Unit 6.

The History of the National Health Service Journal Article

Submission Front Sheet

Unit National Code: RH33MR061U

Programme: Access to Higher Education Diploma (Nursing)

Unit Title and Number: The History of the National Health Service Unit 6

QFC Level and Credit value: 3; 6 credits

Name: Ilona Petrenyi

Date: 27/06/2023

By: Ilona Petrenyi 27/06/2023 1

Unit 6. The History of the National Health Service Journal Article

Table of contents
The History of the National Health Service ......................................................................... 3
The factors that led to the creation of the NHS .............................................................. 3
The NHS responds to the changing demands placed upon it ..................................... 4
How changes to funding have impacted the NHS over the last 25 years .................. 6
References .............................................................................................................................. 9
Bibliography ........................................................................................................................... 9

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Unit 6. The History of the National Health Service Journal Article

First professional institution, such as the

The History of the National Royal College of Physicians (London) was
founded in 1518.
Health Service The first hospitals were founded after that
The history of the creation of the NHS is when they gained a deeper knowledge of
much more interesting if we look further diseases anatomically and pathologically.
into the past. Other bodies were designated for health
“Origin of the phrase ‘NHS’. Dr Benjamin care, e.g. infectious diseases in the
Moore was probably the first to use the "Municipal Hospitals", which later became
words ‘NHS’ in The Dawn of the Health Age. the "District General Hospital". Other
He established the State Medical Service institutions dealt with mental or intellectual
Association in1912, replaced by the Socialist
disabilities and physical illnesses.
Medical Association in 1930.” (Adopted from
Many "voluntary hospitals" operated as
myHSN 2023)
charities.
Basic and community care, such as home
and public health care, developed
separately from hospitals, which belonged
to the local government.
The need for preventive measures has
also emerged due to regular epidemics,
e.g. smallpox, cholera, and typhus.
From the middle of the 19th century,
existing health boards were legally
empowered to ensure water supply,
develop vaccinations and establish
quarantines.

However, medical services were financed

Dr Benjamin Moor (myHSN 2023) by insurance systems only until the
beginning of the 20th century.
The first half of the 20th century also
The factors that led to the
focused on public health, similar to the
creation of the NHS 19th century.

We might think that the foundations of the In 1905 a "minority report" on the poor
health service were laid in the 19th laws and the unemployed called for a
century, but it started already in the 16th "state medical service". In response to
century when the “Poor Law” supported this, the National Insurance Act of 1911
the poor and sick people, with "outside and the Cave Committee in 1921 were the
aid" measures and benefits. first public health funding measures
towards working men and voluntary
At the beginning of the 19th century, the hospitals.
state abolished almshouses and outdoor In 1911, David Lloyd George, Minister of
aid places. Instead, he created Finance (later Prime Minister), created the
workhouses and austerity institutions that Insurance Act, which was about small
cared for the needy. amounts deducted from weekly wages,
At the end of the century, it was expanded supplemented by employer contributions.
with annexes to accommodate the The working men could apply for it and
patients, these were the first infirmaries, choose a family doctor. These GPs as
one could say the first hospitals. 'panel doctors', were given an annual
Care was minimal and conditions terrible, 'capita', which continues today and it is a
Florence Nightingale commented. very important act as it can be said that’s
the real 'birth' of the NHS.

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Unit 6. The History of the National Health Service Journal Article

It was the first time that a central budget

was spent on people's health care.

1942 Beveridge Report (UK Parliament

2023)

After the Second World War, in 1946

Great Britain, as part of the creation of a
comprehensive welfare state, the NHS
became free and the National Health
National insurance act 1911 (myHSN Service Act was passed.
2023) People do not have to pay to see an NHS
doctor.
In 1935, in preparation for the war, the Air But after a few years, people who used
Raid Precautions Department (ARP) was the NHS services had to pay for certain
established, which already showed that things because charges were introduced
the state was ready to group hospitals and in 1952 for prescriptions, dental
ambulances into a single national system. treatments and spectacles. These are the
1935:Victoria Hospital, Swindon – The fees that are still valid today.

Overall, can be seen that the creation of

the National Health Service (NHS) in the
United Kingdom was the result of several
important factors. These are political,
economic and social factors.

The NHS responds to the

changing demands placed upon
it
Gobbard Ward (Flickr 2018)
The NHS was initially organised in
In 1942, an interdepartmental committee three parts. Formerly government-run
led by Sir William Beveridge published the and voluntary hospitals were taken
"Beveridge Report". What was said was over by the NHS, so employees could
a comprehensive "cradle to grave" social work for pay, with permanent jobs.
security system, so that workers would
General practitioners, dentists, and
pay a weekly contribution to the state and
help the unemployed, sick, pensioners
opticians were responsible for primary
and widows. care as contractors, they were not paid
by the government as employees.
It is one of the most important social Maternity, vaccinations, ambulance
history documents in the history of the UK services and child welfare operated
and later NHS. separately as community services.

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Unit 6. The History of the National Health Service Journal Article

Health workers demanded the creation After the war, the newly formed NHS was
of a unified system, and in response to in much greater demand as advances in
this, in 1962 Health Minister Enoch medicine allowed it to help the many
Powell planned the construction of patients left behind. This increased
NHS district general hospitals. These innovation in scientific fields and the
new hospitals are planned to serve discovery of new equipment and
125,000 inhabitants. techniques.
With millions of people already able to
After 1948, the annual costs of the access health services for free, this
new NHS were estimated at more than required the NHS to cope with the
half the original costs of £110 million. huge demand at the same time.
However, over the next 5 years, at the Access to services had to be created.
end of 1949, the total cost of NHS bills
submitted to Parliament was £248 Advances in technology, automobile
million. This increased further for the manufacturing and the use of
following year, to 305 million GDP. motorcycles have increased the
They did not expect these huge sums, number of car accidents and head
however, they found three compelling injuries to motorcyclists. Two major rail
reasons as an explanation. accidents at the time raised the need
for a rapid response from emergency
One of the reasons is the scientific response (A&E) teams. Then, the
research carried out in the new demand for more training was clear, as
structure of the NHS. The result of this accidents required on-site care for
was not a decrease in patients, but the victims every day. The head injuries of
use of successful patient treatments motorcyclists also resulted in an
and new techniques enabled more increased use of neurosurgery teams.
complex patient care, which increased
the number of patients admitted to the Scientific discoveries, drug trials, and
hospital. drug lobbying all used new funds,
which were joined by hospitals and
New and more advanced health health care.
services have made it possible to
improve and cure the lives of people These changes resulted in increased
who might have died (at lower NHS costs, the development of equipment,
costs) up to a decade earlier. The facilities, the hospital administration
health improvement hoped for by the system, and the development of
new discoveries did not materialise management. Closer cooperation with
because a new combination of a large local authorities has also become
number of diseases allowed people to necessary.
use the NHS without paying.
Overall, it can be seen that the
Improvements in healthcare have also developing health sector requires huge
resulted in more people living in old financial resources, and in addition to
age. The elderly were also provided this, the problems of staffing,
with better living conditions compared difficulties in serving patients, and
to the former public service national economic problems continue
departments, where they were to arise in the field of the NHS to this
neglected until their death. day.

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Unit 6. The History of the National Health Service Journal Article

Figure 1: Modern demands on the

health service (Learn direct 2022)

How changes to funding have

impacted the NHS over the last Figure 2: Changes) in UK public spending on
25 years health (Full Fact 2023)

In 2017, the think tank said health spending

NHS spending has risen steadily over would fall to £4bn in 2018/19 over the coming
the past decades, but more slowly in years, but the government only provided
recent years. This can also be caused £1.9bn, around half of what was needed.
by inflation or the size of the economy. Although a higher percentage of trusts (44%)
were in deficit compared to the previous year,
the 2017/18 deficit was reduced to £960
In the years following 2010/2011, they million. The actual underlying deficit was
decreased slightly - although this could around £5bn for the trusts, so that was an
be said for other areas as well. They increase. This £1 billion showed a shortfall
have rebounded in the last couple of excluding subsidies and one-off cost cuts.
According to the Nuffield Trust, it is impossible
years. for NHS trusts to achieve stability and recovery
In 2013, NHS England reported if they depend on endowment funds and one-
a £30 billion shortfall in funding. As the off, short-term cost cuts.
NHS did not generate any savings of
its own, this sum was insufficient to Health in England spent £129 billion in
2018/19. Of this, £115 billion was spent on the
provide care for the increased and NHS. The remaining £14 billion was spent on
aging population. In 2014, they had education, training, IT development and the
already made plans for their own construction of new hospitals by the
savings (22 billion GBP), but the Department of Health.
deficits were still expected to be made The 2018/19 year ended with a total deficit of
approximately 571 million.
up by the government. In the 2015
election program, the new The Nuffield Trust, the Health Foundation and
conservative party promised that the 8 the King's Fund expressed that patient care,
billion would be replaced if the NHS the quality of services and access to treatment
improved its productivity by 22 billion are being hampered by tight NHS spending.
In 2018, to mark the NHS's 70th birthday, the
in an exemplary manner. It was Prime Minister announced that she would
claimed that it would be backed by £10 support NHS funding over the coming years.
billion. According to the government's plans for
2022/23, the NHS in England is facing a deficit
“Health spending grew at an average of over £20.5 billion, spread over five years
until 2023/24.
annual rate of about 3.7% from 1950/51
up to 2016/17, accounting for inflation. “ The coronavirus outbreak in 2020
(Full Fact 2010-2023) required an additional £60 billion in
additional funding, which included

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Unit 6. The History of the National Health Service Journal Article

personal protective equipment for NHS to keep it more under control, there
staff, the development of the Test and were governments that preferred to
Trace program and reducing waiting leave the management for the
times for care. industry.

The increased number of people “The Market Forces Factor (MFF) is an

without permanent residence, or the estimate of unavoidable cost differences
high number of unemployed, who between Health Care Providers, based on
their geographical location. The Market
could not be included in the funding of Forces Factor is used to adjust resource
the NHS, but they used the NHS allocations in the NHS in proportion to these
anyway, this situation was aggravated. cost differences, so that PATIENTS are
Thanks to this increased number of neither advantaged nor disadvantaged by
users and the waiting time for the relative level of unavoidable costs in
examinations has increased to up to different parts of the country.” (NHS, 2023)
24 months. Many people have already
died while they were on the waiting list.
The use of large numbers of agency
staff has impaired or enhanced the
quality of care and aftercare.

This has led to patient dissatisfaction

across the country. In addition to the
difficulties, the NHS had to consider
the quality of aftercare and care, the
use of a large number of beds by
people staying in nursing homes, and Figure 4: Benefits of using market forces in
the long-term retention of staff healthcare (Learn direct, 2022)
relationships. The NHS clearly needed
to re-design, review its funding and A compelling counterargument is to
operations. market forces to classify patients as high
or low risk. Those at high risk will live
shorter and more painful lives without
proper treatment.

The benefits of market forces

1. With more efficient management of
health care, the managers have more
control rights and the management
practice is more transparent.
2. Development in Quality and
innovation offers the opportunity for a
longer and better life.
3. By opening the market, managers
are able to involve new service
Figure 3: Changes in UK public spending on providers who were not there before.
health (Full Fact 2023) 4. Managers can freely decide to
reduce capacity. Managers can reduce
The political ideologies of past areas that are over-provided and incur
governments have determined the high costs, thereby reducing the
extent to which they have been amount of money spent.
involved in the governance of the
NHS. There were parties that wanted

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Unit 6. The History of the National Health Service Journal Article

Disadvantages of using market

forces In 1948, thanks to the Prime Minister of
1. Avoiding monopoly can reduce Health Aneurin Bevan, the National Health
the effectiveness of market forces, Service was launched. This enabled free
health care for everyone. The NHS has
because it would stand in the way
faced many challenges and is willing to
of development and growth. change to provide better services and
2. Distorted information and the preserve health.
obligation of secrecy about the
results of service providers do not Timeline of NHS The following figure
allow customers to choose a shows the important milestones in the first
service provider based on the 70 years.
appropriate information.
3. Classification by type of "wrong"
and "correct" patients suggests that
low-risk patients who are less
expensive use market forces'
providers, while insurers find
loopholes to pay for treatment of
high-risk, expensive patients.
4. Market failure can occur on the
part of both the service provider
and the consumer, if the service
providers do not provide the correct
information, and as a result,
consumers cannot use the correct
service provider.
5. It is not clear whose interests
are served by market forces, as it is
possible that the better quality and
efficient health care causes a
disadvantage to the workers there
due to the way they work.
6. Government control may not be
Figure 5. Evolution of The NHS (Great Bear Healthcare,
able to work with market forces, 2023)
having had the NHS under its 2020. Pandemic. COVID-19. “On 11
control for 70 years. It is difficult to March 2020, the World Health Organisation
cede control to market forces. declared it a pandemic. Globally, over 15
million people have died” (WHO estimate,
The impact market forces will actually May 2022).
have on the development and efficiency of “2021
NHS funding is not yet known, as this is Management/Education/Information
Technology
still an ongoing change.
2022.Management/Integration. NHS Reorg
Currently, NHS workers are dissatisfied
anisation (Major). The Health and Care Act
with many overtime and long working 2022 led to Integrated Care Systems (ICSs),
hours, low pay and moral issues. developing out of STPs.
In order to be able to serve people with 2023. Hospital flow. Year does not start
high quality, with less waiting time, and to well with jammed hospitals/A&Es in the
be able to continue providing continuous news every day, combined with NHS
care, changes are definitely necessary in workers’s strikes and recurrence of COVID-
the healthcare service. 19 and flu.” (myNHS. 2023)

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Unit 6. The History of the National Health Service Journal Article

References
Epearl.co.uk. (2018). The History of the National Health Service. [online] Available
at: https://ldatom.epearl.co.uk//vle/_store/scorm/1623601866-history-of-the-
nhs/scormcontent/index.html#/ [Accessed 27 Jun. 2023].

Health Service Navigator. (2023a). History of the NHS: A Summary. [online]

Available at: https://www.myhsn.co.uk/top-tip/history-of-the-nhs-a-summary
[Accessed 27 Jun. 2023].

Health Service Navigator. (2023b). Origins and prehistory of the NHS. [online]
Available at: https://www.myhsn.co.uk/top-tip/origins-and-prehistory-of-the-nhs
[Accessed 27 Jun. 2023].

NHS England (2023). Market Forces Factor. [online] www.datadictionary.nhs.uk.

Available at:
https://www.datadictionary.nhs.uk/supporting_information/market_forces_factor.html
#:~:text=The%20Market%20Forces%20Factor%20(MFF.

Paul (2023). Structure of The NHS - The Medic Portal. [online]

www.themedicportal.com. Available at: https://www.themedicportal.com/application-
guide/the-nhs/structure-of-the-nhs/?v=79cba1185463 [Accessed 27 Jun. 2023].

Bibliography
Flickr. 1935: Victoria Hospital, Swindon - the Goddard Ward, 2018,

www.flickr.com/photos/swindonlocal/41020767944. Accessed 27 June 2023.

Full Fact. Changes in UK Pulic Spending on Health, 2018,

fullfact.org/health/spending-english-nhs/. Accessed 27 June 2023.

Great Bear Healthcare. Evolution of the NHS, 2023,

www.greatbearhealthcare.co.uk/news/celebrating-70-years-of-the-nhs/.

Accessed 27 June 2023.

Learn Direct. Benefits of Using Market Force in Healthcare , 2022,

ldatom.epearl.co.uk//vle/_store/scorm/1623601866-history-of-the-

nhs/scormcontent/index.html#/lessons/PVXNMtj8BYzv_x4QivbtZm0OwgQkL

UVy. Accessed 27 June 2023.

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Unit 6. The History of the National Health Service Journal Article

---. “Modern Demands on Health Service,” Ldatom.epearl.co.uk, 2022,

ldatom.epearl.co.uk//vle/_store/scorm/1623601866-history-of-the-

nhs/scormcontent/index.html#/lessons/FNrPbO9U6CmsdVxp8NM6ruj6rahElK

wW.

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heritage/transformingsociety/livinglearning/coll-9-health1/coll-9-health/.

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