Impact of NHS

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  • Impact of the NHS
    • Impact on Public Health
      • Life expectancy increased: 1948: M = 65.8 F = 70.1  1979: M = 71 F = 77
      • Better healthcare led to increased affluence
      • 1948-79 there was a general improvement in health of the nation
      • Improvement not universal: Morrison Report 1979 = hospitals received 70% of funding and other services e.g GPs received much less
      • Regional inequalities still existed e.g. lots spent in London
    • Impact on Women
      • Reproduction
        • Decline in birth rate
          • Women born 1920 had 2 kids
          • Women born 1966 had 1.3 kids
        • NHS education and contraceptive pill = fewer babies
        • Side effects of the pill increased risk of stroke and cancer
        • 1968-78: 1.5 million abortions, NHS doctors could refuse to participate in termination
          • 58% abortions = private
      • Childbirth
        • NHS made childbirth in hospital the norm
          • 1950s 60% women gave birth in hospitals
          • 1978 97% women gave birth in hospitals
        • According to a survey, 70 - 90% women in hospital given episiotomy
          • Led to pain when sitting in 68% of cases and longer recovery time
        • Feminists said medicalisation shifted power from women to men
      • Women and work
        • NHS created greater opportunity for women in work
          • BUT not equality
        • New state funded 'caring professions'
          • Women more caring than men so able to find work
        • 1948- govn. recruited 54,000 female nurses
        • Generally women restricted to lower paid and lower status jobs in 1950s and 60s
          • Even worse for black women
    • Impact on mental health
      • 1957 - govn. concerns that mental health not being treated effectively
      • 1957: Royal Commission on Mental Illnesses and Mental Deficiency
        • Argued mental illnesses routinely stigmatised
        • Mental health hospitals operated like prisons
      • 1959 Mental Health Act
        • New terminology: insane = mentally ill ect.
        • Decisions about treatment of mentally ill made by mental health tribunals not judges
        • New open door policy = patients could attend voluntary treatment sessions in daycare centres
      • 1959 Act = move away from residential care to out-patients or drop-in care
      • 1962 Hospital Plan proposed 50% reduction in hospital beds for people with mental illnesses by 1975
      • By 1975 only 15% of day care places needed were available
      • By 1975 only 33% hospital places needed were available
        • By 1975 only 15% of day care places needed were available
    • Health and Class
      • Middle class tended to benefit more than Working class
      • Middle Class
        • 50% GP surgeries in middle class areas built before 1900
        • Middle class areas received £4.98 per head per year
        • Study in 1972 showed middle class areas tended to have per capita budgets 24% higher than working class areas
      • Working Class
        • 80% GP surgeries in working class areas built before 1900
        • Working class areas received £3.19 per head per year
        • Black Report 1980: working class women twice as likely to die in childbirth than middle class women
        • Women and unskilled working class mens were twice as likely to die before 65 than middle class professionals
    • Expansion of Treatments
      • Significant increase in demand
        • June 1948 = 6.8 million prescriptions
        • September 1948 = 13.6 million prescriptions
      • 1949 - 64 = 'pharmacological revolution'
        • More and more medicines available
        • Drug costs increased: in 1964 NHS spent 250% more on drugs than in 1951
      • Vaccinations increased scope of NHS provision
        • Before 1939 only vaccination given routinely was smallpox
        • In 1964 there was vaccinations against diphtheria, TB, polio, whooping cough and tetnus

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