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SLQ 1451 Defects of the 1948 NHS
Defects of the 1948 NHS
One of the major achievements of the Atlee’s government was the introduction of the National Health Service in 1948. This service aimed to provide medical services to every citizen in the United Kingdom. The minister of health at the time, Aneurin Bevan, was one of the greatest advocates of the service. The National Health Insurance system was able to provide health services to 21 million citizens but left the rest of the population to pay for their medical services. The Labour and the Beveridge party came to the realization that people are being deprived off health services mainly because they are not able to afford it. Many doctors did not like the introduction of the National Health Service. The logical reason underlying the doctors’ reactions was that they felt that they would lose money as a result. They believed that the freedom of their profession was going to be jeopardized. Their projections indicated that the number of private patients available to them was going to reduce drastically and, as a result, they will lose out on their finances. The doctors also had the worry that the National Health Service will subject their patients to certain doctors hence they will not be able to choose their own. However, they later realized that their worry was unfounded. Many people appreciated the introduction of the National Health Services. Almost the entire medical profession joined the National Health Service after its inception. Its popularity was however unplanned for. Its resources were being used up much more quickly than it had been anticipated. Funds set aside for glasses, and dental surgery got quickly depleted. The program had set aside £2 million for free spectacles to be used in nine months. This amount had been already used up within the first six weeks. By 1950, the British government had estimated that the National Health Service would require funding of £140 million per year. However, the National Health Service ended up costing £358 million per year. Therefore, since the introduction of the service in 1948, the National Health Service has always appeared to be coming short on money. The Conservatives had promised to maintain the National Health Service during the 1950 election campaigns, but its popularity proved to be irrelevant since the Labour Party eventually won the elections. After taking over the government, the Labour party tried to make adjustments to the service by introducing a charge on medicine prescriptions and dental treatment. Aneurin Bevan resigned to protest against this because he insisted on free health services.
Before the introduction of the National Health Service, the health care organization and general access to it was coupled with a number of drawbacks. The National Health Service was introduced by Lloyd George, who was the chancellor in 1911. There were benefits that were accrued out of this for a low-income earner. It however did not include dependents. The contributions were not scaled according to the income one earned, but it was at a flat rate. The employer and the employee shared the contribution on a fifty-fifty basis. Their contributions earned cash benefits for accident, sickness and disability. The contributors were also entitled to free care from a local doctor. This was, however, limited. The only entitlement they received to hospital treatment was when the suffered from tuberculosis. The doctors got a “capitation fee” which was a standard payment for each patient they treated in the panel. Before 1948, the insurance service introduced by Chancellor Lloyd George was one of the largest healthcare systems in Britain. There were other systems providing medical assistance. The Poor Law, for instance, focused on providing healthcare to the poorest citizens. It also provided other services such as health education and meals in schools. Voluntary hospitals were another major hospital system that provided care to the Britons before the introduction of the National Health Services. The voluntary hospitals were mainly supported by donations from subscribers. In 1930, this system experienced a financial crisis. Briefly put, the British health care system before 1948 was riddled with a lot of problems. It was made up of a shady combination of several institutions which did not exactly meet the people’s need as far as health care was concerned. There was no access to health care for one’s dependents, and there was also no access to hospital care. Most of the citizens used to get over the counter medicine in local pharmacies. Therefore, medical attention caused major financial problems for families in Britain.
The National Health Care system stepped in to offer health care to the entire population in Britain at their exact point of need. The service was funded through taxation. It did not follow the principle of insurance and entitlement was based on contributions. During the war, it had been anticipated that the local government’s public health service would provide a solution to the national health care system. The role of local government was however limited. After charges had been introduced in 1951 by the labor government, it was realized that the National Health System’s structure had a problem. The structure had a measure of compromise in itself aiming to cap the support of the medical profession. The government aimed it to be an entity that was administered locally, but its inception received criticism from a very hostile medical profession. Aneurin Bevan, the minister of health, accepted the fact that the National Health Service could not be successful without the support of the doctors. He tried to save the situation by nationalizing the hospitals. It was immediately disputed by local councilors as they felt that it was a system that lacked democracy. The major reason it was viewed as such was because the local councilors felt that they had been deprived of the control of the country’s health system. The National Health Service was also criticized because of it lacked integration. The service was divided into local, hospitals, and government services. The three parts were intended to operate independently from each other.
The National Health System had components that made it different from other health care systems formed in Britain. Given the fact that it was funded through taxation, it meant that it was going to have some political influence. It was readily accepted by the population because it removed the fear of illness, and it appeared to be very ideal. The only political interference that the National Health Service experienced was through the insurance platform in 1980. Health care matters have, therefore, proven to be more sensitive in the United Kingdom than in other countries since it is based on taxes and not on insurance. The politicians have tried to solve the problems that are being experienced by the National Health Service through making some amendments. One such reorganization includes the introduction of the general practice appointment booking. Despite the National Health Service acquiring a reputation of financial decadence, it has proven to be quite cost effective. The funding projections had been made to come from the local government and not on the national taxation. Hence, its true funding had been grossly underestimated. The funding proportion has since been gradually increased by the government to cater for the deficiencies. This, however, has proven not to be enough since there are increasing numbers of people that are depending on the services. As the government puts in efforts to fund the service, they tend to make poor projections as to the number of people the healthcare service is intended to serve.
Instead, the structure that the National Health Service has taken is the one that has led to its continuing problems. Despite the fact that the previous health systems had been fragmented, dividing the National Health Service into three parts left quite much to be desired. The “polyclinic” has recently been adopted in order to bring together general practitioners, specialists and other services. During the inception of the system, health centers were built as a unification factor. However, very few were built. Another problem that the system faced was that, during its introduction, it was a service that was majorly dominated by doctors and experienced conflict over surgery opening hours.
The Wanless Report provided efforts to give solutions to the problems that health service showed. The report developed what is popularly known as Primary Health Care (PHC). This has enabled a wider range of practitioners to deliver health to the citizens of the United Kingdom. Midwives and dentists have also been given priority through the introduction of Primary Health Care. The practice of ‘counter prescribing is, therefore, being built upon by the community pharmacists. However, lack of democracy has continued to elude the National Health Service since the nationalization of hospitals. Participation of patients and the public had been greatly limited in the structure of the NHS. The government has therefore been prompted to once more reassess the input of patients.
Well, we learn a number of things from problems that riddled the formation of the National Health Service in 1948. The NHS was introduced with the ideology of universal access and giving health care at the point of need and has, therefore, maintained a level of popularity. Since the system is funded through taxation, the government is expected to have a direct influence on the health services being delivered to the citizens of the United Kingdom. Despite maintaining its popularity, the system has been unable to deliver the ideal health care to its citizens. It is, therefore, factual to say that the structures put in place by the National Health Service in 1948 were greatly flawed, and it gave doctors too much influence. There was less focus on positive health, and much more focus was put on sickness. There was also a lack of democratic input in the system. Attempts to deal with such structural problems were often seen as new initiatives. Some of the suggested solutions either partly achieved its intended objective or simply brought new problems altogether. Most decisions that have been made regarding healthcare since the inception of the service in 1948 has proven to be a ripple effect that echoes negatively into the future of the National Health Service.
Recently, there are many reasons that have been attributed for making the service reach a crisis point. One of the reasons is the increasing number of the ageing population. The diseases that could have killed people during the inception of the National Health Services have been cured. Therefore, the mortality rate has greatly reduced. This means that people can able to live for a relatively longer period of time and would, therefore, need continued health services. The projections made might have not factored in the fact that the ageing population would eventually increase as a result. The old people living with long-term, complex conditions such as kidney diseases and diabetes require specialist care, and this is probably draining the National Health Service. Lifestyle factors continued to change since the introduction of the NHS. The lifestyle people are adapting to seem to be creating a negative impact to their health. There has been an increasing trend in people’s alcohol consumption and cigarette smoking. The citizens are also accustomed to poor dieting which does not have enough or any fruit and vegetables. Not doing enough exercises is another reason. There has been a recorded increase in the number of overweight children which signifies that the problem is set to continue. The citizens’ reliance on the health care services is therefore being strained with time. Thirdly, the expectations of the public slowly changed as time went by. The National Health Service mainly focused on tackling diseases. The public, however, continued expecting more and more with time. The NHS is expected by the people to manage health care, social care, issues to do with mental health, vaccination programmes, contraception and maternity services. It is also held accountable for efficient processing of medication and medical appointments. Coupled with the aforementioned facts of a growing ageing population and depreciation of health due to poor lifestyle factors, the NHS is subjected to experience the problems that it has been experiencing. The accident and emergency department is also being strained beyond its capacity. More and more people are visiting these departments due to minor injuries. Though these visits can be argued to be unavoidable, most people are visiting these units as a result of poor management of their long-term health conditions. There is also poor appointment management as insufficient information is given while booking appointments. The visitor numbers continue to grow by the year, and the medical profession is finding it difficult to deal with. There has also been a rising cost as far as health care in Britain is concerned. Since the introduction of the NHS, there have been a lot of technological advancements and innovations in the medical field that would require more in terms of investment. Keeping in mind that there are more and more people that are meant to be catered for, the NHS is bound to experience an economic disaster. It has been projected, based on how the system has been working, without the necessary radical changes the NHS is eventually going to be unsustainable due to major pressures on its finances and debts.
In conclusion, the problems that the National Health Service experienced during its inception in 1948 could have been well avoided. The formulators of the program could have made far much better projections before they introduced the health care system to the public. It appeared that the health care system was introduced on the premise of trial and error. The acceptance and popularity that it eventually received caught it flat-footed because, after only two years since its introduction, it has started experiencing financial problems. Other factors such as an increasing ageing population, deteriorating way of living and increase in costs due to innovations and technological advancements could have been considered. With these issues in mind, the government could have set aside a good amount to fund the system and also factor in room for contingencies. The idea of funding the health care system through taxation was also a major flaw. This meant that the National Health Service will always be affected by politics. This can prove to be disastrous because people can manipulate it in order to serve their own needs. Such flaws have led to continued problems to the NHS, and if something substantial is not done, the system will eventually be abolished.
REFERENCES
WEARDEN, G. “NHS IT project costs soar”: ZDNet, 2004
COLLINS, T. “Is it too late for NHS national programme to win support of doctors for new systems?”: Computer Weekly, 2005
RINTALA, M. Creating the National Health Service: Aneurin Bevan and the Medical Lords: Sage Publications, 2003
KLEIN, R. The New Politics of the National Health Service: Wiley publishers, 1995
EVERSLEY, J. “The History of NHS Charges”, Contemporary British History, Vol.15, pp. 53-75, 2002.
POLLOCK, A. NHS plc: the privatisation of our healthcare: Verso, 2004
MANDELSTA, M. Betraying the NHS: Health Abandoned. Jessica: Kingsley Publishing, 2005
GORSKY, M. “The British National Health Service 1948-2008: A Review of the Historiography,” Social History of Medicine, Vol. 21 Issue 3, pp 437–460, 2008
Daniel Webster was a nationalist who dedicated his life in defending the laws that met their application
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Daniel Webster was a nationalist who dedicated his life in defending the laws that met their application to all states made by the federal government. Robert Hayne supported states’ rights at the nullification or Webster was a supporter of the federal government powers are the earth’s right to create laws that protected that union and I was opposed to the nullification. Webster declared that freedom and the union went together. Daniel Webster says that all the origin of the government and of the foundation on which it starts is erected by the people and those who minister it, are responsible to the people and can only modify the constitution just as the people make sure it to be.
The Southerners thought that the reduced rate of tariffs was still too high. South Carolina threatened that the tariffs of 1828 and 1830 were not abolished they would withdraw from the union if the federal government tried to correct the tariffs. According to the southerners, the two acts enacted were an authorized by the United States’ constitution. They violated the true definition of democracy, and they were therefore null and void at the new law. Abiding upon the state, citizens, and all assurances, contracts, as well as the applications made into with the aim of securing the duties introduced by the act, and all judicial proceedings facilitated in the name of the act shall be deemed to be null and void.
In my view, the most effective primary document is that of the South Carolina. It defends the people and is against the rise of the tariffs on raw materials as well as the manufactured goods and this affects the production and the income of the producers and manufacturers of the United States. According to the southerners, the old tariffs had to be abolished to give room for new tariffs to be enacted through new legislation.
In the 1851 political cartoon, they southerners are protesting against the north of the 1850 fugitive slave act to where the national government made laws that considered the slaves or the people of the African origin as fugitives. In the cartoon, the national government to whom enacted the slave act takes away the slave as they are named fugitive, but the states have its own rules that prohibit and oppose the national law. The states claim that they have a higher law and that they don’t recognize any law from the national government of the United States. The political cartoon also applies to the document one and two as it argues that both the national government and that of the state are different and that the national government law does not with any effect affect the state law.
The 1856 political cartoon document 4, relates to the Kansas-Nebraska act which enacted by the US Congress on May 30, 1854 allowing the people of Kansas and Nebraska to make their decisions against the issues of slavery in their individual states. According to the cartoon, the national government allowed the individual states to make their own decisions on onto whether they could retain slavery or abolish it. The black men were considered to be slaves, and the act of leaving the decision to the individual states would only encourage the white to continue oppressing the blacks. In the picture senator, Stephen Douglas, President Franklin Pierce, James Buchanan and Levies Cars who all are running to be the Democratic Party nominees for president in the 1856 elections are seen forcing a black man against his will an intimidating action, indicating how the whites are racist.
From the picture, the background of making the decisions on whether the states will vote against slavery is made to be seen as democratic, but in the other side, the grounds to which democracy is to be practiced is limited as the black people have no room to express themselves.
Dred Scott, a slave who demanded to seek his freedom via judicial system of the United States, to which emanated with the worst ruling ever. In the year 1857 decision by the Supreme Court of the US in the case against Dred Scott, implies that no Negro would never become an American citizen regardless of the provision by the constitution of citizenship by birth. The term Negro was used to refer to the people of the African origin. The decision by the Supreme Court did not only deny Scott justice but also contributed to the invalidation of the Missouri compromise enacted in 1820 which are the anti-slavery in certain US territories.
Frederick Douglas in document 6 asked whether the significant principles of natural justice as well as political freedom that are bestowed in the declaration of independence are similarly represented to the people of black origin as well. The speech on 4th of July was directed to the American slavery where Douglas condemns the Americans for not being true to their founding principles, in both present and in the past. The audience to his speech must therefore fulfill the quest of the founding fathers in natural justice, Douglas tells the audience that the 4th of July was a sham, as the slave tends to boast of liberty, and as shouts of liberty and equality are a just hollow mockery.
Dred Scott decision during the case of nullification of the Missouri act, confirms Frederick Douglass arguments that the Africans were just considered useless, worthless and treated as slaves and the call for equality was just an active form of mockery to the African population. According to the decision by Dred Scott, any person of African origin could never be an American citizen by birth or immigration, and that’s the call for the natural justice that is embedded in the declaration of independence does not apply to the Negros.
According to William H. Seward, irresponsible conflict refers to the collision of the socio-economic institutions of the north or South America. According to William, in states to which the slave system existed, prevents the slave masters from directly or indirectly securing all the political power and therefore constitute a loading aristocracy while in countries where there existed the free labor system, it prevented the universal suffrage, necessarily obtained adverse state that inevitably becomes a democracy later.
The definition of the Confederacy by Alexander Stephens is based on the idea that; the newly formed government was formed on the opposite ideas to which its foundations are build. The cornerstone of the foundation rest upon the significant truth and that the Negros are not equal to the white men and that subordination of the slaves to the whites as a higher race is the slaves natural as well as normal conditions. According to Alexander Stephens, the Confederate states were founded with the main aim of preserving and expansion of slavery institution.
President Abraham Lincoln in the Gettysburg 1863 claims that the forefathers brought for the continent of America, a nation was born in liberty and dedication to the proposition which called for equality of all men as they were created equal. And that now that they were engaged in a great civil war, they were being tested as to whether the nation born and dedicated to equality, could long maintain the equality prospects. It is through this equality that erupted the full scale of civil war due to the peculiar institution regarded as slavery that was present at the creation of the republic.
In thinking about the primary documents, the states have the power to nullify federal laws if they disagree with them. The reason behind is because the state government originate from the individual countries and form the national government and the will of the people lies in the states. Also, each of the states has a representative to whom addresses the problems of its people. Just like the case of southern Carolina, the tariffs had been raised to a higher cost making their manufacturers pay more, thus reducing the productivity.
It would have resorted to financial losses contributing to the economic fall to the country, and it is to this situation that the state’s government came to the rescue nullifying the act that was formed by the government. They further warned that any act of the judiciary to rule over cases regarding the act would not be respected and would be treated as null and void. In the event where the nullification would not be successful, then the government would take that opportunity to exploit the manufacturers as well as producers of all products.
And this would lead to the collapse of their businesses as well as the gross domestic product of the country which has an overall effect on low income as well as a low standard of living. On the other side the nullification of the Missouri act in Dred’s case showed the American viewed the people of African origin and how they saw them as subjects doomed to slavery and can never attain the American citizenship nor freedom despite the call for equality.
References
Abraham Lincoln’s “Gettysburg Address” (November 19, 1863)
Alexander Stephen’s “Cornerstone Speech” (March 21, 1861)
Excerpt of Daniel Webster’s “Liberty and Union” Speech (January 26, 1830)
Excerpt of Majority Decision in Dred Scott v. Sanford (March 6, 1857)
Frederick Douglass “The Meaning of the Fourth of July for the Negro” (July 5, 1852)
Political Cartoon “Forcing Slavery Down the Throat of a Freesoiler” (1856)
Political Cartoon “What’s sauce for the goose is sauce for the gander” (1851)
South Carolina Ordinance of Nullification (November 24, 1832)
William Henry Seward’s “On the Irrepressible Conflict” (October 25, 1858)
Maintaining Academic Honesty
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25th October, 2010
Maintaining Academic Honesty
Academic honesty can be described as a moral code in academia which encompasses maintaining required academic standards, avoidance of plagiarism or cheating and truthfulness in academic publishing and research. It is applicable in all types of educational settings raging from elementary to graduate school. Honesty is sincerity and truthfulness. It is being upright in actions and principle. Honesty builds a positive image socially and creates a warm atmosphere. Students who engage in honesty enjoy inner peace, long-lasting trust both in academia and in life. Sincerity bears good fruits and helps in interacting with others. Academic honesty enhances social and individual prosperity as well as fair play. The topic of academic honesty cannot be completely discussed without addressing academic dishonesty. Academic dishonesty includes fabrication, deception, plagiarism, sabotage, bribery, cheating and professional misconduct. Dishonesty leads to hate, deceit, miscommunications, mistrust and declining social values. Students should be honest with themselves and others so as to help cope with life challenges. They should know their strengths and work on their limitations. Cheaters never win and winners never cheat. With the changing technology, maintaining academic honesty is increasingly hard. Students engage in questionable ethical manners making them inevitably honest (Donald 2010).
The availability of information from the internet has posed as a challenge for students to maintain honesty. Plagiarism is common for students who find it hard to cite the source of in formation from the variety. Regarding honesty in academics, students have developed an attitude that is less serious. Videos and other instructional articles are readily available to give tips to the students on how to cheat. Academic institutions are unable to cope with the variety ways of cheating formulated by students. Academic honesty is a dual effort exhibited by the faculty and the students. For instance the aspect of grade inflation involves the faculty as the principle determinant of honesty in this case.
Academic honesty is violated in a number of ways. Cheating is achieved through attaining information from fellow students when examinations are on. Students communicate and share information in exams. They allow fellow students to copy from their work. Personification is also very evident in schools especially during exams. Students use unauthorized writing materials in exams. Some alter graded examination and return it to the teachers or instructors for additional credit. Some alter laboratory and research projects misreporting their findings. Others submit their work to research companies and make payments for their assignments to be done by someone else (Wilfried 2002).
Plagiarism is submitting creative products such as ideas and words as one’s own work. It involves reproduction or adoption of other’s original creations without their acknowledgement. Direct quotations, ideas, facts and paraphrases should be accredited to the source. Other forms of violating academic honesty are stealing answer key or examinations, altering academic records and forgery. Some students submit same work for various courses. Others engage in sabotage by impairing intentionally the work of others, distracting them, altering athletic or musical equipments, removing some pages from books, and altering reagents or laboratory samples of fellow students’ experiments. Collusion is the instance where a student intentionally aids another one in engaging in academic dishonesty. Disciplinary of collusion cases should be similar to that of the act itself (‘GWC’ 2010) Students engage in bribery where they pay for answers and gain other academic benefits. Others engage in deception by giving wrong information regarding academic exercises. This may involve false excuses for failing to submit due assignments or claiming that they have submitted their work while they haven’t. Other students engage in fabrication where they give wrong data, citations and information in their academic exercises.
Academic institutions should bear the responsibility of ensuring assigning of grades reflects the skill and knowledge level of students. Academic dishonesty weakens the society by producing intellectually incompetent individuals. To maintain honesty, the faculty should allocate honest grades to the students ensuring that honest students are not disadvantaged competitively. The faculty staff should bear the responsibility of elaborating the true importance of maintaining honesty to the students. It should conduct the students in a manner that makes plagiarism, cheating and any other dishonesty impossible. Students who engage in dishonesty should be disciplined in a manner that is timely (‘GWC’ 2010)
Students should avoid dishonesty, report incidences of dishonesty from fellow students and avoid aiding or being involved in any form of academic dishonesty. The administration is supposed to support students and the faculty to maintain honesty. It should facilitate disciplinary for personnel and the students involved in dishonesty. The administration is also supposed to disseminate the policy of academic honesty and its principles to staff, students and the faculty. It is the responsibility of the staff to co-operate with students, administration he faculty to eradicate cases of academic dishonesty. To maintain honesty, the staff is supposed to notify the body concerned with cases of academic dishonesty when incidences arise. Cases of violation of academic honesty involve evidence. Instructor could orally reprimand the student, deduct the points, give zero points or give an ‘F’ for the whole course. Serious cases involve tougher disciplinary actions such as discontinuity and suspension of the student. Some administrators reprimand students to go on probation as a disciplinary approach. Disciplinary actions helps minimize if not abolish violation of academic honesty thus improving the quality of education (‘GWC’ 2010)
Academic honesty comes with a number of benefits. Students make intellectual progress. The measure of skills, intellectual maturity and knowledge is achieved when one is honest. This helps the students to acquire standard academic success. Institutions that maintain integrity in academics flourish intellectually and are able to win the trust of the society and the world at large. Honesty in academics is reflected when one gets a career where one avoids being engaged in fraud in the workplace. Students who are honest in class will definitely be honest at work with fellow workers and avoid any incidences e that may diminish their honesty. Since potential employers use the qualifications of the student to gage their capability, honest certificates are essential in the job market. If wrong qualifications are handed in, then the result is incompetence at work and failure to deliver which may eventually lead to being laid off. Academic honesty saves the staff and student the emotional agony associated with dishonesty. Dishonesty destructs the student involved and the instructors who may be forced to take a tough disciplinary action against their wish. Honest students earn good reputation and may attract potential employers (Kenneth 2009)
Conclusion
Honesty in academics cannot be over emphasized. Learning institutions should ensure that there is integrity in academics contributed by staff and the students. Disciplinary action should be taken for students involved in dishonesty so as others can learn by example. The academic world maintains its integrity when honesty is emphasized. Honesty exalts education and creates conducive learning environment for students to reap the right rewards for their effort and this helps in pursuing knowledge.
Reference
Donald L. McCabe, LK Trevino. (2010). Journal of Higher Education. Questia. Cengage Learning
Golden West College (GWC). (2010). Academic Honesty Policy. Huntington Beach, CA
Kenneth A. Gabriel. (2009). Management Consulting. Robert H. Smith School of Business. Washington, DC
Wilfried Decoo. (2002). Crisis on Campus: Confronting Academic Misconduct. Cambridge. HYPERLINK “http://en.wikipedia.org/wiki/MIT_Press” o “MIT Press” MIT Press