NHS Mindmap

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  • Why, and with what impact, was the National Health Service created in 1948?
    • Reasons it had to happen
      • During their medical inspection for WWI, 41% of men were rated unfit for combat roles in their medical inspection.
        • 10% of men were rated unusable in any military capacity.
      • Ministry of Health set up in 1919
        • lacked statutory authority and political will required to change the system.
      • 1926- Royal Commission issued that stated the government should either scrap or reform the health insurance system. The Tory government did nothing.
      • Prudential dealth with 75% of health insurance.
        • Friendly Societies, set up to help the poor afford basic medical treatment, handled the rest.
          • Some friendly societies were so small they went bankrupt and left their members with nothing.
      • The 1911 National Insurance Act left many wives, widows, and children reliant on family, community, or a sympathetic GP.
      • In 1948, when the NHS was created, doctors found untreated hernias, skins diseases, tootache, dental abscesses and rotting teeth due to the expense of health and dental care.
      • Hospital provision was bad- there were only 12 voluntary (funded by charity) hospitals in London, and 10 in the provinces.
        • Usually over-crowded by the chronically ill and elderly.
      • 1929 Local Government Act allowed PACs to take over and develop workhouses into proper hospitals.
        • Due to no fixed time limit, uptake was slow outside of London.
      • A shortage of beds, buildings, equiptment, and trained consultants were a problem in 1938.
    • WWII
      • National bloody transfusion established in '38 (near hospitals but far away from bombing) continued after 1946 after the National Blood Transfusion Service.
      • Emergency Medical Service set up in '39 to treat military personnel and (eventually) civilian casualties.
        • National funding led to an impressive growth in the number of beds, operating theatres and specialist treatments available.
      • The health of the average Briton improved during WWII
      • 1944- White Paper- 'A National Health Service', heavily influenced National Health Service Act ('46)
    • Post-war: it's impact.
      • The '46 Act made it much more centralised.
      • Impact of doctor's attitude = they had extra money for each private client they got.
      • Deaths of TB fell from 25,000 to 5,000 per year. Huge drop in polio and diphtheria in the mid-50s
      • Maternal death in childbirth fell from one per 1,000 births in 1949, to 0.18 in '70.
      • Life expectancy increased from 66 to 70 between '50 and '79 (for men) and from 71 to 75 (for women) in the same period.
        • Range of old-age diseases increased.
          • Heart disease and cancer increased through the '50s and '60s before dipping in the '70s due to better diets.
      • NHS cost 4.1% of GNP in '50, and had increase to 4.8% by '70.
        • Dandruff syndrome was a main cause. Additionally, advances in medical science became the norm, and thus more was paid as the norm. Finally, there was a backlog of cases from 1948.
      • Many medical advances made.
        • 1st Kidney transplant in '60. Demand quickly outstripped supply, and kidney failures reached 2% of the NHS budget in the '70s.
        • Intro of the contraceptive pill in '61- use increased from 100,000 to over 1m between '62-'69.
        • CT scan invented in '72, and became standard and eventually gave rise to increased costs.


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