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1. Eliminating disease/ Comprehensive/ Equality Creation of the welfare state in 1948. Collectivist approach- the state would fund this service through NI contributions and general taxation The creation of the NHS meant a commitment to provide a ‘comprehensive health service for the improvement of the physical and mental health of the people’ Therefore the NHS was taking responsibility for all aspects of the nation’s health care. Primary healthcare- GPs, dentists, opticians, pharmacies, accident and emergency Secondary care- referral to hospital specialists. To a great extent the NHS has provided an increasing level of prevention and treatment. However, specialist consultants vary from area to area and drugs are available in some areas and not in others- the post code lottery- every person does not have the same access to all treatments. Waiting lists vary in length from area to area. Geographic inequalities. This shows that welfare is not provided equally in all regions and areas. Rationing of health spending is also used. In May 2011 Mr Devine, a 68 year old Scottish patient with a rare blood disorder, was denied a life transforming drug on the grounds of cost by the NHS Greater Glasgow and Clyde. Also moved towards ‘individualist’ approach. Private health care. Competitive tendering within the NHS. Coalition passed the Health and Social Care Bill- private companies bid to provide services within the NHS- Serco. Spending on the NHS has reached record level- £11.3 billion. Current economic climate there have been cuts- welfare spending will take its share of the cuts. The increase in the number of elderly people and the cost of new machines and new technologies requires an annual 5 per cent increase so the NHS will face cuts. Under efficiency savings around 4000 posts disappeared in 2010-2011. Victim of its own success as new expensive technology and medicines allows people to live longer. Putting more pressure on the NHS. 2. Eliminating Want/ Universal Extending the social security system. Provision from ‘cradle to the grave’ Even from the beginning the idea of basing entitlements on NI contributions meant that many people-mainly women- were excluded and had to depend on means-tested benefits. Labour Government 1997-2010 had a policy approach ‘progressive universalism’. This was an extension of means testing. Benefits they introduced such as Pension Credit and Working Tax Credit were means tested. Child benefit paid to all families irrespective of income. Recognition of the extra cost in bringing up children. However in 2013 the Coalition government will end child benefit payments to higher-rate tax payers, which child benefit will be means tested rather than universal. The Welfare Revolution- Coalition focusing on workshy who often appear in the newspapers highlighting how much they receive in benefits. George Osborne states ‘it will always pay to work. Those who get work will be better than those who don’t’ Therefore the welfare state is not universal across all services. 3. Eliminating Ignorance/ Universal Free compulsory education up to the age of 16 remains a universal provision. However the places in higher education have now given way to the introduction of tuition fees in England and Wales. Annual tuition fees up to £9000. In Scotland, graduates have to repay loans when their salaries reach a certain level. Private education system also in existence- choice. Therefore the state do not fully fund services needed – not Collectivist. 4. Eliminating Idleness Economic policies introduced by the government that would ensure high and stable levels of employment. The central theme of the Labour Government’s social policy from 1997-2010 was to promote social inclusion in order to re-engage those people who were in poverty and had become detached from work, education, health and community. Welfare policies designed to get unemployed off welfare and into work. To increase levels of employment: Working Tax Credits, Child Tax Credit, National Minimum Wage, New Deal, Modern Apprenticeships. To help income levels of those not in work: Jobseeker’s allowance, Jobcentre Plus, Pension Credit. The Welfare Revolution- Chancellor George Osborne announced that £81 billion of cuts would be made to reduce the massive budget deficit. Welfare budget would be cut by £18 billion and this was designed as an incentive to get people back to work. Given the extent of job losses due to cuts in the public sector it is difficult to accept that there are sufficient job for the unemployed to find. 5. Eliminating Squalor/ Comprehensive State should provide adequate housing Affordable council housing was to be available in all areas. ‘Right to Buy’ scheme introduced by the Conservative Government in the 1980s led to thousands of the best houses being sold off at discounted prices. Subsequently, insufficient quantities of social housing have been built. In 2010 in Scotland alone, 5500 houses were built by housing associations and 343 by councils while more than 160,000 households were on waiting lists. The ability of the state to provide social housing has deteriorated.