British Health Service History and Development
Health services in Britain date back as early as the 18th century. By then, health services were offered by volunteers including faith institutional care centres and almshouses run by charitable organisations. From the 1950s the health services were institutionalised and free since they were publicly funded with only small charges to the services offered by the local authorities. However, with time and particularly from the 1980s there was a shift in health services from the social welfare system to the privatised services (Halsey & Webb, 2000, p. 526). The swing in the health service delivery was influenced by the belief that healthcare improved the quality of life for physically challenged and disabled people. The health services also boosted treatment, community health care was cheaper, and it was challenging to coordinate community health with social care. Today health services have grown to include accessibility of healthcare services among the children, adults, elderly and physically challenged individuals. Most health services are carried out at people’s homes and specialised centres, and they include treating patients with serious and complex conditions, helping the sick to manage long-term conditions and provision of preventive and health improvement services. The new developments and achievements in the British health services could not have been attained without contributions of both social democracy and the new right welfare perspective.Social democracy is among the dominant political ideologies in Britain, and it aims to serve citizens best by helping them address their social needs. In any democratic society, citizens enjoy political, legal and social rights. Among the three rights, social right is mainly attributable to the delivery of social services to the citizens and as such through social democratic governments create social policies to find solutions to the challenges affecting the human race. Social policies also focus on improving people’s standards of living in the community. However, with the new right perspective, which is mainly attributable to capitalism, it was difficult for social democracy to fulfil its goals in the provision of health services. The new right ideology finds its roots in the functionalism concept, and it is always against the state’s welfare since it is based on the prospects that it will encourage people to become dependents of benefits. As per the above facts, it is crucial to highlight how social democracy and new right aspects, as well as their historical developments, have impacted the provision of British health services.
Social democracy perspective calls for the establishment of the egalitarian society whereby welfare system is achieved through progressive taxation. The main idea behind social democracy is to create an equal society with fair redistribution of resources between the wealthy and the less privileged (Keating & Keating, 2013, p. 140). The social democracy origin was influenced by how the working class through the provision of labour were exploited. It was believed that social policy would help in balancing labourers’ social statuses with those of employers in the bid to create a fair society where the owners of the capital will not exploit the workers. The efforts to provide health services to equalise the members of the society led to the creation of the welfare system. To overcome threats posed by the radical Marxists, the advocators of the welfare system employed reformation approach to enhance peace and stability in the society.
New right, unlike social democracy, advocated for capitalism. The new right perspective created an unfair society that was characterised by inequalities, and to address this weakness, there was a need of social democratic government to intervene. The above explains why immediately after the war, the focus of the welfare system was to get rid of the health-related issues facing the community and it started with the creation of National Health Service (NHS) to help in the eradication of diseases (Moore, 2003, p. 180). The social issues facing the society were achieved through the mandatory national insurance funding into a common pool upon which the contributions were used to meet the people’s social needs. Nevertheless, the subscribers of the new right such as Maynard Keynes would not allow the establishment of the welfare system without giving a fight, particularly when he bankrolled the vision and reality of the system (Freeman, 2000). The community health service was born from the three healthcare principles created by the welfare system. The three tenets were meeting every individual’s healthcare needs, free of charge services and provision of health care services irrespective of one’s ability to pay. The domiciliary health care services including home nursing were created.
As outlined in the introduction, before the 1950s, health services were primarily the role of volunteers and charitable organisations. The health care providers were unable to offer their care during the war, and this explains why doctors and nurses employed by Emergency Medical Services catered or the healthcare needs of the injured individuals. The move inspired the creation of national services, but the British Medical Association immediately opposed it. However, in 1911, British Medical Association supported the efforts of David Lloyd George to enact a national insurance act to cater for the medical care of the worker only without the inclusion of his family (Halsey & Webb, 2000). At the same time, the volunteers, charitable organisations and churches supported the disadvantaged members of the society who could not afford medical care. The failure to cater for the healthcare of all the members of the society became problematic leading to the reforms initiated by NHS in 1955 (Gorsky, 2008, p. 438). As time progressed, the rising medical costs saw Blair and Thatcher’s government suggest for reformations to make healthcare affordable.
The social democracy on health care in Britain had evolved as early as from 1899 during the Boer war when it was realised the majority of the recruits were unfit. As a result, the country was encouraged to find a solution to healthcare challenges facing its citizens. The idea behind improved health was that exposing fighters to the war created potential risks and casualties. Later the ruins and debris of the two world wars gave birth to NHS and since the new health policy was introduced, and it has had several impacts including some Acts to address people in need of special treatments like mental problems, chronic diseases, and community-based health providers.
Inarguably, both social democracy and new right prospective played and play a fundamental role in the provision of health services. The social democracy advocates for the welfare society to minimise the gap between the rich and the marginalised in society. As a result, it argues for the progressive taxation and provision of social welfare services to disadvantaged. On the other side, the new right was built on capitalism approach where the provision of health should be left for individual responsibility. Nevertheless, despite the differences between the approaches employed by two prospective, they all focus on delivering quality health services to boost the quality of life and increase the life span of the UK citizens. In the end, it can be argued that social democracy outperformed the new right aspect since today NHS offer some specialised health services for free. For example, heart surgery and Gene therapy are provided for free. The heart century that was opened in 1950, a credit to the NHS, but it was impossible to have such services before 1948 (Moore, 2003, p. 181). The benefits associated with the quality healthcare led to the shift of the welfare system and community-based healthcare to the privatised one in the 1980s. The governments and particular the Blair and Thatcher government supported the privatisation of health services. However, the results were increased social care costs bearing in mind in that private entities exist to make profits. Even though this came with the reduced public expenditure, the concerns on the best way to deliver community health services have continued to increase leading to the enactment of Acts in the 1990s and 2000s to boost community health support services. Presently, the aspects of both social democracy and new right are still evident in Britain. The provision of health services is a combined effort for both the government and the private sector. Despite that the private organisations do so for profit, their role cannot be trashed. The volunteers also through charitable organisations have been very instrumental in providing health services to the needy in the communities.
In a nutshell, social democracy killed the exploitive and individualistic nature of the neo-liberalism capitalists who advocated for the approaches that could have denied the community and public at large an improve healthcare. With social democracy perspective, the quality of life has been increased, and people can live for long unlike before. Britain citizens can undergo costly treatments due to the free healthcare system. Even though the social democracy has adopted a few of the neo-liberal strategies through the privatisation of healthcare as advanced the labour, it roles in creating a fair, stable, peaceful welfare system society outshines its weakness.