Introduction The influences affecting the NHS today sometime are not evident unless viewed against the changes and trends that have developed since its inception. After the World War II it was an era of simplicity and desperation the general population had housing crisis, food shortage and raw material shortages etc. Political Influences On a global political stand point there was a uniting of ideas and governments; what we know today as the United Nations (UN).
One of the main ideas which the UN has grown up around is ‘The individual possess rights simply by virtue of being Human’ (The Universal Declaration of human rights); which was adopted by the general assembly in 10th December 1948. This statement is reflect in the core principles of the NHS which states ‘The NHS has a duty to every patient it serves and must respect their human rights’. [1] 1940’s & 1950 The establishment of the NHS was driven by the then minister of health Aneurin Bevan on the 5th July 1948. The funding for the NHS came from central taxation where the rich paid more than the poor for the same services.
The problems of today’s NHS are also still evident since its inception on how to fund and manage it. The NHS became a target for a political platform while destruction of it would be political suicide. In 1951the committee of economic situation identified the NHS for a reduction in expenditure. The Conservative government became committed to tax cuts, and recommended that there be a charge for prescription and charges for dental treatment or to stop the services all together. In 1952 the charges where integrated into the NHS act 1952 which also granted the GP’S ?
27 million in Back pay. In 1953 the guillebaud committee was formed to enquire in to the cost of the NHS the guillebaud report looked in to preventing increases on spending not on cuts. 1956 the report stated they could not find any new ways to increase income or to reduce the expenditure but that “capital expenditure was to low” [2] This report was the first analysis of the NHS but both parties acknowledged the need for it. 1960’s The 1960s saw the rebuild of district hospitals for larger population and the closure of metal institution.
Health minister Powell created a ten year plan for the building of the hospital but neglected psychiatric institution. His speech referred to now as the water tower speech sparked a debate around mental health and community care that could have contributed to the care in the community scheme later on the 1980s. The creation of the Mental Health Act. The creation of the GPs charter, The GPs received incentives and awards and GPs opened joint practices and matured into what we know today. Prescription charges were abolished in 1965 and reintroduced in 1968.
‘The 60’s was classified as a period of growth’ [3] 1970’s The 1970s saw a reorganising or restructuring of the NHS put in place by Health Minister, Richard Crossman(Labour) taking the control from central government to local control but answerable to a regional authority. The battle between labour and conservative’s in power the NHS has been and still is today a battle ground. 1970 conservative came to power sir Keith Joseph as Health Minister, Sir Joseph in the basic structure that Crossman had put in place and where set up in 1974.
1974 Labour returned to power with Barbara Castle as health minister. Miss Castle tried to bring about the end of private treatment in NHS facilities but by the end of her reign ‘only and only a quarter of the pay bed where phased out it may also have led growth of the private health system’. [3] 1980’s The 1980’s the NHS financially started to spiral due to the advancement of technology, pharmacology, the research and the perfection of clinical procedure. In 1982 and new management system was introduced by the Griffith report in 1983.
This saw the birth of the ‘General management’ [4] the system that we have today with, general managers who have the responsibility and accountability. The 80’s saw a growing population placing a higher demand on the NHS and a budget that was out of control. The NHS tried several different approaches to the problem-solving through budgeting and the arrival of waiting lists. Due to an increase of staff and funding and the NHS still in trouble this attracted the spot light of the media and question started to be raised. Margret Thatcher administration.
The Prime Minister Margret Thatcher (PMMT) set in to motion a re-examining of the NHS in 1990 this produced a White Papers ‘Working for patient and caring for people’. The result of this a created the ‘internal market’ [5] which competes for care on a commission basis. This brought about new legislation ‘The National Health Service and Community Care Act’ [5] How it works: Hospital trust contends to provide care taking the running of hospitals away from the health authority but instead buy care from the trust. The local authority commission care for their local people from their own trust or others.
There was a clause called the ‘GP fund holders option’ [5] which allowed some GP to by care for their patients. At the time this was being created the labour party accused of trying to privatise the NHS. This became a major element in their campaign which took them to power in 1997. 1997 The Tony Blair influence? Labour had gone through internal reforms and now dubbed itself New Labour, one of the key promises of the 1997 election from new labour was to ’scrap internal market and GP fund holding, and to replace competition with collaboration’. 2000.
The introduction of PFI (private finance initiative) the new NHS Plan, the idea behind this was investment but the problem with investment is this give privateers a foot hold in the NHS. This influx of investment was used to build new or regenerate hospitals. This was done through sub contracting and out sourcing to private companies. The labour tried to standardize the NHS by endeavouring to put in place National guidelines and considerable collection of objectives or goals/targets. Now Before the election the conservative promise to steer clear of ‘massive structural reorganisation’.
Between this and the PFI this has open a Buffy feel meal to any and all private company who want cash for care. 6 months before the Conservative came to power we saw 3 of America major Health insurance companied opening up in London. So from the 1970 there has been a slow movement toward privatising the NHS Conclusion The main factors that influence the NHS are Politics, greasy palms, and the ability to get away with it. To effectively steel public money turn the NHS private & of course to jump up and down on those who need care. To attack the poor yet again! To create the division between rich and poor even bigger.
The result is that the average person will be in a position where they cannot afford care. ? References [1] (The NHS Choices (2011). NHS core principles. [ONLINE] Available at http://www. nhs. uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples. aspx. [Last Accessed 14 October 2011]). [2] Hansard (25 January 1956). Guillebaud Report. [ONLINE] Available at: http://hansard. millbanksystems. com/commons/1956/jan/25/national-health-service-guillebaud-report. [Last Accessed 16 October 2011]. [3] The national archives (e. g. 2011). Politics of health in the 1960s and 1970s. [ONLINE] Available at: http://www.
nationalarchives. gov. uk/cabinetpapers/alevelstudies/politics-health. htm. [Last Accessed 17 October 2011]. [4] Robert griffith (1983). NHS management inquiry. [ONLINE] Available at: http://www. sochealth. co. uk/history/griffiths. htm. [Last Accessed 17 October 2011]. [5]The National Archives (1990). The National Health Service and Community Care Act’. [ONLINE] Available at: http://www. legislation. gov. uk/ukpga/1990/19/contents. [Last Accessed 13 October 2011]. The NHS Choices (2011). NHS core principles. [ONLINE] Available at: http://www. nhs. uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples.
aspx. [Last Accessed 14 October 2011]. The national archives (1915 -1980). The NHS under the Conservatives. [ONLINE] Available at: http://www. nationalarchives. gov. uk/cabinetpapers/themes/conservative-rule. htm. [Last Accessed 16 October 2011]. Hansard (25 January 1956). Guillebaud Report. [ONLINE] Available at: http://hansard. millbanksystems. com/commons/1956/jan/25/national-health-service-guillebaud-report. [Last Accessed 16 October 2011]. Alan Maynard, (Wednesday 14 July 2010 ). NHS shakeup: a conspiracy to privatise?. The guardian. Wednesday 14 July 2010 (article history), pp. National Health.