Analyse and evaluate the changes to both the welfare state and the National Health Service from their beginnings to the present. Ensure that you focus particularly on the changes under the Conservative Government
Sociology Assignment:
The Development of the Welfare state and the National Health Service in Britain
Task 1
* In pairs produce an A3 poster describing the key developments linked with poverty during the years 1600-1940
See attached sheet
* Individually, describe in more detail two of these key developments
Key Development 1: The Elizabethan Poor Law of 1601 ('Old Poor Law')
The Poor Law of 1601was introduced as a response by the Government to rising levels of concern over how 'the poor' should be supported. As a result of several poor harvests, and soldiers returning from war there was increased vagrancy which concerned the Government who were increasingly worried about the possibility of social disorder and revolt. Under The Poor Law of 160, each parish was made responsible for its own parishioners that were impoverished, frail or handicapped and in need of support. Each parish became obliged to relieve the old and the helpless, to provide work for those deemed capable but who were finding it difficult to find work in their usual trade. The parishes also became responsible for helping to support unprotected children, often by introducing them into apprenticeships at a young age. The funding for providing this was collected by a 'Parish Administrative Unit' which was responsible for collecting poor-rates from the other parishioners. This was a form of revised local tax which was means tested and calculated, collected and then allocated and distributed by unpaid Churchwardens or Parish Overseers (later known as Relieving Officers) who were elected by the parish vestry every year.
There were two types of relief provided for the needy, 'outdoor relief' (through money, supplies of materials such as flax/ wool to provide a skill from which they could make money and work, or as basic foods such as bread) or 'indoor relief' (which included various form of institutional care). Outdoor relief was normally offered to people who were temporarily out of work (e.g. due to seasonal demand of their trade falling), or to fund the cost of a physician to treat those who were sick. Indoor relief was provided in different forms, depending on the classification of the pauper. Three types of poor people were identified in order to assess whether or not and to what extent people were in 'genuine need', and to evaluate the most appropriate ways to provide relief to suit what the individual was seen to require. The first group were 'The Impotent Poor' who were disabled, chronically sick, blind or mentally ill. They were viewed as being poor through no fault of their own and were seen as deserving relief. This was often provided in the form of admission to 'houses of dwelling', almshouses or poorhouses instead of workhouses.
The second group were 'The Able-bodied Poor', who were the unemployed but that were deemed as able to work. They were placed in work-houses where they were given basic labouring jobs in return for food until they could return to their normal work or find an alternative job. The third group were 'Persistent Idlers'. These were the able-bodied who either refused to work, persistently quit jobs or regularly absconded. As a punishment for this 'idleness' they were placed in Houses of Correction which aimed to teach idle citizens how to become respectable through a strict regime of discipline that often involved flogging and beating.
Very few changes were made to the Poor Law Act 1601 until the late 1700's (The Gilbert Act 1782-relating to workhouse unions), but the provision of outdoor relief for the poor gradually declined and the workhouse system was favoured as an alternative as it saved the parish money, and also acted as an incentive for the able-bodied poor to find stable work (as they received no income in the workhouses and were given very low status) and to discourage continued reliance on parish relief.
Key Development 2: The Poor Law Amendment Act (1834)
By the early 1800's little changes to the original Poor Law of 1601 had been made, and there were many criticisms of way it worked and the way in which relief was offered. In 1832 there were 1.5 million paupers in England (10% of the population) and it was felt that the existing Poor Law was not doing enough to reduce the problems of poverty and pauperism. The cost of providing for the poor had increased substantially and people claimed that it but an unfair expense on the mostly middle-class rate payers who had to fund the welfare provision through local property taxes. The standards of relief in the workhouses varied greatly, in some the conditions were very poor, while in others the standard of living was often higher than that of the working rate-payers who funded them ('pauper palaces'). It was also claimed that where the standards of living in workhouses were high, the benefits of using relief encouraged idleness and discouraged personal independence.
The Poor Law Amendment Act was introduced in 1834 in response to these concerns and primarily aimed to deter the able-bodied from claiming poor relief but continue to provide relief for the ailing and the helpless. There were four main recommendations of the new act. Firstly the issue of 'Centralisation' whereby local overseers would remain involved in poor relief but would now be accountable to a Central Board of Control who would hold overall responsibility for the care of the poor and needy. The second was that of 'Uniformity'. Care provided would be of the same standard regardless of where in the country it was offered. This meant that the Elizabethan Settlement Acts (where paupers were returned to their place of birth to receive support) were no longer needed. This aimed to reduce the discrepancies in the levels of care provided in different areas, with affluent areas having better services than poorer districts. A 'Workhouse Test' was introduced under the Poor Law Amendment Act, which was a self assessment test. The only form of relief that was to be offered to the able-bodied poor was a position in a workhouse so a person either had to accept the hard regime of a workhouse or remain independent and live with the consequences. It was hoped that this harsh system would discourage those who did not genuinely need support from claiming it. The payment of outdoor relief was not abolished altogether (despite attempts to do so), although it was now available to far fewer, very rarely to any able-bodied poor and often only to the chronically sick to pay for medical care.
The conditions within workhouses were to change also under the 'Principle of Less Eligibility', introduced as a means of social control aiming to reduce the desirability of claiming state welfare (as it was seen as affecting the work ethics and people's independence). The conditions in a workhouse in terms of diet and living conditions would at all times be maintained at a lower level than those of the lowest independent worker, so that entering a workhouse was only preferable to starving to death. Often inmates had personal belongings confiscated, were not allowed chairs to sit on and could not receive gifts of any sort.
These amendments are characteristic the Victorian attitude towards pauperism, that it is a result of a combination of self inflicted circumstances. There were two main themes of the Poor Law Amendment Acts in dealing with the poor, one of providing a caring role (for those in genuine need) and one as a deterrent role (in making the prospect of claiming welfare less attractive to encourage people to find their own way out of poverty). IT has been since argued that the Poor Law Amendment Acts instead of actually being aimed at reducing poverty (as was claimed), was more about finding means to deter pauperism.
Task 2
* Analyse and evaluate the changes to both the welfare state and the National Health Service from their beginnings to the present. Ensure that you focus particularly on the changes under the Conservative Government, as these were major reforms. Link with previous and subsequent changes. (Essay)
The Welfare State in Britain emerged when the Labour Party came to power with a landslide victory in 1945. In a bid to introduce a more organised system of tackling poverty and providing welfare support than the existing methods that had been developed of the preceding 50 years (which were still based on the Poor Law Acts). The government actively acknowledged, and recognised the importance of reducing the inequalities that existed between different groups in society and in different areas of the country, such as in levels of unemployment, accessibility to public services and the numbers of workers covered by occupational Insurance (for times of unemployment, illness etc). The principles and development of the welfare state were largely shaped by the work of academic civil servant William Beveridge. Beveridge rebelled against the theories of Adam Smith which had underpinned the provision of welfare under the previous Conservative government. Smith argued that individuals should be in control of their own lives and make their own choices, and in this way natural order of different classes would result, with capitalists owning industries and companies that a labouring force would support. Accordingly, he believed that there should be minimal (if any) government intervention in solving societal problems of poverty and healthcare- a stance which many socialists believed exploited and oppressed lower classes. Beveridge agreed with this, and also proposed that if the government was to take a more active and involved role in combating societal problems, the results would benefit not only the health and wellbeing of the population, but also the countries economy as an improved welfare and health system would lead to a healthier and more productive workforce (based on Keynesian theories of economy). In 1940, Beveridge was commissioned to lead a team to investigate outstanding welfare provision, and to draw up a plan for an improved system of welfare provision in the UK. The Beveridge Report, published in 1942, identified 5 giants (Want, Ignorance, Idleness, Squalor and Disease) that need to be reduced and eliminated, and devised a comprehensive system of social security in order to do this. The main feature of this system was social insurance, where all working men and women are obliged to pay a contribution into a national fund which would in turn guarantee them government support in times of hardship such as unemployment and illness. In addition to this the plan also allowed for a non contributory assistance scheme (means tested), child allowances, family allowances and included strategies to improve the education system and council housing- all which would improve the overall welfare of the population. The impact of the welfare state became apparent between 1945 and 1948, when Beveridge's concepts (national insurance, educational reform, family allowance etc) began to be implemented and the issues of the 5 giants began to be addressed and slowly improved. This was through legislation, in particular the Education Act (1944), the Family Allowance Act (1945), the National Assistance Act (1948), the Children's Act (1948) and the Housing Act (1949). One of the 5 giants identified by Beveridge was Disease, and his report proposed that a comprehensive accessible health service, matching that of the welfare system. He thought that the health provision available was fragmented and disorganised, and there was often the littlest care available in the areas most in need. In 1943 the Minister for Health Ernst Brown introduced proposals for a unified health care system with a central government department responsible for the service which would be advised a council and administered by local government areas. In 1945 a new Labour Government was elected and in 1946 a Bill to introduce a National Health Service based on the concepts of Beveridge was passed by Parliament. On 5th July 1948, the National Health Service first came into effect, with the principles that services would be funded from general taxation and that they would be free at the point of use, comprehensive and available to all, regardless of ability to pay. The original structure of the NHS was 'Tripartite' with three arms. The first arm was hospital services. Hospital care was overseen by 14 Regional Hospital Boards which funded 377 local hospital management committees, but the teaching hospitals had their own board of governors and were responsible to the Ministry of Health. The second arm was community and public health services, including maternity/ child welfare, home nurses, ambulances and health prevention/ promotion which continued to be run by separate Local Health Authorities or Councils (which were also responsible for housing, roads and education). The third arm was the Family Practitioner Services. A national network of General Practitioners was established, who were responsible for personal primary health care (including dentistry, optical services and pharmacists), and were also responsible for referring patients to other services (e.g. to hospitals) when needed. They were provided with contracts from 138 executive councils which received money to fund the services directly from the Ministry of Health. The salary structure of GP's was changed and fees were now set and paid nationally. As can be seen, although the three strands were financed centrally (through the Ministry of Health- Government money), they were managed separately.
The Development of the Welfare state and the National Health Service in Britain
Task 1
* In pairs produce an A3 poster describing the key developments linked with poverty during the years 1600-1940
See attached sheet
* Individually, describe in more detail two of these key developments
Key Development 1: The Elizabethan Poor Law of 1601 ('Old Poor Law')
The Poor Law of 1601was introduced as a response by the Government to rising levels of concern over how 'the poor' should be supported. As a result of several poor harvests, and soldiers returning from war there was increased vagrancy which concerned the Government who were increasingly worried about the possibility of social disorder and revolt. Under The Poor Law of 160, each parish was made responsible for its own parishioners that were impoverished, frail or handicapped and in need of support. Each parish became obliged to relieve the old and the helpless, to provide work for those deemed capable but who were finding it difficult to find work in their usual trade. The parishes also became responsible for helping to support unprotected children, often by introducing them into apprenticeships at a young age. The funding for providing this was collected by a 'Parish Administrative Unit' which was responsible for collecting poor-rates from the other parishioners. This was a form of revised local tax which was means tested and calculated, collected and then allocated and distributed by unpaid Churchwardens or Parish Overseers (later known as Relieving Officers) who were elected by the parish vestry every year.
There were two types of relief provided for the needy, 'outdoor relief' (through money, supplies of materials such as flax/ wool to provide a skill from which they could make money and work, or as basic foods such as bread) or 'indoor relief' (which included various form of institutional care). Outdoor relief was normally offered to people who were temporarily out of work (e.g. due to seasonal demand of their trade falling), or to fund the cost of a physician to treat those who were sick. Indoor relief was provided in different forms, depending on the classification of the pauper. Three types of poor people were identified in order to assess whether or not and to what extent people were in 'genuine need', and to evaluate the most appropriate ways to provide relief to suit what the individual was seen to require. The first group were 'The Impotent Poor' who were disabled, chronically sick, blind or mentally ill. They were viewed as being poor through no fault of their own and were seen as deserving relief. This was often provided in the form of admission to 'houses of dwelling', almshouses or poorhouses instead of workhouses.
The second group were 'The Able-bodied Poor', who were the unemployed but that were deemed as able to work. They were placed in work-houses where they were given basic labouring jobs in return for food until they could return to their normal work or find an alternative job. The third group were 'Persistent Idlers'. These were the able-bodied who either refused to work, persistently quit jobs or regularly absconded. As a punishment for this 'idleness' they were placed in Houses of Correction which aimed to teach idle citizens how to become respectable through a strict regime of discipline that often involved flogging and beating.
Very few changes were made to the Poor Law Act 1601 until the late 1700's (The Gilbert Act 1782-relating to workhouse unions), but the provision of outdoor relief for the poor gradually declined and the workhouse system was favoured as an alternative as it saved the parish money, and also acted as an incentive for the able-bodied poor to find stable work (as they received no income in the workhouses and were given very low status) and to discourage continued reliance on parish relief.
Key Development 2: The Poor Law Amendment Act (1834)
By the early 1800's little changes to the original Poor Law of 1601 had been made, and there were many criticisms of way it worked and the way in which relief was offered. In 1832 there were 1.5 million paupers in England (10% of the population) and it was felt that the existing Poor Law was not doing enough to reduce the problems of poverty and pauperism. The cost of providing for the poor had increased substantially and people claimed that it but an unfair expense on the mostly middle-class rate payers who had to fund the welfare provision through local property taxes. The standards of relief in the workhouses varied greatly, in some the conditions were very poor, while in others the standard of living was often higher than that of the working rate-payers who funded them ('pauper palaces'). It was also claimed that where the standards of living in workhouses were high, the benefits of using relief encouraged idleness and discouraged personal independence.
The Poor Law Amendment Act was introduced in 1834 in response to these concerns and primarily aimed to deter the able-bodied from claiming poor relief but continue to provide relief for the ailing and the helpless. There were four main recommendations of the new act. Firstly the issue of 'Centralisation' whereby local overseers would remain involved in poor relief but would now be accountable to a Central Board of Control who would hold overall responsibility for the care of the poor and needy. The second was that of 'Uniformity'. Care provided would be of the same standard regardless of where in the country it was offered. This meant that the Elizabethan Settlement Acts (where paupers were returned to their place of birth to receive support) were no longer needed. This aimed to reduce the discrepancies in the levels of care provided in different areas, with affluent areas having better services than poorer districts. A 'Workhouse Test' was introduced under the Poor Law Amendment Act, which was a self assessment test. The only form of relief that was to be offered to the able-bodied poor was a position in a workhouse so a person either had to accept the hard regime of a workhouse or remain independent and live with the consequences. It was hoped that this harsh system would discourage those who did not genuinely need support from claiming it. The payment of outdoor relief was not abolished altogether (despite attempts to do so), although it was now available to far fewer, very rarely to any able-bodied poor and often only to the chronically sick to pay for medical care.
The conditions within workhouses were to change also under the 'Principle of Less Eligibility', introduced as a means of social control aiming to reduce the desirability of claiming state welfare (as it was seen as affecting the work ethics and people's independence). The conditions in a workhouse in terms of diet and living conditions would at all times be maintained at a lower level than those of the lowest independent worker, so that entering a workhouse was only preferable to starving to death. Often inmates had personal belongings confiscated, were not allowed chairs to sit on and could not receive gifts of any sort.
These amendments are characteristic the Victorian attitude towards pauperism, that it is a result of a combination of self inflicted circumstances. There were two main themes of the Poor Law Amendment Acts in dealing with the poor, one of providing a caring role (for those in genuine need) and one as a deterrent role (in making the prospect of claiming welfare less attractive to encourage people to find their own way out of poverty). IT has been since argued that the Poor Law Amendment Acts instead of actually being aimed at reducing poverty (as was claimed), was more about finding means to deter pauperism.
Task 2
* Analyse and evaluate the changes to both the welfare state and the National Health Service from their beginnings to the present. Ensure that you focus particularly on the changes under the Conservative Government, as these were major reforms. Link with previous and subsequent changes. (Essay)
The Welfare State in Britain emerged when the Labour Party came to power with a landslide victory in 1945. In a bid to introduce a more organised system of tackling poverty and providing welfare support than the existing methods that had been developed of the preceding 50 years (which were still based on the Poor Law Acts). The government actively acknowledged, and recognised the importance of reducing the inequalities that existed between different groups in society and in different areas of the country, such as in levels of unemployment, accessibility to public services and the numbers of workers covered by occupational Insurance (for times of unemployment, illness etc). The principles and development of the welfare state were largely shaped by the work of academic civil servant William Beveridge. Beveridge rebelled against the theories of Adam Smith which had underpinned the provision of welfare under the previous Conservative government. Smith argued that individuals should be in control of their own lives and make their own choices, and in this way natural order of different classes would result, with capitalists owning industries and companies that a labouring force would support. Accordingly, he believed that there should be minimal (if any) government intervention in solving societal problems of poverty and healthcare- a stance which many socialists believed exploited and oppressed lower classes. Beveridge agreed with this, and also proposed that if the government was to take a more active and involved role in combating societal problems, the results would benefit not only the health and wellbeing of the population, but also the countries economy as an improved welfare and health system would lead to a healthier and more productive workforce (based on Keynesian theories of economy). In 1940, Beveridge was commissioned to lead a team to investigate outstanding welfare provision, and to draw up a plan for an improved system of welfare provision in the UK. The Beveridge Report, published in 1942, identified 5 giants (Want, Ignorance, Idleness, Squalor and Disease) that need to be reduced and eliminated, and devised a comprehensive system of social security in order to do this. The main feature of this system was social insurance, where all working men and women are obliged to pay a contribution into a national fund which would in turn guarantee them government support in times of hardship such as unemployment and illness. In addition to this the plan also allowed for a non contributory assistance scheme (means tested), child allowances, family allowances and included strategies to improve the education system and council housing- all which would improve the overall welfare of the population. The impact of the welfare state became apparent between 1945 and 1948, when Beveridge's concepts (national insurance, educational reform, family allowance etc) began to be implemented and the issues of the 5 giants began to be addressed and slowly improved. This was through legislation, in particular the Education Act (1944), the Family Allowance Act (1945), the National Assistance Act (1948), the Children's Act (1948) and the Housing Act (1949). One of the 5 giants identified by Beveridge was Disease, and his report proposed that a comprehensive accessible health service, matching that of the welfare system. He thought that the health provision available was fragmented and disorganised, and there was often the littlest care available in the areas most in need. In 1943 the Minister for Health Ernst Brown introduced proposals for a unified health care system with a central government department responsible for the service which would be advised a council and administered by local government areas. In 1945 a new Labour Government was elected and in 1946 a Bill to introduce a National Health Service based on the concepts of Beveridge was passed by Parliament. On 5th July 1948, the National Health Service first came into effect, with the principles that services would be funded from general taxation and that they would be free at the point of use, comprehensive and available to all, regardless of ability to pay. The original structure of the NHS was 'Tripartite' with three arms. The first arm was hospital services. Hospital care was overseen by 14 Regional Hospital Boards which funded 377 local hospital management committees, but the teaching hospitals had their own board of governors and were responsible to the Ministry of Health. The second arm was community and public health services, including maternity/ child welfare, home nurses, ambulances and health prevention/ promotion which continued to be run by separate Local Health Authorities or Councils (which were also responsible for housing, roads and education). The third arm was the Family Practitioner Services. A national network of General Practitioners was established, who were responsible for personal primary health care (including dentistry, optical services and pharmacists), and were also responsible for referring patients to other services (e.g. to hospitals) when needed. They were provided with contracts from 138 executive councils which received money to fund the services directly from the Ministry of Health. The salary structure of GP's was changed and fees were now set and paid nationally. As can be seen, although the three strands were financed centrally (through the Ministry of Health- Government money), they were managed separately.
