5/27/2023 0 Comments War hospital perscriptions![]() ![]() ![]() Britannica Classics Check out these retro videos from Encyclopedia Britannica’s archives.It was, however, an ambition that was not shared by all – even some within his own Labour party opposed it. The idea, when Aneurin Bevan first introduced his new health system in 1948, had been to abolish most forms of payment. Plans to phase them out, championed in the 1970s by Labour MP Barbara Castle, were finally abandoned followed the Conservative election victory in 1979. So, while we tend to think of the NHS’s defining feature being its delivery of a free health service, private wards were one element of payment that continued within the NHS. Unlike the working-class medical clubs, these organisations survived the creation of the NHS in 1948 by covering the fees for services that fell beyond the scope of the NHS, and for private hospital wards, which were kept as ‘pay beds’ for those who wanted to go private in NHS hospitals. There were also some health insurance schemes available to middle-class individuals, helping them to meet what could be a substantial cost for treatment – whether in the private room of a hospital, a private nursing home or in their own home. (Photo by Kurt Hutton/Picture Post/Getty Images) The almoners payment system in early 20th-century hospitals ensured that provision for the sick poor was not being crowded out, says George Campbell Gosling. Nurses distribute tea at St Bartholomew's Hospital, London, in 1939. They would receive access to a doctor, medicines and sometimes hospital treatment without having to see the almoner, by means of paying in advance. The other scheme was membership of one of the various community-owned mutual aid funds and medical clubs, into which working people could pay while times were good. The insurance granted access to a doctor from the local panel when needed, but usually didn’t stretch as far as hospital treatment. This was a compulsory insurance scheme for workers in certain industries, though it generally did not cover family members. ![]() One was the health insurance element of National Insurance, introduced in 1911 by Liberal Chancellor of the Exchequer David Lloyd George and expanded throughout the 1920s and 1930s. As a result, two schemes provided an alternative for working-class patients. Doctors used the prestige of hospital work to build their credentials for lucrative private practice.įor most people, however, the doctor’s fee of around sixpence (let alone the cost of any medicines prescribed) would have been beyond reach. Private medicine was a marginal activity of the hospitals, but private surgeries were far more common. The payment system was now echoing and formalising the social hierarchies and class distinctions of healthcare beyond the walls of the hospital. This ensured that provision for the sick poor was not being crowded out while also preventing the two classes of patients from having to ‘rub shoulders’. These would often be on a different floor to the ordinary wards – or perhaps in a different building entirely, sometimes taking over a section of the nurses’ block. With its introduction came the separation of middle-class patients, often into a few private rooms within the hospital. The almoners’ payment system began in the more prestigious voluntary hospitals, but soon spread to public hospitals also. However, two-year courses were soon established that combined practical experience with social and economic studies at university. The first generation of these women came from the world of charity work, usually from the notoriously moralistic Charity Organisation Society. But it was assumed that the person making decisions and offering guidance over the financial aspects of treatment for working-class patients should be a respectable, educated, unmarried middle-class woman. These class assumptions usually went unspoken. ![]()
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