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

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

?) the care of the sick and the destitute

?) the decay of the feudal system and

?) the dissolution of the monasteries

?) this practice fell into disuse with

?) by the end of the sixteenth

?) some substitute for the old system

?) century it had become imperative to find

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

?) in 1601, therefore, the Poor Relief Act

?) gave local government authorities in England and

?) some steps to control water

?) local authorities also began to take

?) supplies and to try to check epidemics

?) in the eighteenth and

?) nineteenth centuries British

?) medical services developed

?) medical science

?) qualified doctors greatly increased

?) advanced and the number of

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

?) and subscriptions and were made increasingly

?) hospitals were built with private endowments

?) in Britain, if you are ill you

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

?) or you can pay for private treatment

?) from the middle of the nineteenth

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

?) 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

?) conditions, however, preceded adequate

?) public provision for the care of the sick

?) public measures to promote healthier living

?) rapid growth of towns in the

?) first half of the nineteenth century caused an

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

?) laid down minimum standards for its services

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

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

?) upon which all subsequent health legislation has been based

?) the system was further developed and

?) consolidated by the Public Health Act 1875,

?) 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

?) were entitled to the services of

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

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

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

?) capitation fee for the patients who

?) the doctors who took part were paid a

?) this scheme came to cover most

?) or on a certain number of voluntary sick

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

?) at the same time the voluntary hospitals

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

?) 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

?) some local authorities began

?) services, mainly for schools, mothers and children

?) were unevenly distributed and

?) these various health services, however,

?) were seen to be inadequate

?) troposals for a full health and medical

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

?) service were the subject of many reports in

?) to deal with the war wounded, the

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

?) Emergency Hospital Service, including both

?) industrial canteens were expanded

?) the welfare food service for mothers was introduced

?) and school meals services and

?) 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

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

?) the committee's report, known

?) 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

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

?) announced its acceptance of the proposal in

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

?) in 1943 the wartime all-party Government

?) national health service was

?) the first plan for a comprehensive

?) published by the Government in 1944

?) the final plan was embodied in

?) the National Health Service Act 1946,

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

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

?) this provided a complete general practitioner and

?) hospital service for the community,

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

?) many other countries had

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

?) universal coverage for

?) free medical care was entirely new

?) the principle of

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

?) the British National Health Service (NHS)

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

?) although it is administered by local health authorities

?) nowadays central government is

?) directly responsible for the NHS

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

?) of the health service is paid for by general

?) about 83 per cent of the cost

?) there are charges for prescriptions and

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

?) 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

?) as the population of Britain gets older,

?) the hospital service now treats more patients than

?) were built in the nineteenth century - provide

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

?) NHS hospitals - many of which

?) in Europe although Britain actually

?) the NHS is the biggest employer

?) 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