Health Care Models and Welfare Themes

Abstract

This chapter provides an overview of changes in health care in Britain since the first part of the nineteenth century. The knowledge and practices of health care practitioners have changed dramatically in this period. Most forms of medical intervention that we take for granted towards the end of the twentieth century were unknown at the beginning of the nineteenth century. Not only have forms of health care changed but the role of the state in health care has also been transformed in this period. This transformation can be said to exemplify what is often referred to as ‘the development of the welfare state’. Health care in Britain in the middle of the nineteenth century and health care in Britain in the middle of the twentieth century serve as classic examples of contrasting models of state welfare. For much of the nineteenth century the dominant model of state welfare was the residual model — a minimal state model of health care. By the middle of the twentieth century the dominant model of state welfare was the institutional model — a universalist/citizenship model of health care. This chapter will provide an overview of the changes involved in the move from the minimal state model to the universalist/citizenship model with particular reference to the arrangements for organising and financing health care.