hated Beveridge were not in favour of implementing his recommendations in spite of the creation of Social Security League for garnering support for the implementation. Churchill who was the Prime Minister tried his best to thwart the report and made known his resolve not to implement it until next general election. It was because the ministry was dominated by Conservatives and Labourites and Beveridge was neither of them. He was a non-socialist collectivist. And was described as social evangelist of the old Liberal School by Bevan in 1942. He welcomed the Beveridge report for highlighting the ill effects of capitalism. As Beveridge was Liberal at heart, he joined the liberal party in 1944 and got elected in a war-time by-election, although he had committed not stand in the by-election as an opposition candidate in order not to displease Churchill who was in a half mind to implement his report. But the persons to whom he had committed not to contest the election, themselves contested and sat in the cabinet to vote against his report. Though Beveridge was not successful in 1945 general election, he remained a prominent liberal. Beveridge report became an important policy document for his liberal party and in fact was the only party manifesto for the 1945 election. Beveridge opined that poverty could be removed only through re-distribution of income among the working classes. without resorting to wealthier classes. This in effect meant that better paid employees would financially support their own class who is less fortunate which included the unemployed also. This was based contributory principle of giving benefits as a right in return for contribution made rather than as free allowances from the State. Beveridge disliked being called father of welfare state as he envisioned a social service state in which citizens had duties as well as rights (Rintala, 14-18) . Thus it was only after the exit of the Conservative-led coalition government in 1945 general election, the newly elected Labour government took the initiative to set up a welfare state so as to systematically tackle the five giant evils identified by Beveridge. Emergence of more equal society was the key to welfare state. Beveridge’s investigation discovered the existence of want or poverty. Thus, following his recommendation, a series of legislations were enacted to tackle the problems identified by Beveridge. They were The Family Allowances Act 1945, The National Insurance act 1946, The National Assistance Act 1948. The Family Allowance Act gave all children under 16 allowances except for the first born child. The National Insurance Act brought in new insurance scheme to provide the contributors a range of benefits such as unemployment benefit, sickness benefit, maternity benefit, retirement benefit and widow’s benefit. The National Assistance Act covered the residual people who could not be covered or did not contribute for benefits under National Insurance Act. This Act gives grants in the form of money and /or accommodation who cannot meet their own needs (Walsh, Stephens and More, 46). The National Health Service Act 1946 however was the main legislation providing for a national, comprehensive and free health service for all the people through establishment of the National Health Service (NHS) on 5 July 1948. Prior to NHS, health services were fragmented into private, voluntary, local authority and individual practitioners. The aftermath of the Second World War was the reason for the government’s intervention for the first time and also to have some control over health care providers in the country. Thus, Emergency Medical Service was established to provide coordinated and state controlled hospital bed service as also a national blood transfusion service and an ambulance service (Walsh, Stephens and More, 47). Blakemore (1998) states that this idea had been in discussion for quite some time and the turn of century witnessed an inadequate health service to meet the needs of the entire population. Thus, after the end of the second world war all types of hospital services were nationalised as the Beveridge report had placed the giant evil of disease high on the political agenda. The NHS was established on the following key principles. That the services would be free of cost at the point of delivery. That it would cover all the people in all the parts of the country. That access to the service should be need based that a real clinical need should exist rather than ability to pay, chance or other social criteria. This policy practically brought into effect the democratic socialism in which the Labour government believed. And the universal healthcare was justified on the moral grounds. (Walsh, Stephens and More, 47). Idleness is another aspect (evil) which the .Beveridge report wanted to tackle by creating full employment which was later modified as high and stable employment. When the world war ended, the fear that all the returning soldiers would be jobless was belied since during the immediate post war years, the Labour government nationalised all the public utilities such as gas, electricity, water, coal, steel and the railways which enabled the politicians to manage them to their full potential so as to cerate maximum possible employment. These measures ensured relatively high employment levels until early 1970s (Walsh, Stephens and More, 47). Ignorance which could be tackled by proper education system was attempted to be remedied by The Education Act 1944 as the education system was patchy and fragmented like the health care system prior to the end of world war. Thus, the school leaving age which was 14 earlier was enhanced to 15 and then 16 during 1960s. Equal opportunity was given to all for their right to education (Walsh, Stephens and More, 46). Welfare State Thus, the initial year post-war era witnessed the expansion of welfare state in the U.K. in terms of state run and funded welfare services which also meant the increased intervention in the people’s lives as social reconstruction after the world war was the need of the hour. However, the sociological ideas of the Labour government experienced resistance due to post war economic problems as the post war Britain was short of money. The population though was favour of the social reforms lost confidence due to increasing rate of taxes and increasing prices of commodities. When Churchill came back to power in 1951 as the new head of the conservative government felt that the country still needed to tackle the five evil giants and wanted to continue the welfare policy (( Walsh, Stephens and More ,48) Conclusion The above account of Beveridge report thus was the stimulus to the creation of a welfare state in Britain through establishment of the NHS which relieved the people of economic burden and restored their health. Beveridge who did not believe in free services without corresponding contribution form the beneficiary class somehow paved way for the establishment of a Welfare State. The history has proved his point that there is a limit to free welfare as otherwise it would only mean in collection of more and more taxes. However, it can be said that Britain has reached optimal level of a Welfare State. Works Cited Bartrip P W J. Workmen's Compensation in Twentieth Century Britain: Law, History and Social Policy , Avebury, 1987 quoted in Cane Peter and Atiyah P.S. Atiyah’s accidents, compensation and the law, Cambridge University Press. 2006. Beveridge William, Social insurance and allied services. Report London, HMSO, 1942 quoted in Musgrove P. Health Insurance: the influence of the Beveridge Report. Bulletin of the World Health Organisation, 2000, 78(6) p 844-845 Blakemore. K. Social Policy: An introduction. Buckingham. Open University Press, 1998. Cane Peter and Atiyah P.S. Atiyah’s accidents, compensation and the law, Cambridge University Press. 2006. Chandler Malcolm. Britain in the age of total war, 1939-1945. Heinemann, 2002. Musgrove P. Health Insurance: the influence of the Beveridge Report. Bulletin of the World Health Organisation, 2000, 78(6) p 844-845 Rintala Marvin. Creating the National Health Service: Aneurin Bevan and the medical lords Routledge 2003 Walsh Mark, Stephens Paul and Moore Stephen Social Policy and Welfare, Nelson Thomas, 2000. Read More