This essay will evaluate recent developments within Health and Social care policy. It will focus on the development of charges within the NHS, the ideology behind it and its impact on women, different ethnicities and those living in poverty. It will then go on to analyse the differences in formation and adaption of this policy from devolved governments in Wales and Scotland. Before the start of the ‘welfare state’ in 1948, the majority of Health and Social care services were subsidised by benevolent donations to voluntary hospitals, or through service users paying for their own care (Thornes, 2000:97). This is due to the ideology of the time being that of the government not being responsible for the nation and that people were to stand on their own two feet and support themselves. However, following the massive devastation to the country, both physically and mentally, following WWII, the government’s ideology changed. The labour government in power at the time felt that the nation’s welfare was their responsibility and so the ‘welfare state’ was born. Everyone was entitled to free NHS health care and there was no criteria or eligibility attached. In 1952 the first charges had been introduced in an effort to fund the rapid growth of costs incurred by the NHS, people now had to pay for prescriptions, dentures and spectacles. This move was due to the government’s ideology slowly changing to one of paying for yourself if you can afford to do so, and eligibility and criteria was attached to certain services. If you did not meet the requirements you had to pay. During the 1980s, under the Conservative governance of Margaret Thatcher, the ideology had gone full circle and was back to that of non-dependence of the ‘Welfare State’ and the responsibility of the nation lay with the individual, not the government. It was a time of taking away universalism with a residual attitude. As a result of this shift in attitude present charges were increased and new charges were introduced as a means to reduce public spending (Thornes, 2000:97). Eligibility, criteria and targeting meant that only those most vulnerable were able to access Health and Social care services for free. In 2013 the present ideology is similar to that of 1952. The Conservative, Liberal Democrat coalition government maintain the ideology of taking away universalism and standing on your own two feet. They feel that in having charges for NHS services the stigma attached to
welfare will be reduced and individuals will feel that they deserve the service they are accessing (Thorne, 2000:97). The government also feel that it will prevent the abuse of free services by discouraging people from using Health and social care services which they are not in need of. This is evident with the proposal for those that visit A&E to be charged £10 as a means to prevent unnecessary use of the service. A&E specialist believe that 30% - 40% of visits are unnecessary and that in having a £10 charge upon arrival, which is fully refunded should the condition warrant A&E attention, will significantly reduce the amount of people taking up vital resources (Campbel, 2014). This charge is set to reduce unnecessary visits and waiting times to those who are in actual need of emergency care, however experts feel that they will ‘penalise poorer patients’. Dr Helen Stokes-Lampard, a spokeswoman for the Royal College of GPs has said that "Charging patients for the use of emergency departments would put us on the slippery slope towards the Americanisation of healthcare, where only those who can afford to get it get the care and attention they need," (Campbel, 2014). Dr Mark Porter, chairman of the BMA, said: "The majority of GPs and hospital doctors are committed to an NHS that delivers care on the basis of need and not the ability to pay. In this survey, two thirds of...
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