Before the NHS, the care was provided by e.g. the voluntary hospitals, private GPs, etc. For instance, there was institution such as St Bartholomew’s in 1123 and St Thomas’s in 1215. People in the UK suffered illnesses that were untreated because going to the dentist, optician and doctor cost money that few could only afford, and the mortality rate was very high. The author will be giving an overview of the history before the 20th century and how this has made a difference to the NHS today. In 1848 Public Health Act was introduced by Edwin Chadwick, because people’s health was impacted by an infectious disease like typhoid and cholera and these were still inadequate for many people and sewerage system. By the 20th century, in 1911 National Insurance Act was formed by David Lloyd George, in which a small amount was taken from an employee’s wage in return they were eligible to free healthcare but very limited. Then the hospital service was developed out of the workhouse which was delivered under the Poor Law. The Local Government Act (1929) was the beginning of the end of the Poor Law. Previously and for the duration of the war, it was thought that the public health service in the local government would offer a basis for the national system. But, the hospital was nationalized, and the role of the local government was limited. It was World War 2 that formed the incitement for change (Webster,1988). Then there was National Health Service Act published in 1946 which was led by Aneurin Bevan, he was the labour minister of health. The British Medical Association (BMA) was against Bevins socialist experiment and even further serious was the opposition of doctors who disliked the idea of becoming employees of the government and hospital consultants as they wanted to continue to charge private patients for treatment. Then on 5th July 1948, the National Health Service was established. The service was financed from central taxation and that everyone was eligible for care. The basic system was splitting the service into hospital services, primary care(GP’s) and Community Services. Due to uncontrolled costs, in 1951, the NHS implemented a charge for prescriptions to help the loss of funding. The author will be discussing the health policy and NHS from 1948 to 2010. However, the history of the NHS has influenced the way NHS today, as people are getting healthier and the life expectancy is increasing (NHS England, 2017).
The early years and 19th century healthcare in Britain
In Britain, the early care for people who were ill was provided by the religious foundation. There were three types of medical practitioner; physician, surgeons and apothecaries. During the 18th century many doctors were practicing without any formal qualification. So, the first state regulation was introduced, Apothecaries Act in 1815 that was in authority for licensing and regulating medical practitioner such as GPs in England and Wales. Then Medical Act (1858) created the advance of the General Medical Council (GMC) responsible for authorising doctors and controlling education and disciplinary matters (Ham, 2009, p. 7). The Medical Act was the progress of medical profession, this was the most important establishment of health service during the 19th century.
In 19th century, many British cities increased fast because of the industrial revolution. However, this was going to take a lot of time for public health to improve and change the lives of people that were living in the slums. People lived in overcrowded and dampness and dirty house; people ate, cooked and slept in a filthy state. There were no drains, so the piles of waste were all over the place and there were diseases which was the main problem for people living in the slums. The living condition was so bad that many people’s lives were cut short. There was an infectious disease such as cholera and typhoid spreading around which was a threat to people’s health. Then in 1848, Public Health Act provided adequate water supplies and sewerage system. Then public health became in charge of local people’s health. The purpose of the act was to help public’s health and to make sure there is more effective facility for improving sanitary conditions of towns and places in England and Wales.
The development of hospitals and policy in 20th century
In the 20th century, National Insurance Act was introduced by David Lloyd George. As poor people could not afford medical help, so the Act gave some medical help to the people. But, this was only entitled to people who worked. There was limitation such as the Act only insured for workers that were covered but, this did not cover their families; and it did not provide hospital care, only the GP service was provided (Ham, 2009, p. 10).
But, in 20th century hospitals and medicines started to develop, and this became gradually selective the choice of patients, by paying more attention to their acutely ill patients and people with infectious diseases. The hospital service had been divided into voluntary and municipal hospitals. Voluntary hospital improved as a charitable institution for the poor people during the 19th century, but it slowly reliant on patients that could pay for the service and this concerned them for losing on their original mission for treating the poor.
Whereas Municipal hospitals were part of wide range of health service that was provided by local government, this was during the 19th and early 20th century. The key issues with municipal health service were that they reliant on taxes from the local rates system, which means that the poorest area had the minimum amount to spend on the health service. The hospital service was equipped with staff not qualified and not have the necessary skill, training and qualification, and it was the Local Government Act(1929) was the beginning of end of Poor Law(Greener, ……REFERENCE TO BE ADDED (HERE)
The Beveridge Report (1942) was aimed to give a comprehensive system of social insurance. It proposed that people working should be payed weekly contribution to the state and in return, the benefit would be paid to people that are retired, unemployed, sick and widowed