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Task 1.2 Analysing the historical land marks of Social and welfare

policies of past and present, explain how the quality of life for the service users have improved over time:

P1.1: Identify key historical landmarks in social welfare, focusing on the period up to 1945:

The Key historical landmarks in social welfare focusing 1945 period were: In 19th century it was the role of religion, the voluntary sector in welfare. And in early 20th century Liberalism and the foundations of British welfare, votes for women.Let us analyse the historical landmarks of Social welfare policies for a period of upto 1945.

1901 Seebohm Rowntree’s first study of poverty in York, Poverty: a study of town life

1903 Charles Booth’s study of poverty in London, Life and Labour of the People of London

(1906 – 1912) THE NEW LIBERALISM: To make people liberal in their living.It is said by Lloyd George that ‘We will draw a line below which we will not allow people to live and labour’

1906 School Meals Act

1908 Old Age Pensions Act: means-tested pensions from age 70

1909 The People’s Budget: super tax introduced, child tax allowances introduced

1911 National Insurance Act: sickness insurance and limited provisions for unemployment

(1913 -1941) CHANGE AND DEVELOPMENT: It mainly focuses on dealing with problems individually.Beveridge Report goes this way: ‘In all this change and development, each problem has been dealt with separately, with little or no reference to allied problems’.

1920 Unemployment Insurance Act: non-manual workers included.

1925 Widows’, Orphans’, and Old Age Contributory Pensions Act: first national scheme of contributory pensions

1936 J.M. Keynes’ General Theory of Employment, Interest and Money

1940 Old Age and Widows’ Pensions Act: pension age for women reduced from 65 to 60

(1942 – 1945) TOWARDS A ‘BEVERIDGE’ WELFARE STATE: Contributing for the welfare of the people.Beveridge Report goes this way:‘It is, first and foremost, a plan of insurance – of giving in return for contributions benefits up to subsistence level, as of right and without means test, so that individuals may build freely upon it’.

1942 Sir William Beveridge’s Report on Social Insurance and Allied Services

1943 Juliet Rhys Williams’ work-tested Citizen’s Income

‘The Beveridge Plan,will have the effect of undermining the will to work of the lower-paid workers to a probably serious and possibly dangerous degree. The prevention of want must be regarded as being the duty of the State to all its citizens, and not merely to a favoured few’

Family Allowances Act: £0.25 a week for each child after the first.

P1.2 Outline evolution of health and social care policies following World War II until 1979:

This is the time during the war when the government got committed to full employment through the Keynesian Policies, free universal secondary education, and the introduction of secondary allowance.

1946 National Insurance Act:Has flat-rate NI benefits.Provided a comprehensive system of unemployment, sickness, maternity and pension benefits funded the by employers and employees, together with the government .

1948 National Assistance Act: Poor Law got abolished

1955 Richard Titmuss’ Eleanor Rathbone Lecture on the Social Division of Welfare: ‘The tax saving that accrues to the individual through income tax allowances is, in effect, a transfer payment’

1959 National Insurance Act: graduated pensions got introduced

1962 Milton Friedman’s Capitalism and Freedom includes negative income tax proposals

1965 Poverty ‘rediscovered’: The Poor and the Poorest, Brian Abel-Smith and Peter Townsend

1966 Supplementary Benefit replaces National Assistance.Rate rebates got introduced.

1971 National insurance invalidity benefit got introduced.Family Income Supplement (FIS) introduced (and with it the poverty trap)

1972 Heath Government’s Proposals for a tax-credit scheme.Tax credits become Conservative policy. First national scheme of rent rebates (and higher rents)

1975 Social Security Pensions Act: State Earnings-Related Pensions (SERPS). Earnings-related national insurance contributions introduced at 5.75%

1976 One-parent benefit got introduced

1978 ‘Meade Report’ on The Structure and Reform of Direct Taxation includes a chapter on Social Dividend. SERPS gets implemented.

1977-79 Tax-free child benefit phased in, replacing taxable family allowance and child tax allowances.

P1.3 Outline health and social care policies from 1979 to the present day:

(1979 – 90) TOWARDS A RESIDUAL WELFARE STATE: It was said by Margaret Thatcher that ‘We offered a complete change in direction’.

1980 Social Security Acts 1 and 2: Instead of earnings pension upratings got linked to prices. Education Act: Local Education Authorities allowed to choose whether to provide school meals: fixed prices and national nutritional guidelines got abolished.

1982 National insurance contribution increased to 8.75%. Earnings-related supplements with national insurance unemployment and sickness benefit cease to operate.

1983 First official reference to Basic Income in the report of the Meacher sub-committee of the House of Commons Treasury Select Committee.National insurance contribution increased to 9%. National insurance sickness benefit replaced by statutory sick pay. Rent/rate rebates got replaced by housing benefit.

1984 Basic Income Research Group formed.Child dependency additions with national insurance unemployment benefit cease to operate.

1985 Norman Fowler’s Social Security Review. Billed as ‘the most fundamental since World War II’, but did not examine integrated systems.

1986 Social Security Act: Three major Bills in one (Got effective from April 1988)

1987 National insurance maternity grant replaced by statutory maternity pay. Payment of half and three-quarter rate national insurance unemployment benefit ceases.

1988 Tax cuts and benefit cuts.Top rate of income tax down from 60% to 40%. Standard rate of income tax down from 27% to 25%.The withdrawal of income support from most 16-17 year olds.Cuts in housing benefits, SERPS and national insurance widows’ pensions. Maximum rate rebate limited to 80% of liability.Child benefit frozen.Income-tested Family Income Supplement replaced by means-tested Family Credit. Free school meals restricted to families on Income Support.

1989 Child benefit frozen.Abolition of pensioner earnings rule.Social Security Act introduces actively seeking work test.

1990 Liberal Democrats’ Conference votes for Citizen’s Income.Independent taxation of husbands and wives introduced, but with married couples’ allowance for husbands

Child benefit still frozen.

(1991 – 1996) CUTS AND TINKERING: Peter Lilley said,‘The changes I have announced today will help shift the balance back to a benefit system that does not discriminate against married couples, and which aims to reduce benefit dependency by helping people into work’.

1991 Child Support Act introduced.Benefits Agency established. Child benefit unfrozen.

1992 Disability living allowance replaces mobility allowance and attendance allowance for the under-65s. Disability working allowance introduced.Additional minor reforms of disability benefits.

1993 Peter Lilley launches sector by sector review of social security.

1994 Budget introduces ‘welfare to work’ measures to ease transition into paid work and encourage full-time work.Introduction of child care allowance for certain parents claiming family credit and related benefits.

1995 Incapacity Benefit replaces Sickness Benefit and Invalidity Benefit.Phasing out of additional assistance for lone parents.Cuts in housing benefit for young people

Pensions Act reforms occupational pensions, reduces value of SERPS, extends scope of personal pensions, and equalises pension age for women born after 5th April 1955 (with phasing in from 60 to 65 for those born after 5th April 1950).

Cuts in housing benefit and in help with mortgage interest for income support claimants.

1996 Jobseeker’s allowance replaces unemployment benefit and income support for the unemployed.Contributory benefit is paid for 6 months instead of 12 and the level is reduced for 18-24 year olds.The Asylum and Immigration Act 1996, introduces restrictions on benefits, housing and employment for asylum applicants.

(1997 – 2008) NEW LABOUR: Tony Blair said ‘In future, welfare will be a hand-up not a hand-out’

1997 Tony Blair becomes Prime Minister. First Labour government for 18 years.

1999 Family Credit replaced by Working Families Tax Credit (WFTC) and Disabled Persons Tax Credit (DPTC).Winter fuel payments of £100 per year for those aged 60 or over introduced. Payments are not means-tested.

2000 Benefit entitlement for new asylum seekers ends.

2001 Children’s Tax Credit introduced – a tax allowance for those with children.

Bereavement benefits reformed so that widowers as well as widows entitled to benefits when their spouses die.

2002 State Second Pension replaces SERPS. Carers and those with children under 6 become entitled to credits in accruing pension rights.

2003 Child Tax Credit (CTC) and Working Tax Credit (WTC) replace WFTC, DPTC and Children’s Tax Credit. Payment depends on a claimant’s annual income and is assessed annually unless there are certain changes of circumstances during the tax year.WTC includes payments for childcare but only up to 70% (later 80%) of the childcare costs and a maximum limit.9 out of 10 families with children qualify.Pension Credit introduced, replacing income support for people aged 60 or over.Guarantees a minimum income for pensioners and often paid to top up state retirement pension.Work-focused interviews for benefit claimants introduced. Claimants for certain benefits are required to participate in an interview with a personal adviser in order to meet entitlement conditions.

2005 Civil partnerships introduced for same-sex couples. Cohabiting same-sex couples treated in the same way as heterosexual couples for benefit purposes rather than as two individuals.

2006 The Government’s White Paper Security in Retirement proposes an increasing retirement age, personal savings accounts, and a basic state pension uprated in line with earnings from 2012.Winter fuel payments increased to £200 (£300 for a person aged 80 or over).

2007 The House of Commons Work and Pensions Committee’s report on Benefits Simplification recommends a Single Working Age Benefits and publishes a costed Citizen’s Income Scheme in its evidence.

2008 Welfare Reform Act 2007 comes into force. As well as making minor changes to benefit legislation, it introduces a Local Housing Allowance to simplify Housing Benefit for privately rented tenants. The Employment and Support Allowance (ESA) replaces Incapacity Benefit and Income Support paid for new claimants on the basis of incapacity for work. Claimants face tougher tests before being granted ESA which also makes the benefit system even more complicated.

M1.1: Analyse and express your views.

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.

During 1945,the government was committed to full employment through the Keynesian Policies, and introduced free universal secondary education, and the introduction of secondary allowance.Family allowances, a national health service and full employment were the main considerations during that time.Many policies provided a comprehensive system of unemployment, sickness, maternity and pension benefits funded the by employers and employees, together with the government.

Another important aspect that needs to be considered for the social and health welfare in the UK is the social citizenship model.The issues regarding the social citizenship model was not a challenge in the anticipation of the emergence of the Conservative Party leader in 1975 and the Prime Minister in 1979. After 1975 the government actually promised low taxes, less state intervention, as well as lower levels of public spending. In the theory it involved, vital cuts in the welfare spending.

But at present,policies reduce benefit dependency by helping people into work. New Labour and social inclusion, important legislation and health and social care initiatives begin to take over the society with which we live in.

D1.1: Critically compare and explain the facts:

Upto 1945

Till 1975

At Present

It deals with role of religion, the voluntary sector in welfare. Also dealt with free universal secondary education. Sickness was a primary cause of pauperism, and the Poor Law authorities began to develop 'infirmaries' for sick people.

It deals with policies regarding welfare state. Beveridge report is based on three assumptions:family allowances,health service,full employment.Other than this it was during this period the Insurance,Pensions,Tax credits,Family Income supplement etc was introduced as benefits to the common man.

It deals with New Labour and social inclusion, important legislation and health and social care initiatives,New Rights and Thatcherism.Also the changes done by Peter Lilley announced that today will help shift the balance back to a benefit system which aims to reduce benefit dependency by helping people into work

Task 2.1: Explain and analyse the process of key acts coming through

the parliament to become the policy of the government. Explain in terms of Health and Social policy. Analyse the influential factors which shapes the key themes and concepts in a parliamentary act. Evaluate the impact on service users once an act becomes the policy/law.

P2.1: Identify and analyse the processes involved in development of a key Act of Parliament:

An Act of Parliament creates a new law or changes an existing law.Also Acts are Acts of Parliament which have been given Royal Assent. All Acts of Parliament start life as a Bill which must pass through Parliament. These must be distinguished from Private Members’ Bills which are Public Bills proposed by backbench MPs. Public Bills originate from a number of different sources.It may arise from government, civil service, government agencies, political parties, committees, enquiries, legislative process, green/white papers, debate.The Government decides whether or not to agree to these proposals and put them before Parliament. Once a department has decided that it wishes to ask Parliament to pass legislation on a certain topic, it will undergo a consultation process with interested parties. The extent of this process will differ depending on the complexity, importance and urgency of the matter. It may take many months or a few days. The first stage is often a consultation document called a Green Paper which sets out in general terms what the Government is seeking to do and asks for views. Once these are received and taken account of (or not) the Government will produce a White Paper, which sets out the proposals decided upon and the reasons for the legislation. These two stages may be contracted into one.These stages are not fixed by formal rules and are subject to change. For example, it is increasingly common for draft Bills to be drawn up and circulated for consultation before being formally laid before Parliament, an example being the Mental Health Bill 2002. Occasionally Bills are scrutinised by the Parliament.In terms of Health & Social department ,health policy is a set course of action (or inaction) undertaken by governments or health care organizations to obtain a desired health outcome.The overall health care system, including the public and private sectors, and the political forces that affect that system are shaped by the health care, policy-making process. Public health-related policies come from local, state, or federal legislation, regulations, and/or court rulings which govern the provision of health care services. Nurses are very familiar with institutional policies including those developed and implemented by the Joint Commission on Accreditation of Healthcare Organizations. Policy making takes place in a wide variety of settings ranging from fairly open and public systems. The location of decision making in the public or the private sector, the scope of the issue, and the nature of the policy all have an impact on the characteristics of a policy. Since a basic understanding of the policy process is the first step in strategizing how to activate potential power and influence meaningful changes in the health care system, We will discuss the three phases of policy making. Basically there are three phases of policy making: the formulation phase, the implementation phase, and the evaluation phase. During the formulation phase there is input of information, ideas, and research from key people, organizations, and interest groups. At this point the issue is framed; the purpose and desired outcomes are clearly identified & strategies most appropriate to the desired outcome are selected; and needed resources are identified and planned. The implementation phase involves disseminating information about the adopted policy and putting the policy into action. In this phase, the proposed policy is transformed into a plan of action. The policy process also includes an evaluation and modification phase when existing policies are revisited and may be amended or rewritten to adjust to changing circumstances.

P2.2: Analyse the factors that influenced the key themes and concepts in the Act:

Health depends on a number of factors, including biological factors, environmental factors, nutrition, and the standard of living.The main factors currently affecting people's health in the United Kingdom include smoking, bad diets, alcohol, and lack of exercise. While the British government has worked to reduce the influence of these factors, only the people themselves can put an end to them by changing their attitudes toward health.Apart from these many other factors act as influential factors which shapes

the key themes and concepts in a parliamentary act.

Evaluation and evidence are not the only factors that influence policy making and service

delivery.The experience, expertise and judgement of policy makers, and those people who have responsibility for planning and delivering policies and public services, are important factors in the policy making process. So too are the finite resources that are available for policies, programmes and projects.The values and value system within which contemporary politics take place are also contributory factors to the policy making process.This includes beliefs, ideologies, and party manifesto commitments. Policy making also involves habitual and traditional ways of doing things that may sometimes defy rational explanation yet nonetheless exist and often define what can and cannot be done in making and implementing policy. The influence of lobbyists and pressure groups on policy making also paves an important way to reach the target. The policy making process can be strongly affected by unforeseen circumstances and contingencies, the response to which can sometimes be opportunistic rather than well thought through, soundly evaluated, and evidence based.

P2.3: Evaluate the impact of the Act on service users:

Generally, as the function of health and social care, it can be concluded as a body which provide services that relates to ‘care services’ but the two bodies are separated in term of governing, policies, act, and so on. The UK government are concerned with the separation of social and health care. Because of the separation, it cause a major problem such as service fragmentation, higher cost of treatment and problem in continuing care after discharge from the hospital.Reflecting to this problem, the UK government has put a priority in integrating these two entities.The Govt organization can ensure better benefits to service users by having benefits to:

Strategies for health promotion

Health and safety

Manual handling

Data protection

Food handling

Care practice

Mental health

Children Disability

Task 2.2: M2.1: Critically analyse and explain how political leaders leading the country through economic hardships and recession in the aftermath of World War 2 and leading to the World War 2, made key improvements through parliament acts for their people.

Also political leaders leading the country through economic hardships and recession in the aftermath of World War 2 and leading to the World War 2, made key improvements through parliament acts for their people.Political leaders introducing few other acts to make key improvements in parliamentary acts.They were:

Health Act 2009: It proposed measures to improve the quality of NHS care, the performance of NHS services, and to improve public health. 

Health and Social Care Act 2008: It contains significant measures to modernise and integrate health and social care.

The Local Government and Public Involvement in Health Act 2007: It is an Act to make provision, with respect to local government and the functions and procedures of local authorities and certain other authorities; with respect to persons with functions of inspection and audit in relation to local government; to establish the Valuation Tribunal for England; in connection with local involvement networks; to abolish Patients' Forums and the Commission for Patient and Public Involvement in Health; with respect to local consultation in connection with health services.

Health Act 2006: It is an Act to make provision for the prohibition of smoking in certain premises, places and vehicles and for amending the minimum age of persons to whom tobacco may be sold; to make provision in relation to the prevention and control of health care infections; to make provision in relation to the management and use of controlled drugs; to make provision in relation to the supervision of certain dealings with medicinal products and the running of pharmacy premises, and about orders under the Medicines Act 1968 and orders amending that Act under the Health Act 1999; to make further provision about the National Health Service in England and Wales and about the recovery of National Health Service costs.

Task 2.3 D2.1

Critically explain and analyse how person centred care could

be improved for the service users with the on-going policy changes from the government. Why is it important for the political sector of the country need to evaluate and understand the final impact towards the service users before processing those social acts through parliament?

Most major public policies are subject to modifications in a incremental fashion. Making smaller changes in existing policies are usually less controversial than making major changes as they require less understanding of comprehensive relationships and less effort to achieve. An example of incrementalism in health policy can be seen in the many changes that the Medicare Program has undergone since its enactment in 1965. A change to the program of importance to advanced practice registered nurses came in 1998, when the U.S. Congress added nurse practitioners and clinical nurse specialists as providers who can bill for Part B services they provide to Medicare beneficiaries. Since then, Congress has tweaked Medicare program many times and added a number of preventive services to the Medicare program. Most recently Medicare Part D, an optional prescription drug program available for Medicare beneficiaries, has been added.

If we think about why is it important for the political sector of the country need to evaluate and understand the final impact towards the service users before processing those social acts through parliament,the Govt is actually responsible for.That needs to be understood first. As any health care issue moves through the phases of the policy process, from a proposal to an actual program that can be enacted, implemented, and evaluated, the policy process is impacted by the preferences and influences of elected officials, other individuals, organizations, and special interest groups. These different factions do not necessarily view the issue through the same lens and often have diverse and competing interests. Added into the mix are the partisan agendas of the two political parties, the Democrats and the Republicans.The political party holding the majority usually has the political advantage.Decision makers rely mainly on the political process as a way to find a course of action that is acceptable to the various individuals with conflicting proposals, demands, and values.As a general rule, any policy involving major change, significant costs, or controversy will be relatively more time consuming and difficult to achieve and will require the use of more political skills and influence than will policies involving less complex changes. Throughout our daily lives, politics determines who gets what, when, and how. Political interactions take place when people get involved in the process of making decisions, making compromises, and taking actions that determine who gets what in the health care system. Special interest groups and individuals with a stake in the fate of a health care policy use all kinds of influencing, communication, negotiation, conflict management, critical thinking, and problem solving skills in the political arena to obtain their desired outcome.

Task 3.1. Explain the current policy initiatives in Health and Social Care and evaluate the impact on service users. Analyse the differences in formation and adaption of social policy initiatives from other national perspectives.

P3.1: Identify current policy initiatives in all health and social care.

The Department of Health & social care works to define policy and guidance for delivering a social care system that provides care equally for all, whilst enabling people to retain their independence, control and dignity.Government strategies and policies aimed at providing a broad range of health care services and facilities.Other current initiatives include complementary health settings, or public health arenas,with children, older people or those with disabilities.Apart from these initiatives there are also few that act as policy initiatives in all health & Social care facilities.They are disability,gender, ethnic issues, community care,poverty and social security, crime and criminal justice, health and health services. For promoting health the initiatives that need to be taken are labelling regulations to inform consumers of nutritional content of foods,Educational campaigns to promote healthy diets and special programmes targeted to children,Promotion of consumption of fruits and vegetables for the general population,Fruit and Vegetable distribution programmes for school children.Also there is a chance where there will be multi-agency partnerships that creates many job opportunities in line with government initiatives to address health improvement, health inequalities and social exclusion, the health of children, young people and families, care and wellbeing of older people, those suffering from mental health problems and community development.This inturn gave rise to increased employment opportunities in these Health & Social care.Child social care, like many public services is under pressure to make financial savings, greater use of resources and effective working practices are essential if the sector is to continue delivering high quality care.Other Initiatives may be

Employee related initiatives: Increasing skills & employability of unemployed people,working Family tax credit,National Minimum wage

Area Focused initiatives: Health focused zones

Initiatives to tackle social exclusion:National Strategy for Neighbourhood renewal (Hunter, 2003,58)

P3.2: Evaluate the impact of these policy initiatives on service users

The United Kingdom Government uses a wide range of evaluation methods to ensure that policies, programmes and public services are planned and delivered as effectively and efficiently as possible to the service users.A major driving force for high quality policy evaluation in U.K. is the Government’s commitment to evidence-based policy making. This requires policy makers, and those who implement policies, to utilise the best available evidence from national statistics, academic research, economic theory, pilots, evaluations of past policies,commissioned research and systematic consultation with delivery agents.The Government’s strategy for public spending and taxation also provides the context within which policy evaluation takes place in the U.K. The UK Government has undertaken, and is currently undertaking, a number of randomised

controlled trials of policy initiatives. In the field of labour market and welfare policy, the

Restart evaluation (1990) randomly allocated unemployed people to a compulsory major

interview at 6 months unemployment to see if this had the effect of successfully reintroducing them to the labour market. This is one of the largest and best-known randomised controlled trials in U.K and it established a clear and positive impact on exits from unemployment with lasting effects still.

P3.3: Analyse the differences in formation and adaption of social policy

initiatives from other national perspectives

The social & healthcare policy initiatives emerged as a distint area in the UK in the early 20th century.To make a civilized society by provision of welfare benefits to the citizens ,irrespective of their ability to pay for them and aim for universal health service,pensions & state education.

In USA health care is been controlled by private & occupational insurance schemes with the state playing no part.It is the same with Japan.

In Western Europe there are health care systems that are run by both private & state run insurance schemes.

In wales it maintains the patient centered focus and answerable to all citizens of the state.Also it involves the communities in the development of the policies for healthcare.

So many health problems are prevented before they start of.

In Scotland the plan is an contract between the government & the individual citizen.

The English policy is straightforward.It ensures commitment to improve the health service rather than the policy itself.It is a contract between govt,service & the customer.

In Welsh document it is based on the notions of community enhancement & community capacity building.But it is absent in English & Scotland documents(Adams, Robinson, 2002:63-65).

Task 3.2 (M3.1):

Critically analyse the contemporary policy developments in

Health and Social Care. How would you expect these policies could

improve quality of life of your service users under your care at a facility?

The policies can improve the life of the service users by participating in the interest groups,such as patient organizations.And it paves the way for influencing healthcare as a representative in parliamentary system.Participating in public hearing processes,participating as members in publicly appointed boards & councils.

Task 3.3 (D3.1):

Critically explain and analyse why does the Health and Social

policy of a country needs changing over time, depending on many other

factors such as economic stats of the land, improvement of knowledge

about different diseases and conditions, regional and global political

influence?

The policies are not fixed by formal rules they are always subject to change.Beveridge report states ‘In all this change and development, each problem has been dealt with separately, with little or no reference to allied problems’ Also according to Margaret Thatcher ‘We offered a complete change in direction’.Changes are done inorder to benefit the service users as well as a benefit to legislation leading to progress in their achievements.As we know that the changes of the industrial revolution led to the development of the towns, rapid population growth, and the first experience of modern unemployment and the trade cycle. Moreover making enhancements in existing policies are usually less controversial than making major changes as they require less understanding of comprehensive relationships and less effort to achieve.Although any policy involving major change, significant costs, or controversy will be relatively more time consuming and difficult to achieve and will require the use of more political skills and influence than will policies involving less complex changes.In case of unemployment statistics it changes frequently over time.Also for improvement in knowledge the might be full fledged students ready to get employed the govt needs to make appropriate actions for this kind of situation.

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