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What changed when the NHS was established?/Why was the NHS established?

Learning Outcomes:

* To identify the changes that came about in the treatment of disease due to the creation of the NHS.
* To identify the main reasons why the NHS was established in 1948.
* To recognise advantages and disadvantages to the structure of the NHS in the 21st Century.

Video Starters


Title: Health care for all in 1948

Duration: 04:49

Description: The rise of the NHS is clearly explained here and is tied in with the increase use of surgery to treat medical conditions. The completely free NHS lasted only four years before prescription charges had to be introduced as the scheme was costing more than the government was prepared to spend. An example is given of how far technology has brought us, from originally having only four minutes to carry out a heart operation to modern day machines which take over the role of the heart.

From BBC Class Clips 

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Title: Introduction of the National Health Service

Duration: 00:53

Description: The introduction of the National Health Service in 1948, entitling most people to free at point of access health care. Personal recollections compare access to medicine before and after the introduction of the NHS.


From BBC Class Clips 

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When you have watched both of the video clips, share your thoughts on what the main arguments for and against establishing the NHS were on this page.

Evaluating the impact of the NHS

1. The demand for the types of care provided by the NHS.
As soon as it started there were 30 million people who registered with a doctor. The poor could go to a doctor, get treatment and not worry about the cost. Millions of prescriptions were written each year. The rich also used the NHS. There were few private patients who still wanted to pay for treatment or hospital care: though there are still some areas in which people do opt, in relatively large numbers, to pay for private health care. The types of services offered by the NHS is vast, covering all manner of health issues from pregnancy through to death.

2. The treatment that the NHS gives patients.
Open to everyone. More surgery is done. There are better anaesthetics so there is more complicated surgery. There are heart transplants. Patients are treated for cancer with surgery or chemotherapy. There are hip replacements. Childless couples can get fertility treatment. Accident and emergency departments treat millions of patients. Children are vaccinated against diseases like TB and measles. A criticism of the treatment that the NHS gives is that in some cases the waiting time for the treatment is too long.

3. Health education.
There are campaigns about the risks from smoking. Fewer people smoke now than in the past. People are warned about alcohol abuse. The government uses the NHS to spread ideas about the importance of a healthy diet and regular exercise. As a result of these people are living longer. Life expectancy is around 80 years. This type of education includes health visitors, education packs for schools and for use in surgeries and public information films.

4. The health of the poorest people.
The poor suffer more from cancer and heart disease. They are more likely to smoke. They are also the least likely to access information about healthy living, partly because literacy levels tend to be lowest in more deprived areas. For some of the poor a healthy diet is not possible due to the cost. Fewer of the poor visit the dentist regularly.

5. Women’s health.
Women now visit the doctor more often. They visit the doctor more than men do. Before the NHS they did not go as often as men (they did not have health insurance). There are screening programmes for breast cancer and cervical cancer.

Explore an interactive history of the NHS to see how it has developed.


Create your own short documentary about the NHS.


Use software such as Windows Movie Maker to collate video clips, images and text. You can add a voiceover or soundtrack if desired. Note - you will need to download the clips and possibly convert them into a different format, depending on which video editing software you are using. My pupils - the files are all stored on the school network.

Sources of Video Clips:

Pathe News - search results for NHS

NHS Videos - current videos used by the NHS

The BBC - the NHS at 60

Sources of images:

The Wellcome Trust - searchable image collection






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