Evaluation of Healthcare Demand, NHS Creation, and National Health

This journal article examines the evolution of healthcare in the UK, focusing on the social factors and ideological shifts that created the demand for publicly funded healthcare. It traces the historical context from the Poor Law to the establishment of the National Health Service (NHS) in 1948, analyzing the key factors, including the influence of social reformers, the rise of the Labour movement, and the reports commissioned during and after World War II. The article details the principles underpinning the NHS, its funding model, and its impact on the health of the nation, including increased life expectancy, reduced infant mortality, improvements in mental health, and a decrease in unhealthy habits. The study highlights the significance of the NHS in the UK's healthcare system and its contributions to public health.

HEALTHCARE
HEALTHCARE
Name of the Student
Name of University
Author’s note

1
HEALTHCARE
Social factors and underlying changes in ideology which created the demand for publicly
funded healthcare
Before 19th century, Poor Law was first passed by Queen Elizabeth and it is regarded as
the first legal attempt to improve the overall conditions for destitute. However, this Poor Law
only attempted to health poor people, but the overall ideology was vague as the law failed to
analyse the reasons behind the generation of poverty or poor health and well-being (Leonard
2013). The work done by Elizabeth Fry, Thomas Chalmers and Octavia Hill during 1800 tried to
establish the reason behind poverty. The main reasons behind poverty and poor well-being that
was highlighted include poor or dilapidated or over-crowed housing and poor sanitary condition
of the houses. The poor well-being while residing under this deprived set-up also accounted for
the high rate of mortality and morbidity among the poor and this accounted to outbreak of
epidemic, killing 1000s of people (1831 to 1838) (Ashton and Young 2013). The work
undertaken by Edwin Chadwick Royal Commission during mind-1830s further stated that poor
sanitization is irrevocably linked with high rate of mortality among poor. His works directly
influenced amendment in 1834 Poor Law and led to the establishment of the 1848 Public Health
Act. Public Health Act (1848) aimed towards improving hygiene and public sanitation (Davies et
al. 2014). Public Health Act (1848 to 1875) consolidated a number of prior acts and helped to
establish clean water supplies, sanitation and reduction of diseases. In order to execute 1875 Act
Local Authorities were appointed to oversee public health (Davies et al. 2014). The
establishment of the Public Health Act (1875) from the perspective of social reformer bought
change in the ideology of the health reform system. Moreover, during mid1800 the first Liberal
government came to power which eradicated the conservatives’ power in the United Kingdom.
Again during the advent of the 20th century Labour movement started which attracted the

2
HEALTHCARE
working class leading to change in the overall view-point of the society (Ashton and Young
2013).
Hospitals were started during later 1800s but were mainly voluntary hospitals and mainly
looked after the poor when they fell ill. Majority of this morphed into teaching hospitals or
cottage hospitals assisted by visiting consultant and general practitioners. There were no
facilities to coverage the health requirements of the mass. With this growing need, National
Insurance Act was establishment in 1911. This act laid to the foundation of the publicly funded
healthcare system (Grimes 2016).
Factors which led to the creation of the National Health Service as part of the Welfare
State
During 1919 Lord Addison, the first British Minister of Health, commissioned Lord
Dawson in order to produce a report on the schemes which are requisite for the systematized
provision of health and medical services under the opinion of the Council. This idea outlined the
plan of the establishment of network of the primary and secondary health centres. This idea was
taken a step a further in the Labour Party Conference in the 1934 and this led to the official
documentation of the NHS. Before the onset of the Second World War there was a consensus
which operated hospitals locally and voluntarily (Scott et al. 2018). This healthcare system was
gradually integrated to the nationally run healthcare service. The care offered by the healthcare
professionals were then included under the daily wages. During 1941 and 1944, numerous
reports for healthcare service to deliver free healthcare population were extracted gradually.
During 1944, Aneurin Bevan drew conclusion that previous plans for integrating voluntary and
local hospitals under local level funding were flawed and un-workable (Dixon-Woods et al.

3
HEALTHCARE
2014). This initiated the development of the nationally operated network which would take over
the local government and integrate them in single service. National Health Service was published
in 1944 under the White Paper 1944 reform. The mission set to deliver comprehensive health
services to people. National Health Service (NHS) aimed to generate local responsibility at the
local or the state level under the active supervision of the ministry of health (NHS 2013). NHS
was set in succinct set of principle under which all the healthcare professionals are required to
work. This short set of principle underpinned the entire functioning of the structure of NHS
(Dixon-Woods et al. 2014).
NHS was financed through taxation (publicly funded) under the National Insurance
Scheme. Although the taxation plan did not worked effectively as the overall cost exceed over
the margin, the establishment of the publicly funded service was made (Dixon-Woods et al.
2014).
Effect that the National Health Service has had on the health of the nation
Introduction of NHS led to several improvements in the overall healthcare system. It led
to increase in the overall life-expectancy. The improvement in the life-expectancy is attributed to
advent of immunization against infectious diseases and advent of successful intervention for the
non-communicable diseases. Moreover, advent of steroids leads to cure and decrease in the
overall sufferings if older adults from severe age-related diseases like arthritis, leading to
increase in the life-expectancy of the older adults (Office for National Statistics 2019).
The implementation of the NHS also led to improvement of the infant mortality.
Decrease in the infectious diseases at the time of birth, improvement of the mother’s health and
nutritional level at the time of delivery and neonatal care lead to decrease in the chances of

4
HEALTHCARE
premature delivery or preterm delivery. NHS also helped in the improvement of the overall
mental health outcome (National Institute for Health and Care Excellence 2019). Improvement in
mental health is attributed to decrease in the level of substance abuse, suicidal tendencies and
decrease in the stigmatization of the mental health survivors. NHS also leads to a decrease in the
unhealthy habits. NHS promoted awareness in the domain of smoking, drinking and substance
abuse by setting up community health centres, rehabilitation and general practitioner services
(NHS 2018). NHS also led to the foundation of Accident and Emergency service development
along with health promotion campaign for the reduction of health inequalities (NHS 2019).

5
HEALTHCARE
References
Ashton, E.T. and Young, A.F., 2013. British social work in the nineteenth century. Routledge.
Davies, S.C., Winpenny, E., Ball, S., Fowler, T., Rubin, J. and Nolte, E., 2014. For debate: a new
wave in public health improvement. The Lancet, 384(9957), pp.1889-1895.
Dixon-Woods, M., Baker, R., Charles, K., Dawson, J., Jerzembek, G., Martin, G., McCarthy, I.,
McKee, L., Minion, J., Ozieranski, P. and Willars, J., 2014. Culture and behaviour in the English
National Health Service: overview of lessons from a large multimethod study. BMJ Qual
Saf, 23(2), pp.106-115.
Grimes, S.S., 2016. The British National Health Service: State Intervention in the Medical
Marketplace, 1911-1948. Routledge.
Leonard, E.M., 2013. The early history of English poor relief. Cambridge University Press.
National Health Service. 2013. Key Legislations. Access date: 31st Jan 2019. Retrieved from:
https://www.england.nhs.uk/about/equality/equality-hub/resources/legislation/
National Health Service. 2018.Smoke-Free. Access date: 30th Jan 2019. Retrieved from:
https://www.nhs.uk/smokefree
National Health Service. 2019. When to go to A&E. Access date: 30th Jan 2019. Retrieved from:
https://www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergency-care/when-to-go-to-ae/
National Institute for Health and Care Excellence. 2019. Infant Mortality. Access date: 30th Jan
2019. Retrieved from: https://www.evidence.nhs.uk/search?q=infant%20mortality%20rate%20in
%20uk

6
HEALTHCARE
NHS. 2016. Principles and values that guide the NHS. Access date: 31st Jan 2019. Retrieved
from: https://www.nhs.uk/using-the-nhs/about-the-nhs/principles-and-values/
Office for National Statistics. 2019. Living longer: how our population is changing and why it
matters. Access date: 30th Jan 2019. Retrieved from:
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/
articles/livinglongerhowourpopulationischangingandwhyitmatters/2018-08-13
Scott, T., Mannion, R., Davies, H. and Marshall, M., 2018. Healthcare performance and
organisational culture. CRC Press.