part 4: modern public health Flashcards
(35 cards)
1
Q
charles booth
A
- social researcher
- conducted a piece of research in 1889
- showed 35% of london’s population lived in ‘absolute poverty’ despite having jobs
- some wages so low that people couldn’t afford to live
- showed poverty was linked to nation’s high death rate
- highlighted that there was a poverty life-cycle meaning people’s economic status could fluctuate in life
- report ‘life about labour of the people in london’
2
Q
seebohm rowntree
A
- factory owner in york
- investigated living conditions in york in 1900-01
- invented term ‘poverty line’
- meant minimum amount of money a person needed to earn to stay out of poverty
- estimated 20,000 people or 28% of city’s population at some point in life were below poverty line
3
Q
the boer war
A
- fought between britain and boers in south africa
- in 1899 when it started, over a third of volunteers to join the army were unfit for service
- lots of people had illnesses linked to poverty and poor living conditions
- a gov committee discovered that many men were unfit for service as they led unhealthy lives
4
Q
1867 reform act & elections
A
- it gave vote to more working class men
- in 1900 election, labour party entered candidates for first time and won two seats
- increased number to 29
- liberal party won in 1906 but wanted to ensure labour didn’t gain more seats in future
- liberal part saw own reforms as a way of maintaining support of working-class voters
5
Q
liberal reform
A
- came to office in 1906 and immediately began policy of social reform
- new attitude that recognised that being poor wasn’t always the fault of the poor
- gov had to do something
- helped old, young, ill, disabled
6
Q
content of liberal reforms
A
- 1906: free school meals
- 1907: school medical inspections
- 1908: old age pensions act
- 1908: children’s act
- 1909: labour exchanges act
- 1911: national insurance act
7
Q
free school meals
A
- 1906
- introduced to improve health of kids
- by 1914 over 150,000 children having a daily free meal
- made compulsory for authorities to provide meals in 1914
8
Q
school medical inspections
A
- 1907
- schools began free medical inspections of pupils
- recommended any necessary treatment
- after 1912 healthcare for these children was free
9
Q
old age pensions act
A
- 1908
- people over 70 with an annual income of less than £21 a year received a pension of 5 shillings a week
- those who earned over £21 a year or were married received a smaller amount
10
Q
labour exchanges act
A
- 1909
- aimed to match up employers and employees
- 430 job centres by 1913
11
Q
children’s act
A
- 1908
- children protected by law against cruelty from their parents
- children that were criminals sent to borstals, not adult prisons
- children under 14 not allowed in pubs
- cigarettes or alcohol not to be sold to children under 16
12
Q
national insurance act
A
- 1911
- set up a system where workers had a sum of money deducted from wages to pay for health care and sick pay
- workers had to join and paid 4p for insurance stamps
- free medical care in scheme
13
Q
reasons for liberal reform
A
- effective workforce was needed: britain’s position as world’s leading industrial power was being challenged by germany and usa
- healthy army needed: boer war 1/3 volunteers failed medical inspection
- growth of trade unionism: politicians feared that workers might turn to communism if standards of living didn’t improve
- scale of problem: life expectancy was 45, richest 10% owned 92% of country’s wealth
- pressure from social reformers: booth and rowntree
- individuals: lloyd george and churchill
- increasing information about poverty: from charities, civil servants, local authorities
14
Q
who led liberal party?
A
david lloyd george
15
Q
opposition to liberal reforms
A
- some argued the reforms didn’t go far enough
- labour party said more should be done to help women who were less likely to benefit from national insurance
- also argued that old age pension payments should be higher
- some conservatives said that giving people too much from state would make them dependent on aid and support
- also thought it might reduce people’s desire to work
- concerns about cost to taxpayers
16
Q
impact of reforms
A
- improved living conditions of poor, unemployed, elderly and young
- improving quality of nutrition and living conditions was a big preventative step in stopping people becoming ill
17
Q
reforms to reward soldiers after ww1
A
- gov realised importance of having a healthy population which was prompted by war
- lloyd george wanted to have ‘homes fit for heroes’
- after ww1 overcrowded housing was banned
- 1918 compulsory for local councils to provide health visits and support for pregnant women
- 1919 councils started to build housing for poor families
- reduced slum living overall and therefore reduced easy spread of disease like TB from
dirty living conditions - gov recognised issue and brought about change
18
Q
impact of ww2
A
- when children evacuated to countryside more realised differences in living standards across areas
- need to raise large armies made gov aware of problems created for society by an unhealthy workforce
19
Q
ministry of health
A
- 1919 ministry of health set up
- looked after sanitation, healthcare and training of doctors and nurses
20
Q
later reforms
A
- 1934 free school milk act, critical as britain hit by great depression
- almost 1 million homes built by labour gov between 1945 and 1952
- new towns act of 1946 create whole new towns close to large cities
- 1956 clean air act established smokeless zones in cities
- 1980 black report said that there were still inequalities in health between rich and poor
21
Q
beveridge report
A
- 1942 sir william beveridge (liberal politician) wrote about the state called beveridge report
- wrote in response to poor healthcare system
- very popular and sold over 100,000 copies within a month
- claimed everyone had a right to be free of the ‘five giants’: disease, want, ignorance, idleness, squalor
- highlighted people’s quality of life needed to improve and suggested the gov should be responsible for it
- report suggested that welfare should be available to everyone in need
- should be paid for by tax payers
22
Q
impact of beveridge report
A
- prompted the NHS, to provide care
- to be funded by taxes
- and ensure even unemployed and poor would have access to better healthcare, overcoming massive class divide in public
health
23
Q
welfare state
A
- gov’s involvement in improving public health and social security is called welfare state
- implemented by labour party in 1945
- welfare state included a health service that was ‘free at the point of delivery’, a weekly allowance for families to look after their children and a ‘benefits’ system to give financial help to the very poor
24
Q
creation of NHS
A
- aneurin bevan set it up in 1948
- minister of health for labour party
- organised founding of NHS based on principles of beveridge report
- people had received free healthcare during the war and people wanted service to continue
25
opposition to NHS
- general medical council: they represented doctors, concerned that doctors would be employees of the gov, worried that doctors would lose independence and receive less pay and freedom
- bevan promised to pay doctors and allowed them to continue working privately as well
- lots of conservatives disliked NHS but too popular to abolish
- argued the cost of NHS would be too great and taxpayers shouldn't have to pay
26
birth of NHS
- everyone in country could receive free health care, regardless of income
- included eye tests, hearing tests, prescriptions, hospital care
- to ensure it was fully staffed, nurses and domestic workers from caribbean and ireland were employed
27
introduction of prescription charges & cost
- bevan believed it should provide free health care for all, regardless of people's income
- initial budget was £437 million each year, equivalent in £15 bil now
- £116 bil estimated in 2015
- was a significant cost especially when suffering from war debts
- in 1951, bevan resigned from gov when charges for prescriptions were introduce to pay for cost of korean war
- original plan to pay through national insurance contributions but only covered 10% of costs
28
success of NHS
- child mortality rates fallen
- new and improved hospitals have better facilities
- vaccines have eradicated diseases like TB
- healthcare and affordability of treatment is better in britain compared to most countries
- improved life expectancy: women 1948 70.3 years, 2018 83.1 years
29
prevention
- often cheaper than medical treatments
- campaigns encouraging healthy eating and discouraging smoking and drinking have been introduced
- healthy eating campaign promotes eating five portions of fruit and veg each day
- 2005 tobacco advertising legally banned
- cancer screening preventative measure to try and find cancer in early stage so treatment more cost effective and less ill
- vaccination programmes organised and funded through NHS
30
NHS today
- new medicines and treatments constantly developed
- runs public health campaigns to encourage people to lead healthier lives
- encourages to stop smoking, eat healthily, have safe sex, get vaccinated
- faces ongoing challenges about cost of new treatments
31
NHS treatment impact
- hospitals provided maternity care
- child welfare services
- ambulances
- GPs provided care and advice in community
32
hospitals and health centres
- gov took control of all hospitals
- many rebuilt and facilities improved
- money into funding equipment
- health centres set up
- hospitals paid by gov but still allowed to treat private
- better hospitals as funding has increased to provide new buildings and specialist wings
33
training doctors and nurses
- funded medical research
- NHS spent money on training specialist staff
- grants provided to help fund degrees and qualifications linked to medicine so medical careers more accessible for poor students
34
change of NHS over time
- more staff employed: 1.7 mil making it 5th largest employer in uk, reflects demand increase, nurses more specialised
- costs country more: gov had to invest more money in NHS
- charged: struggled to keep up with demand for free healthcare
- focus on prevention: lifestyle campaigns, more health checks
35
gov impact on public health
- only improved when they moved away from laissez-faire attitude
- prompted by other factors but ultimately nothing would get done other than gov
