The Development of Health Care Provision in Britain - Essay Example

?The Development of Health Care Provision in Britain. Essay Plan Introduction Provision in early history, the middles ages and into the 19th century.Reasons the NHS finally came into being. Reasons for opposition to the scheme Some early developments Conclusion Introduction Since the very first person arrived in Britain there would have been those who fell ill or were injured from time to time. In Roman times doctors were often Greeks and might belong to a private family as well as acting as general practitioners. There were also doctors and medical assistant attached to the invading Roman army. Even in families where there was no doctor some member of the household would have acquired some necessary medical knowledge:-. Unwashed wool supplies very many remedies…..it is applied….with honey to old sores. Wounds it heals if dipped in wine or vinegar….yolks of eggs….are taken for dysentery with the ash of their shells, poppy juice and wine. It is recommended to bathe the eyes with a decoction of the liver.(Pliny, 1st century C.E.) There would also be wise women, often herbalists. The History of Hospitals and Health Care in Britain This situation would have continued until the Middle Ages when the very first hospitals appeared, driven by Christian convictions, and founded as religious institutions. St Bartholomew’s Hospital, in central London, was founded in the 12th century by a monk. These religious foundations were based upon ideas taken from the gospels, as in Matthew chapter 9 where there are several examples of Jesus caring for the sick. . By the time of Elizabeth I the state was beginning to play its part. In response to the increasing number of vagrants and wandering jobless an act of 1601 set up the first poor houses, and these would have included at least minimal care for the sick and mentally fragile who were also poor (Bloy, 2002). Local taxes were used to support such ventures. It was in the 18th century that many of today’s larger British medical institutions came into being as voluntary hospitals. At first these were in long established cities such as London and Edinburgh. With the coming of the Industrial Revolution newly burgeoning cities such as Manchester also opened hospitals. These were funded by private contributions. Specialist hospitals such as those dedicated to maternity care, and eye hospitals, also opened. Asylums were under the care of local authorities (Voluntary Hospitals Database, undated). At this time though nursing training was rudimentary . It was only with the threat of various wars , including the Crimean War and the First World War, that the need for formal training became obvious. In 1911 the National Insurance Act became law. This is an important stage in the founding of a welfare state, and it resulted in care being provided for many people . There were many schemes to help poorer people to pay for their care. In Birmingham the Birmingham Hospital Saturday Fund was begun in 1873 by a local clergyman (BHSF Undated) .The fund was one of several from various parts of the United Kingdom and continued into the days of the National Health Service when, for the payment of a few pence weekly, people could ensure a place in a convalescent home after an illness. The aims of the organisation today are still to provide convalescence, but also to invest in medical research. Meanwhile richer people continued to visit private clinics or to have doctors visit them at home. The majority voluntary hospitals and schemes later became incorporated into the National Health Service, which was initiated by the Labour government in 1948, based upon an ideal of good health care being made accessible to all, whatever their situation in life. According to Rivett (Undated) this principle had been in existence for at least a century, with many individual initiatives, and the London County Council even wanting to provide its own hospitals, but not enough had been done to make it a reality. In I920, soon after the end of the First World War, Lord Dawson produced, at the request of the then Liberal government, a report about how a more united health service might be organised. This then developed as an idea which came out of the Beveridge report ‘Social Insurance and Allied Services’. He cited five ‘giants’ to be overcome in the post war reconstruction of Britain. These were ‘want, disease, squalor, ignorance, idleness’. The report stated that :- Medical Treatment covering all requirements will be provided for all citizens by a National Health Service. The response to this report, and to a number of other factors laid down the foundations for the idea of the welfare state, and this included the National Health Service (NHS Timeline, 2012). In February 1944 the then Minister for Health Henry Willink produced a White Paper ‘A National Health Service’ (Nuffield Trust , 2012). It was helped by the number of hospital beds which had been established as a result of needs created by the Second World War, as well as a national ambulance eservice, and in 1946 a blood transfusion service. The view that adequate health care was a right, not something which depended upon the nearest charity and how much was raised at the local fete. There was also general agreement by politicians from all parties that the existing services needed rethinking as they were a chaotic mess. Each voluntary hospital had its own rules and having individual admission policies – some maternity hospitals for instance would turn away married women, having been set up with other aims. The Salvation Army in Hackney had for some time provided maternity care to unmarried women, and set up its ‘Mother’s Hospital’ in Lower Clapton in 1913 to meet the needs of married as well as unmarried women, often the widows of soldiers and so far from home, there being no other provision in the area (The Lost Hospitals of London , undated). The fact that each had different aims, funding , and rules led to what would now be called a post code lottery of provision. Within the voluntary section great efforts were needed to raise funds and deciding how it should be spent. Outside the hospitals access to a general practitioner was free to low paid workers, but this provision did not extend to their wives or children, or to those workers with a somewhat better income level or to the retired. The voluntary sector was having financial problems and, because of the Second World War had involved the setting up of an emergency medical service to meet the increased needs caused by the war. The younger members of the health professions, especially young doctors, were increasingly convinced that something better could be done. Their seniors though were making a lot of money without the N.H.S. and did not welcome the wide reaching changes. They also believed that their freedom as professionals would be constrained, and that their wealthy patients would disappear. These misgivings were eventually overcome as they were given many concessions by the government. The N.H.S. finally began in 1948, under Health Secretary Aneurin Bevan, in Clement Atlee’s Labour government, as an umbrella organisation bringing together such people as hospitals, opticians, dentists and pharmacists. This early ‘Free at the point of use’ service did not last in its entirety. In 1952 a prescription charge of 1/- (One shilling) was brought in and dentists also introduced charges. Health ministers found that they had very little control over the performance of NHS because the true power was with the doctors in those days. There were huge funding difficulties , as there still are, in the main because of the advances made in medical care and the related costs. Over time the charges to patients would be removed and more often increased, but the principle remains that general practitioner and hospital care is still free at the point of use, although people do of course make contributions throughout their working lives, the money being deducted directly from their wage packets. This however does not cover the complete costs and so taxes in other forms are also required. Conclusion Care provided in those early years was very different from today. They did not of course have all the modern technology. Life spans were shorter and stays in hospital were often much longer , extending into weeks after surgery, rather than days. Home births were also very much the norm, often without any or very little in the way of ante-natal care. Despite all its problems , the care provided today, built on the work of those early years, results in most cases in better care being given, and higher survival rates for such things as cancer and premature birth. There is much to be thankful for. The modern day National Health Service is often criticised, and does of course have its faults, some of them major ones, but it remains so much than what was there before, and is far better than is available in most countries. References Barts Health Trust , 2012, St Bartholomew’s Museum, viewed ,22nd February 2013 http://www.bartsandthelondon.nhs.uk/about-us/museums-and-archives/st-bartholomew-s-museum/ BHSF, undated, viewed 23rd February 2013 http://www.charitiesdirect.com/charities/birmingham-hospital-saturday-fund-medical-charity-and-welfare-trust-502428.html Bible, New International Version, 1990, London, Hodder and Stoughton Bloy, M., 2002, The Poor Law , 1601, viewed 22nd February 2013, http://www.victorianweb.org/history/poorlaw/elizpl.html N.H.S. Timeline, viewed 23rd February 2013, http://www.nhs.uk/Tools/Pages/NHSTimeline.aspx Nuffield Trust, 2012, Reform in the NHS , viewed 23rd February 2013, http://www.nhshistory.net/shorthistory.htm Rivett,G., Undated, National Health Service History, viewed 23rd February 2013 http://www.nhshistory.net/shorthistory.htm Pliny, quoted in Medicine in Ancient Rome, History Learning Site, viewed 22nd February 2013 http://www.historylearningsite.co.uk/medicine_in_ancient_rome.htm The Lost Hospitals of London , The Mother’s Hospital, undated, viewed 23rd February 2013, http://ezitis.myzen.co.uk/mothers.html Voluntary Hospitals Database, undated, viewed 22nd February 2013 http://www.hospitalsdatabase.lshtm.ac.uk/the-voluntary-hospitals-in-history.php#2 Read More