People in today’s society are living longer, one of the reasons for this is due to better living conditions, also people have higher expectations of what they expect from the government to assist them to have a better life. The NHS is funded from taxpayer’s money, so surely these taxpayers should be given the service that they want? But is this always possible? People want their taxes to be lowed, they vote for the politicians that say that they will lower taxes, but then they moan when they have to wait 6 months to have an ingrown toenail removed, or when they have to wait half a day at their local accident and emergency department.
So what do people expect? They expect a good NHS service they would like to have the ethos of ‘free at the point of contact’, which was granted in 1948 by Bevan during the liberal reforms. The phrase ‘cradle to the grave’ comes from the Beveridge report in 1942. Beveridge stated that we needed to change the ideology based on individualism and replace it to collectivism, this meaning that people needed help to get them selves out of the never ending poverty cycle, and times were changing so we needed help from the government to fund the particular areas which Beveridge had identified as being problem.
One the areas that he identified as needing funding was Health care, this was the start of the NHS that we all know today. After it was set up working class people could access health care that prior to the start of the NHS they could not afford, however it is true to say that the NHS is no longer ‘free at the point of contact’. So why is this? One of the reasons could be advances in medicine, when the NHS was first set up there was no hip replacements which cost around 48 thousand pounds, there was no organ transplants which save life’s and leave the NHS to pay the occurred costs.
Babies born at 23 weeks would have died previously but with advances of better understanding of how to help them thieve, which comes from research and discovery of new treatment and equipment, not only costs but also makes the birth rate increase, this means that they will be more likely to live longer so this will impact on the spending from the NHS to provide them with health care for the rest of their lives. Neither Beveridge nor Bevan could predict the scientific advantages of today’s modern medicine that have enhanced the life’s off so many people helping people to have increasing longevity.
The original ideology that the NHS would be free to all from the first point of contact was soon to change, three years after its creation they were forced to introduce some fees, the first being charges for prescriptions of one shilling, (5p), this was legislated for as early as 1949 but did not get implemented until 1952. The conservative government also implemented charges within the NHS, prior to this year eye tests were free for all, after this people receiving benefits and children were they only ones entitled to free eye tests. So is less money being spent on the NHS?
In 1975 the NHS was placed under “severe financial restraint”, and the government told local councils to introduce rigorous means testing to drive the people away from using the services, this saw massive cutes being made in 1976. Thatcher comprised a new policy that penalised the poor, the people for whom the NHS was their only option. She increased prescription charges by sevenfold, in 1979 and 1983. However much worse came when she introduced the internal market meaning that hospitals had to fight for scare resources. The privatisation and cuts resulted in the number of public service workers falling by two million.
Thatcher and her party wanted to reverted backwards to individualism not collectivism, she wanted to irradiate the benefit culture and felt by introducing privatisation this would encourage people to make provision for themselves for their own health. The only way that you can measure the costs of spending since 1948 to the present day is by looking at GDP expenditure. The percentage of GDP expenditure in 1948 was 3. 5% there was a dramatic increase around 1951 to 3. 8%, however there was then a decrease between 1952 and 1955 to 3. 0%.
After 1955 we saw a steady increase to 4. 8% in 1976, there was then a small but dramatic fall in the percentage of GDP expenditure within NHS spending to 4. 1% in 1979, but it then steadily increased once again to 5. 0% in 1982 to 1984. The biggest increase to 5. 8% was in 1992 after that the spending of GDP within the NHS has remained above 5. 0% and in 2003 it reached just above 7%. Since 2003 there has been an increase of a 2% rise. So looking at these figures the amount of money being spent on the NHS is rising, but what if we compare the UK to the rest of the world?
The total amount of private and public spending on health as percentage of GDP in the UK is 7% compared with 7. 5% in Japan, 7. 9% in Italy, 9. 1% in Canada, 9. 5% in France, 11% in Germany and a massive 14% in the United States of America. So it is clear to see that the UK is lagging massively behind the rest of the world with money being spent on the health care. Why can’t we have more money being spent on our health care? Why are we lagging behind? Since 1997 there has been an increase of almost 2 billion pounds in five years by the increased cost of the NHS administration and Estates staff why is this money not being spent on our NHS?
I believe that the NHS should be run by doctors and nurses and not be changed time and time again by politicians. However more money is being spent on the NHS and it clear to see that Britain’s are living longer and this is because of medical advances as I previously mentioned, prior to the NHS many babies died before their first birthday, diseases that are easily cured have been eradicated, by the materialization of inoculations such as TB, tetanus, diphtheria, whooping cough, measles, mumps and rubella. However the emergence of new diseases are costing our NHS, such as Aids and Alzheimer’s.
Alzheimer’s has become more common because people are living longer, before hand this illness would not have shown, as most people would have died at a younger age before the onset off this illness. Health workers now promote health to help eradicate problems such as heart failure, by making us all aware that obesity is on the rise and by recognising that it needs to be treated in an early stage this will result in less money having to spent in the future on obese patients. This is done by educating people that, five portions of fruit and vegetables are important to maintain a healthy lifestyle.
For many years milk vouchers have been available for children under the age of five, to ensure that they get at least one pint of milk a day for health benefits such as healthy bones and teeth, but now this has been increased to include fresh fruit and vegetables, parents on income support now get i??2. 80 per week per child aged under 4, this is too help them provide their children with five portions a day and a pint of milk a day to maintain a healthy diet which will enhance their health prospects, hopefully resulting in less health problems in later life which cost the NHS money.
This is an example of prevention rather than cure. Prevention methods will save the NHS money in the long having term. So what impact is longevity having on us as a nation? Pensions are being affected because of longevity; the government no longer has the finances to provide pensions for all. Also the problems of families not having so many children due to the fact that more often than not they all thrive, this leads to the drop of adults within time that are contributing national insurance payments, which pays for the state pensions.
Today there are almost four working adults to each pensioner, however in 2005, without increasing the state pension age this would decrease to two working age people for each pensioner. Gone are the times when you retired at 60 years old for women and 65 years old for men, people under a certain age now can look forward to working for many more years, due to the fact that longevity has been increased thanks to the NHS. It is not common to reach the age of 90 where before hand you were lucky if you reached the age of 70.
The government also is going to increase the state pension age of retirement to 68 years of age between 2024 and 2046. In 2006 a white paper was published by the government, about security in retirement working towards a new pensions system. The white paper sets out a number of proposals, for the changing of state pensions for people who reach state pension age on or after the 6th of April 2010. It is proposing that people have to set up personal accounts – a new way to save.
The government estimate that around seven million people are currently under saving for retirement. It is recognised that parts of the pension market is working well, but it is failing for people on low income or average incomes, once again these are the people that are at a disadvantage. I found two reasons that the government say about why people do not save for pensions, the first being that there is a choice paralysis, people have difficulty choosing which pension would be best for them they are afraid that they will make the wrong choice.
The second being that people are living for today, it is easier to make decisions about what will happen today, instead of what will happen in 40 years. They say that many people do not wish to think about getting older, let alone how to save sufficient money for their retirement. I fit into the category of low income and feel that both of these statements play relevance on me not having a private pension to date, but I also feel that my main reason for not having a private pension is the lack of money that I feel I have to contribute towards it.
With the new scheme, individuals will be entered into a personal account automatically if they earn about i??5000, employees will pay contributions of around four percent on their earnings, between i??5000 and i??33500 a year. The employee contribution will be matched with 3 percent from the employer together with around 1% in form with the normal tax relief from the state. The band of earnings on which contributions will be paid will be up rated in line with earnings to ensure the scheme is sustainable.
Employees aged 22 and below state pension age will be eligible for automatic enrolment, and employees outside these age bands will be able to opt into the scheme, and also have access to an employer contribution if they fall within the earnings bands. The government hope that this will solve the crisis that the welfare pension state is in, and will stop the teenagers of today become poor pensioners.
Only time will tell if this will work, I really hope it does, as it is very worrying to think off the children of today not being able to meet the basic costs of living when they retire. To conclude it is very clear to see that people are living longer and something has to be done about meeting the cost of illnesses and the aging population that this brings. Bevan could never predict the changes that have been made within the NHS, and I hope that he would be pleased with the result, even with its problems.
The rising cost of living is always going to be a problem, but they government is looking into ways of making sure that in the long term people are prepared, by saving and by health promotion to help them to maintain a healthy lifestyle to hopefully decrease their chances of occurring illness that can be avoided. I feel that there will be more privatisation within the NHS and maybe this will be good, as long as the people whom the NHS was set up to help do not lose their rights to a good fair service. These people being disadvantaged people and the poor, also that no one would suffer as a result of any privatisation.