Health and Social Care
Section 1
Task 1 Historical and Contemporary Landmarks of Social Welfare Provision
Introduction
A social welfare provision is considered pertains on any program o the government that also seeks to provide a minimum level o income, service or other support for the disadvantaged people like the poor, elderly, disabled students, unpaid workers like mothers and other caregivers and minority groups (NationMaster 2008).
States or nations that offer a broad social welfare programs are frequently recognized as having a welfare state (NationMaster 2008). The phrase ‘welfare state’ was first used by Alfred Zimmern during the late 1930s in order to distinguish the difference between the policies of the democracies and war state of the dictators of Europe (Farlex 2009). Political system under the said state, government, rather than the individual or the private sector has the liability for the welfare of its citizen, at the same time providing a guaranteed minimum standard of life, together with the insurance against the hazards of poverty, illness as well as social deprivation. Welfare services comprises of social security, which makes different provisions against disruption of earnings due to sickness, injury, old age or even unemployment. They take the forms of unemployment and sickness benefits, family allowances as well as income supplements that is being provided and financed through the insurance schemes of the government (Farlex 2009).
Elements of a welfare system began to be constructed in the parts of Western Europe during late 19th century. German takes the lead during 1883, with its compulsory national accident and sickness insurance law that was introduced by Chancellor Otto von Bismark and was financed by a state subsidy. In 1898, the New Zealand introduced pensions while Austria-Hungary in late 19th century, Norway in 1909, Sweden in 1910 and Italy, UK and Russia in 1911 introduced their national health insurance. In1935, the US followed by introducing the Social Security Act of 1935due to different political and social pressures, together with the extensions of voting rights. In early 1940s with the UK taking the lead, a comprehensive welfare state, which covers all its elements and available to all was established (Farlex 2009).
Evolution of Health and Social Care Policies in the UK
1945 – 1979
During the war, the government was committed to full employment through the Keynesian Policies, free universal secondary education, and the introduction of secondary allowance. In 1942, the Beveridge Report proposed a system of National insurance that was based on the three assumptions: family allowances, a national health service and full employment and it became as a major propaganda weapon, with both the major parties committed to its introduction (Robert Gordon University n.d.). The British social policy was dominated by the Poor Laws that was first passed during 1598 and continued till 1948 or lasted in one form or another for about 350 years. The said abolition was due to the fact that the Poor Laws were much hated, thus much of the social services during the 20th century, which include the national insurance were framed in order to avoid having to rely on them (Robert Gordon University n.d.).
In 1945, the Labour Government was elected and introduced three vital acts which are:
- the 1946 National Insurance Act that implemented the Beveridge scheme for the social security;
- the National Health Service Act 1946; and
- the 1948 National Assistance Act, which abolished the Poor Law, while making the provision for the welfare service (Robert Gordon University n.d.).
All of the said Acts were timed to come into force on June 7, 1948. In addition, the Children Departments was founded in 1948, under the 1948 Children Act, which states that the local government receives the children in care in any case of abuse or neglect will be the duty or responsibility of the local authority (Robert Gordon University n.d.).
The Family Allowances Act 1945 ensured that the dependent children under 15 years of age, those aged 15 – 18 and still in education and older non-working children over 15 were provided by Family Allowance and Child Tax Allowance. In addition, the National Health Service Act 1948 provided people in Britain with free diagnosis and treatment of illness, at home or in hospital. Furthermore the National Assistance Act created a financial safety net for those who are in total poverty, because they are not covered by the National Insurance Scheme (Care and the Law 2008).
The National Insurance Act in 1946 provide a comprehensive system of unemployment, sickness, maternity and pension benefits funded the by employers and employees, together with the government (Citizenship n.d.). The legislation instituted a comprehensive state health service, effective from July 5, 1948. People in work, except married women, paid 4s 11d per week in National Insurance contributions. For the average employee, it will amount to about 5% of their income. The said provision was considered as the best and cheapest insurance policy ever offered to the British people, of any people anywhere (Spartacus n.d.).
Another important aspect to be considered regarding the social and health welfare in the UK is the social citizenship model. The issues regarding the social citizenship model was not that really challenge in the anticipation of the emergence of the Margaret Thatcher as the Conservative Party leader in 1975 and the Prime Minister in 1979. Thatcher promised low taxes, less state intervention, as well as lower levels of public spending. This involved, in the theory at least, vital cuts in the welfare spending. The succession of Thatcher governments between 1979 and 1990 became synonymous with the idea regarding the rolling back the state (Citizenship n.d.).
1979 To the Present Day
Between 1980s and 1990s, UK sought to improve the incentive for working in its social welfare system, with some modest success. The government focuses on development and reforms in social programs like changes in the benefit schedules. The main focus on the UK reforms focuses on increasing the benefits accruing to those in work relative to those not in works. The Family Tax Credit 1988 was considered as the relative legislation in the said year, but it was replaced by Working Families Tax Credit in 1999. Aside from that, UK policies towards unemployed young people were also designed to move people from dependence on state to work. The New Deal for Young People introduced in 1998, and results to both push and pull elements, in order to get young unemployed people into work. The government focuses on toughening the work search criterion along lines that have been developed duringmid-1980s. Aside from that the government is also offering job subsidy for employers for young people who are unable to find their regular jobs (CentrePiece 2004).
In addition, in terms of pension, UK pension focuses on encouraging different workers and firms to contract out part of pensions throughout the fully-funded occupational schemes that had helped to reduce the pay-as-you-go costs of the publicly provided pensions. The said law required all individual to belong to some pension plan. Aside from that, favorable tax advantages also help to induce a large proportion of the population in order to purchase personal pension during 1980 and 1990s (CentrePiece 2004).
During late 1990s, the government focuses on the development regarding the stakeholders pensions specialized for the low wage workers. This had helped to improve the job mobility (CentrePiece 2004).
During 2000s and up to present, the government of the UK focuses on the issues regarding poverty and social exclusion. Different social programs and policies focus on the low income, children, young adults, working-age adults and older people. In terms of children poverty, the government focuses on improving the life of the working adult, in order for them to focus on giving their children good lives. The government focuses on reforms to the tax credits and benefits, in order to help families out of poverty (Palmer & MacInnes 2006).
In terms of youth, the period since 1997, has witnessed a renewed emphasis and focused on the development and improvement of a coherent framework for youth policy in the UK that focuses on the goal of promoting inclusion and participation of the youth (Fahmy 2008). The said action is very important because of the fact that the government focuses on making jobs available for the youth, and employment can protect young people from poverty (Lacovou & Aassve 2007).
Although, adult poverty is getting much less media attention compare child poverty, the government is working overtime, in order to focus on the cases of poverty among adults. One of the most important developments for the UK in terms of handling poverty among adults is the introduction of Pensioner Minimum Income Guarantee in 1999 and its extended and revamped version, Pension Credit during 2003 (Palmer & MacInnes 2006).
Above all, the government of the UK also focuses on the cases of older people in the country. This has been done by focusing on the different medical and health aspect that could help them to cope with the daily living. Thus, the government focuses on the social inclusion of the older people, in order for them to experience good quality of life.
Task 2 – Health and Social Care Act 2001
It is important to consider that the number of older people in the UK is growing, aside from that; people are living longer than they ever did (). As a result, older people make up an ever increasing proportion of UK’s population. In 2003, there were already 20.0 million people, aged 20 and above in the UK, it shows a 45% increase over the five decades, from 13.8 million during 1951. Thus, the said number is expected to rise by 36% by 2031, or a total of 27.2 million people aged 50 and above (National Statistics 2005).
In July 2000, the Government published the NHS Plan: A Plan for Investment, A Plan for Reform (CM 4818-1), together with the NHS Plan: The Government’s Response to the Royal Commission on Long Term Care (Cm 4818-II). In September 2000, the Government published the Pharmacy in the Future – Implementing the NHS Plan. From then on, action has been taken in order to implement many of the proposals set out, thus, in October of the same year, the Scottish Executive published the Response to the Royal Commission on Long Term Care and provision is made in the Health and Social Care Act 2001 (Crown 2001).
During the Act’s parliamentary stages, the bill was subject to a number of amendments. In its original form, the bill proposed the abolition of Community Health Councils or CHCs in order to be replaced by Patients Councils. But, the said element o the bill was withdrawn during its progression through the House of Lords, and under the Act, the role of CHCs will continue, alongside the new scrutiny functions for Local Authorities (Blackburn with Darwen Borough Council 2001). In addition, the Care Trust model has been formally introduced under the Health and Care Act 2001 (Glasby & Littlechild 2004). It is a type of NHS body that was introduced in 2002 in order to provide a better integrated health and social care (Department of Health 2002).
On the other hand, the said Act is also connected to other aspect of parliament, including the aspect of Human Rights. The Committee examines areas where human rights concern arises, including the treatment of older persons in the health care (Joint Committees on Human Rights 2007, p. 9). It focuses on the application of human rights principles in ensuring proper treatment for older people in different hospitals and care homes. The reason behind the said parliament is because of the different reports the Committee received pertaining on poor treatment, neglect, abuse, discrimination as well as ill-consideration discharge towards older people. Thus, it offers a legislative changes and a role for the new Commission for Equality and Human Rights (Joint Committees on Human Rights 2007, p. 9).
The said parliament act focuses on the different poor treatment of older people in healthcare which focuses on the following concerns:
- malnutrition and dehydration;
- abuse and rough treatment;
- lack of privacy in mixed sex wards;
- lack of dignity especially for personal care needs;
- insufficient attention paid to confidentiality;
- neglect, carelessness and poor hygiene;
- inappropriate medication and use of physical restraint;
- inadequate assessment of a person’s needs;
- too hasty discharge from hospital;
- bullying, patronizing, and infantilizing attitudes towards older people; and
- discriminatory treatment of patients and care home residents on grounds of age disability and race (Joint Committees on Human Rights 2007, p. 9).
Age Concern and Health and Social Care Act 2001
Age Concern’s mission is to promote the well-being of all older people, at the same time, help to make later life a fulfilling and enjoyable experience. Thus the organization focuses on the following principles:
- prevent poverty and maximize income in retirement;
- promote age equality and enable older people to make full contributions to the economy, society and neighborhoods;
- maximize healthy life expectancy and promote health, independence and wellbeing for all older people;
- achieve greater social inclusion of the most disadvantaged older people and challenge the causes of exclusion;
- achieve a step change in effectiveness and efficiency, where in a crucial element will be a greater focus on older people as customer and contributors to all that the organization do (Age Concern 2009).
One of the most important themes and concepts about the Age Concern that influence the Act is the fact that the organization focuses on the different aspects regarding health and care aspects which include, health ageing, health and health care, social care and care and careers, mental capacity and end of life care. Thus it helps to encourage different policy makers to become more aware of the importance of maintaining the health of older population. This is reflected on the target of the government to focus on poverty, thus promote a greater independence and well-being in later life (Age Concern 2009). In addition to that, the organization focuses on the aspect of the Act, which sets out a new role for local government in the scrutiny of local health services (Blackburn with Darwen Borought Council 2001). As a support, Age Concern focuses on the different promotion strategies of National, regional and local health which addresses the needs of people of all ages, at the same time acknowledging the different initiatives that can be effective for different age groups. Furthermore, the organization also focus on the initiatives of the local authorities in taking some actions in order to remove different environmental barriers to physical activities for people of all ages, like ensuring pavements that pavements are safe and there are enough and sufficient street light (Age Concern 2009).
Above all, the most important theme of the Act concerning the Age Concern is the responsibilities and accountabilities of the health worker in taking care of older persons, which primarily focus on the human rights of the older people. This can be seen on the policy aspect of the organization which focuses on the National Institute for Clinical Excellence or NICE guidance, towards the public health professionals. Thus, the organization believe that each and every health and social care service should deliver provision for older people living in institutions, which include care homes and prisons, on a par with services for those living in the community (Age Concern 2009).
Section 2
Task 2 – Social Initiative Formation: Ireland
The direction of social policy in Ireland is considered as a vital in the process of development that will help to prevent, alleviate and eliminate homelessness and poverty in the Irish society. Thus, it shows that this is different from the focus of the UK government, which focuses on the different aspects regarding health and other financial support. The Irish government recognizes the importance of analysis during the level of social policy formulation and implementation and why they are committed to the professionally developing, engaging at the same time, responding to the different policies and issues that are important to their responsibilities. Thus, they focus on homelessness, impact of homelessness, youth homelessness, child poverty and homelessness, health housing and homelessness and the different housing policies in the country (Focus Ireland n.d.).
On the other hand, in terms of older people, Ireland, just like the UK government, focuses on the social inclusion. It enables the people, who are marginalized in order to obtain and minimize the standards of living, access to the different services at the same time, the social life that are regarded as the norm for the majority of people in the country. Thus, different government policies and programs are making huge effort and contribution towards the social well-being (Social Inclusion n.d.). Based on the current performance of the country, it can be said that the government is doing its best in order to maintain inclusion of older people. In terms of housing, most of older people in the country have their own homes, while few have an outstanding mortgage (Social Inclusion n.d.). The said situation is somewhat the same in terms of medical and health services towards the older people, where in different amenities are available in order to cater the needs and demands of the older people in the country. On the other hand, social isolation is considered as a risk for older people, and it has a potential consequences. There are different aspects that are included in this factor, primarily the issue regarding the availability of technology and communication. It will be important to focus on the usage and access to the Information and Communication Technologies or known as the e-Inclusion (Social Inclusion n.d.).
In connection to the Health and Social Care Act 2001, Ireland has its own reformed Health and Social Care Act in 2009. The reason behind the said reform is to put in place the different structures which are considered as patient-led, patient-centred and responsive to the different needs and demands of the patients, clients and carers, at the same time, becoming more effective and efficient (OPSI 2009). Thus, just like the first Act, it will help to provide a legislative framework where in the proposed new health and social care structures can operate and seeks to set out, as transparently as possible, the high level functions of the different health and social care bodies.
Above all, both of the Acts can seek either within the body of the Act or by securing the enough authority to make subordinate legislation, in order to build the different parameters within which each health and social care body will be permitted to work and institute the essential governance and accountability arrangement that can support the efficient delivery of health and social care in both countries (OPSI 2009).
References
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