The Pathos of Politics (121-1) United Kingdom

United Kingdom

England was first to industrialize, and its people suffered accordingly. The health and welfare of workers deteriorated during the 19th century, owing to lack of decent urban housing and unsanitary conditions. This provoked a movement toward sanitary reform that ended up establishing public health institutions.

The explosive growth of cities was at root of the health problem. London’s population doubled 1801–1841; Leeds nearly tripled. With such growth came a jump in death rates. In cities across England, death rates nearly doubled as industrialization took hold.

“Friendly societies” emerged in the early 19th century. These were private associations of people in the same livelihoods who pooled funds for insurance for its members, including health care.

Though ostensibly designed to provide health care to the indigent, the Poor Law of 1834 was based on the principle that getting public assistance would be so unpleasant as to put off all but the most desperate.

English Poor Laws were recurrent attempts to provide relief to the indigent dating back to 1536. The Poor Law system declined from the early 20th century with the introduction of welfare reforms and improved private mechanisms, such as friendly societies.

After much campaigning by the Health of Towns Association, and yet another severe outbreak of cholera in London, the British government passed the Public Health Act of 1848. It established a central health board which had little power and no money. Local boards continued to do what little they could to improve public health infrastructure.

The idea of a unified state medical service began with the Poor Law of 1909. The National Health Service (NHS) was established in 1948, with separate services for England, Wales, and Scotland. Fearing loss of income and institutional constraints, doctors were initially opposed.

Though private health continues as an add-on, NHS provides the majority of British health care. Most patients pay nothing for treatment, which hugely saves administrative costs. Some must nominally pay for prescriptions. NHS is financed through taxation.

In the 21st century, the ruling Conservative Party allowed Britain’s public health system to sorely deteriorate. Long well-regarded by the public, the NHS showed severe stress from lack of funding in the mid-2010s. A shortage of doctors and medical staff had those on the job near revolt for their punishing hours and pay. Services of all kinds were slow, including emergency care. 3.9 million patients were on waiting lists for operations in 2016, yet the government refused to provide the needed funding.

The UK has fewer beds per head compared to virtually all other EU nations, fewer doctors and nurses, reduced access to investigations such as MRI scans, and is spending less on medications. ~ English physician Chaand Nagpaul, head of the British Medical Association, in 2018