In detail describe the historical development of the welfare state since 1945 and how these dates have affected health and social care provisions.

Kirsty Metcalfe

In this task I am going to examine and describe how the welfare state was invented and developed since 1945. The welfare state as we know it today was a far cry from the Elizabethan England where people were offered no security and, in desperation, were forced to beg the streets in order to survive. In these times only the very minimum security was offered to the elderly, however the unemployed were left to starve to death.

There was no particular change in these laws until the industrial revolution, which was an important period in the social history of Britain. The industrial revolution marks the change of agriculture to factory production work. This caused serious problems for the people of Britain as many jobs, which was done by hand, such as weaving, where now being done by a machine, leaving many people unemployed. Also, there was a major shortage of houses due to people being forced to leave their homes to urban areas to be near the factories.

In 1834 the poor laws were created in which it was declared that if people were unemployed it was by choice as the people who couldn’t find a job were simply idle and the work was available if they really wanted it. It was after the 1834 poor law that workhouses were created. Many people would only enter the workhouses as an alternative to starvation. The workhouses were considered harsh and degrading yet the sick and the elderly were treated in the exact same way. To enter a workhouse would result in you loosing your dignity, and many people chose the other option, which was death.

It was towards the end of the 19th century that the state began to accept responsibility for the welfare of its citizens. Seebohm Rowntree did a study of the citizens of York and came to the conclusion that poverty was not the fault of the poor. This led people to believe that the content and general idea behind the 1834 poor laws was wrong. As a result of this people’s attitudes began to change towards the poor, which led to a number of factory acts being created. A few examples of these acts were limiting the number of hours people could work, and a major change was ending child labour. It was then, in 1870, after child labour was ended a system of primary education was introduced and made compulsory for children up to the age of ten. The idea behind this was to occupy children but it helped all children get educated, regardless of their social status and income.

At the beginning of the 20th century all services were ‘selective’ and were only offered to those who were in need of them the most. A ‘means test’ was carried out to asses whether a family should receive financial help, however, the foundation of the modern welfare state was established when people began to believe that all services should be universal and offered to everyone, despite their financial or social status.

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This all began to change during the second world war, when the prime minister, Winston Churchill appointed Sir William Beveridge to investigate existing National insurance schemes after realising that at the end of the war they would be a great need for medical attention. Also it was acknowledged that many soldiers who went to war healthy and carefree would return unable to work and would rely upon the state to help them survive. In June 1945 the Beveridge report was produced and became an instant best seller for the values and beliefs based behind the book. The report set out a plan for social security reform and was based on tackling five ‘giant evils’ which were

Want (Poverty)
Disease (ill health)
Ignorance (lack of education)
Idleness (unemployment)
Squalor (poor housing)

It was after the Beveridge report was produced that the idea of ‘universality benefits began. The state first began to tackle the problem of poverty and therefore as a result the 1945 Family allowance act was created offering cash payments every week for every child under the age of 16 after the first-born. For the first time it was offered to every family in Britain despite income or social status. After the family allowance act was passed the National insurance act 1946 began, offering a range of benefits to those who chose to contribute to it including sickness benefits, unemployment benefits, widow and maternity benefits. A follow on from this was the National Assistance act 1948 which introduced provisions to those who were not covered.

One of the major successes of the Beveridge report was the creation of the National Health Service (NHS). Before the NHS, health services were provided through private, voluntary and care sectors, however the outbreak of the second world war cause the government to intervene and take control of Britain’s Health care provisions. The National Health Service was set out by a key piece of legislation called the 1946 National Health Service act which set out the principle that free health care should be given universality. The National Health Service (NHS) was born on 5th July 1948. The NHS was based on three key principles, which were that services would be free at the point of delivery, it would cover all people in every area of the country and that access to the services would be based upon clinical needs rather than the ability to pay, which was extremely different to health care services before the NHS. The NHS gave people free access to G.P’s, hospitals, specialists, dental and eye treatment and hearing facilities, however, in 1951 NHS charges were introduced for the first time which was cost for dentures and 1952 charges for dental treatment was introduced. In addition people were charged per prescription form, which is a procedure that is still carried out today. Many years later the NHS still remains a major and successful part of the welfare state.

Another of Beveridges ‘giant evils’ was ignorance. Before the Second World War the education system in Britain was, like the healthcare system, patchy and not offered to everyone. Building on the 1870 laws of offering education up to the age of ten, the education act 1944 was created. It was apiece of legislation that established the three-part secondary education system (grammar, technical and secondary modern schools). The legalisation was based on the theory of equality, as education was now free to everybody in the country all children were given a equal chance to learn in the type of school that best suited them.

The last two of Beveridges ‘giant evils’ was squalor and idleness. At the end of the of World War Two there was a great need for housing as many were destroyed during the blitz. As a result and in an attempt to tackle squalor the government gave local authorities funding and between 1950-1955 over one million new council houses were built. This combat the problem of squalor that was facing the government.

After the war many people feared high unemployment yet this problem didn’t appear as the government nationalised many public utilities such as gas, water and electricity industries as were the coal, steel and railway. This enabled the government to manage big parts of the economy. High employment rates lasted until the 1970’s, however, after 3 decades, in which time the welfare state became a fixed element in Britain, unemployment became rife, as did inflation, which caused people to believe that major social reform was in need. This was when ‘Thatcherism’ began.

‘Thatcherism’ is the term used to describe the idea behind the conservative party, led by Margaret Thatcher who took power in 1979. Thatcher had what could be considered as a more restricted view of the welfare state as she believed you should look after yourself rather than pay high taxes to pay for services such as the NHS. Her radical ideas greatly affected the welfare state between the years of 1979-1997 as the government introduced means testing and selective welfare.

One of the first things Margaret Thatcher did was privatise public services and sold off lots of council houses, this was to encourage people to buy their own home rather than rely upon public housing. By doing this she was supporting her theory that you should look after yourself rather than let the government look after you. The consequence of this was a widening gap between the rich and the poor, which worked against all previous legalisations.

Whilst the NHS wasn’t directly privatised by Thatcher’s government many support services such as cleaning and catering was. The NHS went through several reorganisations. Charges for dental care and prescriptions were increased, funding control was introduced to health care where budgets were given and must be stuck to. Many changes happened to the structure of the NHS including abolishing area tiers and disbanding the area health authorities. The conservative government effectively ended the universal approach to health and social services. After 3 terms in office, Margaret Thatcher- who had received the name of ‘iron lady’ retied and was succeeded by John Major, also a member of the Conservative party.

In 1997 New Labour took power ending the 18-year Conservative rule. Under the control of Tony Blair, New Labour claimed to have found a ‘ third way’. It is Tony Blair’s belief that work is the surest way out of poverty so the new welfare state is based on ‘work for those who can and security for those who can’t’ the New Labour party has tried to combine the beliefs of the Old Labour party and the Conservative party to bring the public a welfare state that will work for everyone. The government still accepts it has a responsibility to support its citizens, yet the citizens must also support themselves. In recent years the government has being criticised for many decisions made concerning the welfare state, yet, in my opinion, the New Labour government has done a fair job in making the world a better place and creating equal opportunities despite social class or income group.