Health and Welfare

The early twentieth century

Until the early years of the twentieth century patients usually had to pay for their health care. Free treatment was sometimes available from Voluntary Hospitals and a few local councils ran free hospitals for local people.
In 1911, the government introduced a system of National Insurance. Workers, employers and the government all paid money into the scheme. In return, the workers could get free medical care, although they usually had to pay extra for medicines. This system worked quite well for employees, but most women and children were not covered.
Between the two World Wars, there was a widespread view that these arrangements were not good enough. However, the Second World War delayed attempts to deal with the problem.

The National Health Service


In light of the sacrificial war effort made by the whole British population, and amidst much debate, a National Health Service (NHS) was set up in 1948. It was part of a broader policy of creating a welfare state. The three main ideas behind the NHS were:
  • It was paid for by taxation
  • People received free treatment
  • Anyone could receive care, even people visiting the UK or living there temporarily.
The NHS provided three kinds of care:
  • Hospitals
  • General practitioners (local doctors)
  • Community services, such as health visitors, midwives and ambulances.


The NHS was more costly to run than had been expected, so charges had to be introduced for medicines prescribed to patients. Costs also grew as new treatments became available, such as:
  • A polio vaccine
  • Dialysis for kidney failure
  • Chemotherapy for cancer.
During the 1970s, it became clear that the NHS could not afford to provide unlimited access to all the latest treatments, particularly because the average age of the population was constantly rising. From the early 1980s onwards, successive governments reformed the NHS, trying to make sure that it provided the best value for money.

Medical improvements

The twentieth century saw more medical progress than any other in human history. Major developments included:
  • The discovery of different blood groups - this made blood transfusions much more effective
  • Improvements in the design of artificial limbs
  • The development of techniques to monitor what was happening under the skin, such as X rays, electrocardiographs and magnetic resonance imaging
  • Improvements in surgical techniques, such as organ transplants
  • The development of antibiotic drugs, such as penicillin, to combat infection
  • The development of vaccines against a range of serious diseases, including measles, tetanus, mumps and influenza.

The end of the twentieth century

By the end of the twentieth century, health standards in the United Kingdom and throughout the developed world had improved enormously. Infant mortality rates dropped sharply and people, on the whole, were living longer, healthier lives than ever before. No longer was death and bereavement a daily factor in people’s experience and many of the killer diseases of the past had become treatable. The most common causes of death became cancer and heart disease.
Scan and go

Scan on your mobile for direct link.