Health Care
in the UK
The NHS
In this unit you will learn:
•How and why the NHS was created
•What the original aims of the NHS were
•Individualist and collectivist views of health care
•New Labour’s “Third way”
•Improvements in health
•New health problems
•The growth of private health care
•The advantages and disadvantages of private
health care
The Five Giants
The NHS was set up in 1948 as a result
of the Beveridge report.
Beveridge had identified five problems:
• Disease
•Ignorance
•Squalor
•Idleness
•Want
The NHS 1948
Nye Bevan was
the Minister of
Health who
oversaw the
creation of the
NHS.
“Administration
will be the chief
headache for
years to come”
Aneurin (Nye)
Bevan
The main political parties all agreed on the basic
principles of the NHS: a comprehensive service,
caring for all and free at the point of use.
Individualist Vs Collectivist!
Ideology - part of Thatcherism
Ideology -socialism
Responsible for own health
Strong link between
poverty & ill health.
Lifestyles- smoking drinking
poor diet, little exercise
Individuals are aware of the health
risks of these
Individuals should be allowed to opt
out of paying for NHS & allowed to
put this money towards Private
Medical Insurance (PMI)
Poverty related ill
health is wider than scope of NHS housing & benefits
Government has a responsibility to
narrow inequalities of society
Lifestyle choices linked to poverty stress of unemployment & lack of
knowledge
The Third Way
Labour governments since 1997 have drawn on
both individualist & collectivist ideas to come up
with the Third Way idea.
•The need to address the issue of poverty:
-improving housing
-improving education
-get unemployed back to work
• The need for individuals to take responsibility:
-promotion of healthier diet
-promote taking exercise
-discourage bad habits - drinking,
-prevention better than cure
Health Improvements
Life expectancy has increased:
Men
1950
66 years
Women
71 years
2000
74.4 years
79.6 years
Why?
•Setting up of NHS
•Better nutrition (rationing into 1950s)
•Better Housing
•Improvements in medical care
•Reduced infant mortality
•Preventative treatment of disease
In the future
life expectancy
might reach
100 years!
Vaccinations
•TB - Tuberculosis major killer made
worse by overcrowding.
Now drug resistant
strain of TB becoming
a problem.
•Whooping Cough
•Diphtheria
•Tetanus
•MMR controversy
•HPV - cancer
Improved drugs &
surgery
•Better detection & treatments of cancers
•Transplant operations
•Heart by-passes
•More drugs
•Use of
technology
Better Lifestyles?
•Less people smoking
•Greater awareness of health issues
•Preventative programmes
But: will same be true in 50 years time? Elderly today had a
healthier diet & more exercise than children growing up today have.
Problems:
•Junk food, additives & processed meals
•TV & PC
•Cars
•Mobiles???
•Less exposure to germs!
•HIV & AIDS
New Health Problems
•MS & ME
•Meningitis
•E-Coli
•BSE and variant CJD (mad cow disease)
•Increase in allergies & asthma
•High death rates from cancer & heart disease
•Lack of exercise
•Poor diet
•More elderly people
Can you think of any others?
Private Health Care
•12.7% of the population have
private medical insurance (PMI).
•More PMI companies: BUPA & AXA
•These companies advertise - get examples.
•People pay for one off operations or treatments.
•Cosmetic operations have greatly increased.
•NHS viewed as not always providing the best and most up to date
treatments.
•The NHS often has long waiting lists to see specialists & have
operations.
•Thatcher encouraged individual responsibility - tax relief for over
65s paying PMI.
Advantages of Private Health Care
•Individual choice - how to spend your money
•Takes some pressure off NHS - cuts waiting lists
•Focus on individual responsibility - you smoke you pay
more PMI
•Some treatments/surgery not available on NHS - Some
fertility treatments
•Doctors can top up wages doing private work - prevents
brain drain
•Creates additional employment - medical & non-medical
•Allows top executives & key workers to get fast treatment
- preventing a slowing of the economy
•Private health gives the patient greater comfort - choice
of meals, private room, TV and phone.
•Private patients still contribute to the NHS
•Patients have greater choice on the timing of operations
•Private hospitals can operate on NHS patients - further
cutting waiting lists
•Private Health care has always been available in the
UK and could not now be reasonably removed.
•The private sector shares resources and facilities with
the NHS.
•The private sector conducts a great deal of medical
research
Disadvantages of Private Health
Care
•Choice only for the well-off
•Makes NHS look second class
•Queue jumping
•Common reward from companies
employees for good work
to
•All medical staff trained by NHS - private sector never pays for
training
•Moonlighting - working in both NHS & private - results in
overworked & tired doctors
•Lessens pressure on the government to improve NHS if “cream”
using private
•Primary Health care not private - only London has
good coverage of private doctors - private patients
still have to use NHS doctors
•Some groups of people may find it hard to get PMI
- elderly, disabled & terminally ill
•Not subject to same controls Intensive Care Units in NHS have
to have ICU trained nurse on duty
at all times - private hospitals don’t
•No emergency treatment facilitates
Essay question
How does this private sector contribute to health care
in the UK? This question requires you to look at
PPP/PFI as well as private health care.
15 Marks