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?) the care of the sick and the destitute

?) the earliest social welfare services in Britain were provided by various religious orders, augmented in medieval times

?) by the manor houses and merchant and craft guilds, which assumed as part of their duties and responsibilities

?) this practice fell into disuse with

?) the dissolution of the monasteries

?) the decay of the feudal system and

?) some substitute for the old system

?) century it had become imperative to find

?) by the end of the sixteenth

?) in 1601, therefore, the Poor Relief Act

?) Wales the duty to provide from local taxation for the sick, the needy, and the homeless

?) gave local government authorities in England and

?) local authorities also began to take

?) supplies and to try to check epidemics

?) some steps to control water

?) nineteenth centuries British

?) medical services developed

?) in the eighteenth and

?) qualified doctors greatly increased

?) medical science

?) advanced and the number of

?) and subscriptions and were made increasingly

?) hospitals were built with private endowments

?) available on a charitable basis to the general population, while free 'infirmaries' were provided under the Poor Law for the destitute, aged and infirm

?) in Britain, if you are ill you

?) can receive free treatment on the National Health Service (NHS)

?) or you can pay for private treatment

?) century working people of modest means began increasingly to insure against periods of illness by subscribing to provident

?) from the middle of the nineteenth

?) and friendly societies and sick clubs

?) medical practitioners would at

?) many public-spirited

?) that time remit all or most of their fees to the poor

?) public measures to promote healthier living

?) public provision for the care of the sick

?) conditions, however, preceded adequate

?) first half of the nineteenth century caused an

?) intensification of sanitary problems with consequent cholera, typhoid and other epidemics

?) rapid growth of towns in the

?) the passage of the Public Health Act 1848 which, for the first time, established a comprehensive public health system under unified control and

?) a programme of sanitary reform, associated particularly with Edwin Chadwick (1800-90), Secretary to the Poor Law Commission, led to

?) laid down minimum standards for its services

?) consolidated by the Public Health Act 1875,

?) the system was further developed and

?) upon which all subsequent health legislation has been based

?) for personal health services began to improve

?) in the twentieth century the provision

?) rapidly as the result of the progress of medical knowledge and the wider availability of treatment

?) a general practitioner in return for regular contributions made by themselves and their employers to certain insurance organisations, known as approved societies

?) the National Health Insurance Act 1911 introduced a scheme whereby all people earning wages less than £160 a year (later raised to £420)

?) were entitled to the services of

?) the doctors who took part were paid a

?) had asked to be on their list and been accepted

?) capitation fee for the patients who

?) this scheme came to cover most

?) of the poorer half of the population while the rest were dependent for their medical care either on paying fees as private patients,

?) or on a certain number of voluntary sick

?) the aid of voluntary donations and contributions and the fees of other patients

?) at the same time the voluntary hospitals

?) expanded their free services for the poor with

?) began to develop into local

?) authority general hospitals

?) after 1929 the Poor Law Infirmaries

?) to provide improved social and health

?) services, mainly for schools, mothers and children

?) some local authorities began

?) were unevenly distributed and

?) these various health services, however,

?) were seen to be inadequate

?) the inter-war years; it was, however, the Second World War which precipitated reform in this, as in many other matters

?) troposals for a full health and medical

?) service were the subject of many reports in

?) Emergency Hospital Service, including both

?) to deal with the war wounded, the

?) voluntary and municipal hospitals, was developed within existing organisations as required

?) industrial canteens were expanded

?) and school meals services and

?) the welfare food service for mothers was introduced

?) and to make recommendations on the way that social services should be reconstructed after the end of the war

?) set up under Sir William (later Lord) Beveridge to conduct a survey of the existing national schemes of social insurance and allied services

?) in 1941 an inter-departmental committee was

?) as the Beveridge Report, was published in 1942;

?) it recommended far-reaching changes involving a considerable extension of both the health and social security services and formed the basis of much post-war social legislation

?) the committee's report, known

?) in 1943 the wartime all-party Government

?) announced its acceptance of the proposal in

?) the Beveridge Report that a comprehensive health service for all purposes and all people should be established

?) national health service was

?) the first plan for a comprehensive

?) published by the Government in 1944

?) and the National Health Service started on 5 July 1948

?) the final plan was embodied in

?) the National Health Service Act 1946,

?) hospital service for the community,

?) this provided a complete general practitioner and

?) and expanded the preventive social and environmental services provided by local authorities

?) had paid contributions and their dependants, and to pensioners

?) developed compulsory health insurance schemes, but under them rights to health care were generally confined to those who

?) many other countries had

?) free medical care was entirely new

?) universal coverage for

?) the principle of

?) equal basic health care, free of charge, for everybody in the country

?) the British National Health Service (NHS)

?) was set up in 1948 and was designed to provide

?) nowadays central government is

?) directly responsible for the NHS

?) although it is administered by local health authorities

?) of the health service is paid for by general

?) taxation and the rest is met from the National Insurance contributions paid by those in work

?) about 83 per cent of the cost

?) children, pregnant women, pensioners, and those on Income Support, are exempt from payment

?) there are charges for prescriptions and

?) dental care but many people, such as

?) with a local doctor (a GP, or General Practitioner)

?) most people are registered

?) who is increasingly likely to be part of a health centre which serves the community

?) ever before, although patients spend less time in hospital

?) the hospital service now treats more patients than

?) as the population of Britain gets older,

?) were built in the nineteenth century - provide

?) NHS hospitals - many of which

?) nearly half a million beds and have over 480,000 medical staff

?) the NHS is the biggest employer

?) in Europe although Britain actually

?) spends less per person on health care than most of her European neighbours

?) an increased emphasis on managerial efficiency and the privatisation of some services (for example, cleaning)

?) restructuring of the Health Service with

?) during the 1980s there was considerable

?) in the 1990s a number of NHS

?) reforms were introduced by the Conservative and Labour governments including self-management of hospitals and

?) a 'market' for patients who were referred to hospitals for treatment