Development of the Welfare State

The welfare state started in 1944 after the liberal called William Beveridge published a report in 1942, Beveridge was chairman of a committee that Churchill commissioned to investigate the welfare system and recommend improvements. The Beveridge report was a government report that was influential in founding the welfare state. Beveridge proposed widespread reforms to the system of the social welfare to address what he described as the five “Giant Evils” in society, squalor, want, ignorance, disease and idleness by which he ment housing, poverty, education, health and employment. Beveridge argued these could be solved by a state run insurance system , and in contrast to previous schemes a minimum level of life would be established that was not extreme or punishing the sick for not be able to work .the solution was the welfare state with social security, free education for all children , a national health care system , full employment and council built and run housing .Beveridge wanted to ensure that there was an acceptable minimum standard of living for citizens in Britain which nobody fell below. The welfare state was created to be safety net to give relief during hard times and suffering.

 Every worker would contribute weekly or monthly to the national insurance scheme, this would help build a fund that payed out benefits to those who were sick or unemployed. The scheme would also pay pensions at the end of a person’s working life. The introduction of the national insurance under the National Insurance Act 1911 was one of the first steps in the creation of the welfare state. It was created for people who worked, the worker, employer and state would contribute into to this scheme in return workers were entitled to a level of free medical care and money in the event of unemployment. However, the worker’s family weren’t entitled to free medical care. The Beveridge report suggested a system of social insurance covering every person regardless of income. it offered nothing less than a cradle to grave welfare state.

The NHS started in 1948, Aneurin Bevan officially started the NHS on 5^th July across the UK. It was available to all regardless of wealth. Aneurin Bevan ambition was to build a health care service that was free to all, there to everyone who needed it and would be funded by general taxation. Some doctors were against the start of the NHS and didn’t want to work for the government, this because they’re earnings were by the patient they didn’t want to go work for the government and earn very little. The was a deal made and doctors would be paid per patient. Under the new National Health Service prescription drugs, dental treatment and glasses were also free to all but in 1952 charges from prescriptions glasses and dental treatment were introduced, the charges were one shilling for prescriptions and one pound for dental treatment. These charges were abolished in 1965 and remained free until June 1968 when the charges were brought back. In Scotland charges for prescriptions were abolished in 2011, Scotland followed in the footsteps of Wales and Northern Ireland leaving England the only place in the UK to charge for prescriptions. Issues with todays NHS is an aging population , disease that would have killed people years ago have been cured so people are living longer and this also means they may be living with other illnesses , heart disease and diabetes , these will need to be treated so this may put a strain on GP’s and A&E peoples lifestyle choices put a strain on the NHS too much drinking , smoking and poor diets these can be the reason people are becoming unwell . by 2020 there could be a 30 billion funding gap because of rising costs.

Priority frameworks

Mental health is a key area in health inequalities and is related to physical health and other factors such as education, community factors like racism and crime. 1 in 6 adults will suffer some form of mental illness this may range from more a common condition depression to schizophrenia which may affect 1in 100. Mental health issues are not well understood and often there is a stigma and individuals may be disadvantaged or discriminated against. Poor mental health is an important public health issue and mental health inequalities still exists in Scotland. Individuals who are disadvantaged or live in poverty have an increased risk of developing a mental health issue. 

Examples of health inequalities are                        

Adults living in deprived areas are twice as likely to have a common mental health issue than someone in a less deprived area (22% versus 11%).

Scottish suicide rates are 4x higher in deprived areas than in less deprived areas, rates of suicide increase as the level of deprivation increases with the poorest area 30% higher than the rate of Scotland generally.

The good mental health for all framework aims at tackling stigma and discrimination as these can contribute to mental health issues, and making sure individuals have access to resources and support. Action is required from national and local government and other agencies i.e. NHS, employers and other third parties. The Scottish government suicide action plan 2018 sets out 10 key actions with the aim to reduce suicide in Scotland by 20% by 2020. Some of these actions are mental health and suicide prevention training, raising awareness and developing a Scottish crisis care agreement to support those affected by suicide. The plan also highlights a need for all agencies to work together to reduce the number of suicides in Scotland.

 In my work place I work alongside other agencies, CPN’s, social work and private care providers. A preventive health measure in my work place is to support individuals who have mental health disorders take medications to stop them from becoming unwell, I would support them to do a daily shop or attend appointments. helping them to access resources whether it be benefits or employment. With the right support and opportunities in the right employment it can be good for the wellbeing and improve their quality of life. Individuals that I work with are more likely to be living in poverty due to unemployment, some employers are less likely to employ an individual with a mental health disorder due to poor work record because of fluctuating levels of impairment and lack of resources. It’s my role to support an individual to access these resources to either get into paid employment or voluntary work.

Health and social care delivery plans aim is to have a better quality of care in Scotland, that will allow them to focus on early intervention, prevention and supported self-management the plan is that people needing to go into hospital can stay longer for those who need it, if day surgery is used more often. This will allow hospitals to use resources more effectively. And people can be discharged safely and quickly. This plan is set out to enhance health and social care and so that people in Scotland live longer and healthier lives at home or in care settings. This will help improve our social care system by;

•         is integrated;

•         focuses on prevention, anticipation and supported self-management;

•         will make day-case treatment the norm, where hospital treatment is required and cannot be provided in a community setting;

•         focuses on care being provided to the highest standards of quality and safety, whatever the setting, with the person at the centre of all decisions; and

•         ensures people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

This care plan will make sure support and treatment fits individual needs and that the individual is at the centre. East Ayrshire council uses the health and social care delivery plan.  Health and social care providers are working together to provide a high standard of care and putting the individual receiving care at the centre of there care package. The integrated scheme aims to support individuals who have a disability or long-term illness in their own home and are safe from harm. I support in dividuals in their own homes who have a learning disability and mental health disorders. In my work place a preventative health measure would be supporting individuals with learning disabilities in their own home. Supporting them to live independently and make their own choices. The Health and Social Care Standards sets out a standard of care that a person can expect 2.2 I am empowered and enabled to be as independent and as in control of my life as I want and can be.  And the SSSC Codes of Practice 3.1 states that I will promote the independence of people who use services and empower them to understand and exercise their rights. They have community alarms in their tenancy’s , these are in place to safeguard  them from possible harm and abuse .If an individual presses their button it goes through to community alarms who then would contact the staff base to alerts us that an individual may be needing support or is at risk .

 Legislation

Adults with Incapacity (Scotland) Act 2000 provides a framework to safeguard and and manage the finances of an individual who lacks capacity due to mental health issues or who cannot communicate. This act was one of the earliest pieces of legislation to be passed by the Scottish parliament. This legislation allows other people to make decisions on their behalf, the decision that are made must benefit the individual who lack capacity. The Health and Social Care Standards states a person be included 2.11 my views will always be sought and my choices respected , including when I have reduced capacity to fully make my own choices.

The Mental Health (Care and Treatment) (Scotland)Act 2003 makes sure that individuals with mental health disorders receive the right treatment and care. The act allows medical professionals to detain and treat individuals against there will on grounds of a mental disorder. The act is set on 10 guiding principles, including principles of non-discrimination where a person with a mental health disorder should have the same rights and entitlement as someone with other health needs. Participation is another principal, the person should be completely involved as much as they are able, in all aspects of assessment, treatment and care. their past and present wishes should be taken in to account and all information in a way they understand should be given so they are able to fully participate.

• British History, Parliamentary Legislation [online]Available; https://spartacus-educational.com/Lhealth48.htm [accessed 24/01/2019]
• East Ayrshire Council , Health And Social Care Integration available; https://www.east-ayrshire.gov.uk/Resources/PDF/E/East-Ayrshire-Integration-Scheme.pdf [accessed 24/01/2019]
• Health and Social Care Delivery Plan (2016) available; https://www2.gov.scot/Resource/0051/00511950.pdf[accessed 24/01/2019]
• NHS Health Scotland, Suicide available;www.healthscotland.scot/health-topics/suicide[accessed 24/01/2019]
• Scottish Government (2017) Health and Social Care Standards: My Support, my Life [pdf] Available: https://www.gov.scot/binaries/content/documents/govscot/publications/publication/2017/06/health-social-care-standards-support-life/documents/00520693-pdf/00520693-pdf/govscot%3Adocument?forceDownload=true [Accessed: 12/10/2018]
• Scottish Social Services Council (2016) Codes of Practice for Social Service Workers and Employers [pdf] Available: http://www.sssc.uk.com/about-the-sssc/multimedia-library/publications?task=document.viewdoc&id=239 [Accessed: 12/10/2018]
• The foundation of the welfare state(2010)available; https://www.slideshare.net/wal147/the-foundation-of-the-welfare-state[Accessed 24/01/2019]
• Wilde, R (2017) The Creation of Britain’s Welfare State [online] available, https://www.thoughtco.com/creation-of-britains-welfare-state-1221967
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