John Simon
John Simon succeeded Edwin Chadwick in the role of public health administration, he is considered as the ‘third father’ of public health. Professional Simon was a member of the Royal college of Surgeons and then made a member of the Fellows of the Royal college of Surgeons. In 1855 he became the medical officer to the Board of Health, with the help and advice of scientists and engineers he helped to install the first sewerage systems in a number of towns throughout the 1850’s and 1860’s.
Simon was responsible for the ‘Sanitary Act’ which meant local authorities were responsible for maintaining and extending their range of sanitary powers. And also the ‘Public Health Act 1875’ which required all new residential construction to include running water and an internal drainage system, as well as other things.
20th Century
William Beveridge
In 1941 the government ordered a report into hoe Britain should be rebuilt after the war, William Beveridge was chosen to conduct this report, he wrote Social Insurance and Allied services which he became best known for and later known as ‘The Beveridge Report’. The report proposed that people of working age should weekly contributions ‘national insurance’. These contributions should then be used to benefit people who were sick, unemployed, retires or widowed. Beveridge argued that implementing this system would ensure minimum standards of living were provided and that no one should fall below. From this report The Welfare State was introduced and the emergence of the National Health Service.
Beveridge believed security and relief was needed to tackle what he called ‘the five giants on the road to reconstrution’ which were:
- Want – From which came the Benefit system
- Disease - From which came the NHS
- Ignorance - From which came the Education system
- Squalor - From which came the Local Housing systems
- Idleness - From which came the Department of employment
The National Health Service (NHS)
The NHS was created in the aftermath of the Second World War and based on the proposal William Beveridge made in Beveridge report. The NHS provided completely free healthcare to patients based citizenship and need rather than the payment of fees or insurance premiums. All services were provided by the same healthcare professional in the same place of practice but were now funded by the central taxation, not national insurance and everyone was eligible to receive care. It was divided into three sections – Hospital services, Primary care and community services as it still is today.
The Black Report
The Black report was published by the then Department of Health and Social security in 1980. Its purpose was investigating health inequalities in the UK. It high lightened that the overall health of the nation had improved since the introduction of the welfare state but there was widespread health inequalities, the main cause being poverty. The report was commissioned in 1977 by the Labour secretary of state but was not published until 1980 by the Conservative government.
The Acheson report
Like earlier report the Acheson report also demonstrates health inequalities in the UK and their connections to social class. The report was commissioned to highlight priority areas of health inequalities in order to develop policies to reduce them. Donald Acheson made 39 recommendations to address the health inequality in the UK. Three key areas were identified as crucial to the improvement which were:
- All policies likely to have an impact on health should be evaluated in terms of their impact on health
- A high priority should be given to the health of families of children
- Further steps should be taken to reduce income inequalities and improve the living standards of poor households
The report also called for more funding for schools in deprived areas, more benefits for women of child bearing age, young mum as well single parents. Smoking in public place and tobacco advertisements were also called to be restricted.
21st Century
Public Health White Paper – Choosing Health
People interest in their health was on the increase and this was recognised in the White Paper 2004, which lead to recommendations on new approaches to public health in order to reflect the rapid changes and increases in today’s society. The role of tackling causes of ill health and inequalities fell to the government to support and empower individuals to make changes in their own lives. There are three underpinnings principles of the document which are:
- Informed choice – with the protection of children considered and to not allow one person choice have an effect on others
- Personalisation – provide tailored support to individual
- Working together – effective partnership
The report highlighted areas of priority that needed addressing such as reducing the number of people that smoke, reduce obesity which leads onto improving diet and nutrition and increasing exercise. The need to encourage sensible drinking and improvements needed in sexual and mental health. Areas of action were also set out in the white paper. By 2010 all schools such have an active travel plan in place for their school, working with the national charity Sustrans, local authorities such build new cycle lanes and tracks. And the main area the NHS will help to train people in make healthier choices, all NHS staff will be trained in order to deliver key health messages to their patients and NHS will become a model employer delivering the right message to everyone.
