Creation of the Welfare State

Before Liberal Reforms

Most health care was still done by women in the family using herbal or folk remedies, patent or other medicines
bought from a chemist.
Doctors charged per visit so were still mainly used by the wealthy. Increasingly doctors were either GP’s who set up
‘practices’ and visited patients in their homes or specialists who worked in large hospitals.
Most cities now had infirmaries, fever houses, and asylums offering free basic care for the poor. They were run by
local councils or charities.

The Liberal Reforms

The government increasingly became involved in healthcare between 1900 – 1946, due to: -
1. 1 in 3 recruits for the Boer War (1899 – 1902) were declared unfit, this made them realise they had to get
involved in improving health to defend the empire.
2. Charles Booth researched poverty in London 1891-1903. He found that levels of poverty were higher than
initially predicted. He also found that many people in poverty weren’t unemployed but worked and yet
didn’t earn enough to escape poverty.
3. Seebohm Rowntree did a similar study of poverty in York in 1901 and found similar results to Charles Booth.
4. The election of the Liberal Party to government in 1905 led to the Liberal Reforms championed by
Chancellor of the Exchequer David Lloyd George.

This led to new laws including 1902, 1906 free school meals, compulsory training of midwives, 1907 health visitors
paid by government to help mothers, 1908 old age pensions, 1911 National Insurance Act, 1912 Clinics set up in
schools, 1919 Ministry of Health set up, 1940 free immunisation programme set up for diphtheria.

National Insurance worked on the principle that for each time a worker was paid, employers would pay a portion,
employees would pay a portion and the government paid in a portion. If a worker was ill then he could claim 10
shillings of this money back for up to 26 weeks to use to cover some of the cost of his medical bills. This did not cover
medical costs of workers wives or children however.

Why was the NHS set up? (1948)

 WW2 highlighted poverty people were in i.e. evacuation.
 Beveridge Report (1942), which identified 5 giant evils in society, Ignorance, Idleness, Squalor, Want &
Disease, recommended it
 Emergency medical services in WW2 showed that government could provide free health care.
 People now expected the government to get involved in people’s lives.
 The Labour government 1945-51 promised to create the NHS.

NHS improved people’s health as it gave everyone free access to healthcare. The NHS costs a great deal to run and
has seen the introduction of prescription charges in 1951. The NHS now concentrates on preventing illness and
using education to try and stop people getting ill in the first place. (See smoking and healthy eating campaigns)

The NHS

WW2 made people realise the importance of government involvement in health care. Plans were made for National
Health Service, which was set up in 1948 by health minister Aneurin (Nye) Bevan. This gave free access to health
care for everyone and was a land mark event for public health in Britain.

Prevention: Since 1948 the government has taken more action to prevent people getting ill:

 Funding more vaccinations

 Better disposal of rubbish and sewage
 Laws reducing air and water pollution
 Laws improving health and safety at work
 Environmental health officers inspecting food outlets
Education

Since 1948, the government has funded posters, leaflets and adverts to try and raise awareness of illnesses. Laws
have also been passed to try and influence people’s behaviour- like the smoking ban, high tax on cigarettes and
putting nutritional information on food packets. This education of the public was done in part to reduce the long
term cost of treating people later in their lives due to their poor lifestyle choices.

Training
Improvements were made to doctors, nurses and paramedics training.
 Doctors’ training involves wide range of study, theory and practical work and takes about 7 years. They
can then choose to specialise.
 Nursing degree or diploma takes 3 years of theory and practical work on different wards. Can then
specialise i.e. midwife
 Doctors and nurses training is never complete – on going.