Pearson Edexcel · A-Level · History
Course version: 9HI0 · Version from Sept 2015
Public health: health provision, 1918–45; the creation and impact of the…
Full specification wording
Creating a welfare state, 1918–79: Public health: health provision, 1918–45; the creation and impact of the National Health Service (NHS), 1945–79, and the challenge of medical advances.
Between 1918 and 1945, health provision in Britain was fragmented: voluntary hospitals, municipal hospitals, friendly societies, and the Poor Law offered uneven care, while the 1911 National…
Checked against the Pearson Edexcel 9HI0 specification (opens in a new tab) on .
- Point 2 of 3
- 3 key terms
Study notes
From the checked teaching notes for this specification point.
The idea
Between 1918 and 1945, health provision in Britain was fragmented: voluntary hospitals, municipal hospitals, friendly societies, and the Poor Law offered uneven care, while the 1911 National Insurance Act covered only some workers. The Second World War exposed these gaps, leading to the 1942 Beveridge Report and the 1944 White Paper. In 1948, the NHS was created, providing free care at the point of use, funded by taxation. Its impact included improved access, but also rising costs and debates over prescription charges. From 1945 to 1979, medical advances such as antibiotics, vaccines, and new surgical techniques extended life expectancy but posed ethical and financial challenges, including resource allocation and the need for evaluation.
What earns the marks
- Explains the pre-1945 mixed economy of health care: voluntary hospitals, municipal hospitals, friendly societies, and the Poor Law, with uneven access and funding.
- Analyses the impact of the Second World War on health policy, including the Beveridge Report (1942) and the 1944 White Paper, leading to the NHS.
- Evaluates the creation of the NHS in 1948: free at the point of use, funded by taxation, and the role of Aneurin Bevan in overcoming opposition.
- Assesses the impact of the NHS 1945–79: improved access, reduced financial barriers, but rising costs, prescription charges (1952), and regional inequalities.
- Explains the challenge of medical advances: antibiotics, vaccines (e.g., polio), new surgical techniques (e.g., hip replacements), and their ethical and financial implications.
- Uses specific evidence, such as the 1911 National Insurance Act, the 1946 National Health Service Act, and the 1952 prescription charges, to support arguments.
Common mistakes and how to put them right
Claiming the NHS was created in 1945.
Put it right: The NHS was established by the 1946 Act and began operating in 1948.
Stating that the NHS immediately eliminated all health inequalities.
Put it right: Regional and social inequalities persisted, and charges for prescriptions and dental care were introduced.
Ignoring pre-1945 provision and treating the NHS as a sudden creation.
Put it right: The NHS built on wartime emergency services and earlier reforms, and its creation was a gradual process.
Assuming medical advances only had positive effects.
Put it right: Advances also raised costs and ethical dilemmas, such as who should receive expensive treatments.
Exam tips
- Plan essays to address each part of the statement: health provision 1918–45, creation and impact of the NHS 1945–79, and medical advances.
- Use precise dates and terms, such as 1942 Beveridge Report, 1946 National Health Service Act, 1948 launch, and 1952 prescription charges.
- When assessing impact, consider different groups: patients, doctors, taxpayers, and the government, and evaluate short-term versus long-term effects.
- Incorporate historians' views, such as those on the NHS as a consensus achievement or its financial sustainability, to strengthen analysis.
Try the lesson
The start of the Creating a welfare state, 1918–79: Public health: health provision, 1918–45; the creation and impact of the National Health Service (NHS), 1945–79, and the challenge of medical advances. lesson, made from checked teaching notes for this specification point.
Have a go first
In which year was the National Health Service established in Britain?
Listen
Between 1918 and 1945, health provision in Britain was fragmented: voluntary hospitals, municipal hospitals, friendly societies, and the Poor Law offered uneven care, while the 1911 National Insurance Act covered only some workers. The Second World War exposed these gaps, leading to the 1942 Beveridge Report and the 1944 White Paper. In 1948, the NHS was created, providing free care at the point of use, funded by taxation. Its impact included improved access, but also rising costs and debates over prescription charges. From 1945 to 1979, medical advances such as antibiotics, vaccines, and new surgical techniques extended life expectancy but posed ethical and financial challenges, including resource allocation and the need for evaluation. A strong answer earns marks for these points. Explains the pre-1945 mixed economy of health care: voluntary hospitals, municipal hospitals, friendly societies, and the Poor Law, with uneven access and funding. Analyses the impact of the Second World War on health policy, including the Beveridge Report (1942) and the 1944 White Paper, leading to the NHS. Evaluates the creation of the NHS in 1948: free at the point of use, funded by taxation, and the role of Aneurin Bevan in overcoming opposition. Assesses the impact of the NHS 1945–79: improved access, reduced financial barriers, but rising costs, prescription charges (1952), and regional inequalities. A common slip: claiming the NHS was created in 1945. Instead, the NHS was established by the 1946 Act and began operating in 1948. Exam tip: Plan essays to address each part of the statement: health provision 1918–45, creation and impact of the NHS 1945–79, and medical advances.
Put the events in order
Put these events in the order they happened, earliest first.
- 1. Beveridge Report published
- 2. National Insurance Act covered only some workers
- 3. Prescription charges introduced
- 4. National Health Service Act established the NHS
- 5. NHS began operating, providing free care at point of use
Key words
Say what each word means before you turn the card.
Continuity and change in health provision
Try answering aloud or in your head before turning the card.
The role of war in promoting social reform
Try answering aloud or in your head before turning the card.
The impact of the NHS on access and inequality
Try answering aloud or in your head before turning the card.
See every definition
- Continuity and change in health provision
- Health provision between 1918 and 1945 was fragmented and uneven, then the NHS was created in 1948 providing free care at the point of use, funded by taxation.
- The role of war in promoting social reform
- The Second World War exposed gaps in health provision, leading to the 1942 Beveridge Report and the 1944 White Paper.
- The impact of the NHS on access and inequality
- The NHS improved access and reduced financial barriers, but rising costs, prescription charges and regional inequalities persisted.
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