The first couple of days in London (Monday-Thursday) went well, but definitely not as planned. From our first step off the plane into Heathrow Airport (London, England) my roommate and I fell very ill. Whatever has been going around, we got it, but luckily it has passed.
In terms of academics the first week included a light scheduled with two classes over the course of Thursday and Friday. The focus of Thursday’s class was on the origins of the NHS, Pre-NHS policies in Britain, and the chaos of medical care that consumed the UK prior to the creation of the NHS. Friday we focused on learning more about how politics and the NHS intertwine, where some would even argue that despite the NHS being a health service it is really a large scale political project.
Amongst our readings and assigned videos, one documentary recounting the history of the founding of the NHS really stood out to me. I will include some of my thoughts and comments on it below along with the video link.
Thoughts:
Over the course of the documentary certain events of the early 19th century were pointed out to highlight the progression of thought in terms of how health was understood and managed amongst different communities in England and eventually in the country as a whole. Progression began with an emphasis on tackling infant mortality rates with midwives becoming more commonplace being granted pensions, salary, and standard of care training. While there were still many issues with the greater integration of midwives and the limits of what they could achieve, overall infantry mortality increased drastically. During this time middle class families held the belief that doctors were the appropriate professional to hire to usher in a new child, however midwives produced greater results due to the overwhelming amount of work doctors faced. Due to the expensive nature and busy schedules of doctors, vulnerable citizens such in low income brackets were left exposed and in 1911 health insurance schemes organized by local government to serve the poor were put into place. That said, unemployment was at an all time high and the unemployed, women, and children were left uncovered by any means of insurance. In fragmented communities this was addressed through medical aid societies where the community members would contribute money into a larger pool to cover medical expenses of community members. While communities like this were effective, pandemics (ie. Diphtheria) still impacted the majority of citizens and it was not until the onset of WW2 that the English central government finally began to address health concerns and initiate a vaccination program. This shift saw the central government's influence extend to monitoring the health of youth in schools and seeking to understand risk factors for health via experimentation at the local level. Finally, in 1948, the central government took the reins and control of public health by implementing the NHS.
What I found most intriguing was firstly the social health experiment conducted at the Paneer health center and the foundational knowledge of risk factors the experiment discovered, and two, the community of Judea where Aneurin Bevan was born and the influence that the medical aid society had on his eventual creation of the NHS. These two points prior to the NHS seem to have heavily fueled the creation of the NHS and informed its understanding and vision of public health.
