17. Great Britain as a welfare state.

Welfare Concept of government in which the stale plays a key role in the protection and promotion of the economic and social well-being of its citizens. It is based on the principles of equality of opportunity, equitable distribution of wealth, and public responsibility for those unable to avail themselves of the minimal provisions for a good life. Social insurance, a provision common to most advanced industrialized countries (e. g. . National Insurance in the U. K. . Old-Age, Survivors, Disability, and Health Insurance in the U. S. ). is financed by compulsory contributions and is intended to provide benefits to persons and families during periods of greatest need. Public provision of basic education, health services, and housing (in some cases at low cost or without charge). The comprehensive measures of social insurance adopted in 1948 by Great Britain on the basis of the report on Social Insurance and Allied Services (1942) by Sir William (later Lord) Beveridge.

Cash benefits The current system of cash benefits, though substantially modified since its introduction in 1946. is based on the 1942 "Beveridge Report" Every employed person pays a national insurance contribution^ percentage of earnings). Is collected by employers, also an employer contribution. Self-employed - separate arrangements. The revenue from contributions —*into the National Insurance Fund. Insured individuals are entitled to unemployment compensation, cash benefits during sickness or disability, and a retirement pension (at age 65 for men, 60 for women). Benefits for individuals injured in work-related accidents and for widows Anyone may also be eligible for noncontributory benefit. In 1965 a statutory system of redundancy, or severance, pay was introduced. Employees who lose their jobs through no fault of their own receive lump-sum payments whose cost is met in part by their employers and in part from a general levy on employers. The major noncontributory benefits, paid out of general tax revenues, offer poverty relief to individuals and families whose income and savings fall below some prescribed level. The benefit of last resort is income support (formerly supplementary benefit); it is payable to individuals whose entitlement to insurance benefits has been exhausted or has left them with a very low income and to those who never had any entitlement to an insurance benefit. Other means-tested benefits assist low-paid working families with children and help people on low incomes with their housing costs. An important class of noncontributory benefit is not means-tested, the major example being child benefit, a weekly, tax-free payment for each child, usually payable to the mother. The 1946 system changed. The original Beveridge scheme was modeled on private insurance and offered flat-rate benefits in return for flat-rate contributions. Under the Social Security Act of 1973 the flat-rate contribution was replaced from April 1975 for all employed persons by a percentage contribution of earnings up to a ceiling. Pension arrangements were criticized in the 1950s and '60s because the flat-rate pension failed to keep many elderly people out of poverty. The Social Security Pensions Act of 1975 overhauled the system by introducing a substantial earnings-related pension, to be phased in over 20 years, so as to raise the income of pensioners.

17. Great Britain as a welfare state.

The Beveridge arrangements offered financial support to families through a dual system of income tax allowances and a taxable family allowance for all children after the first. The result was complex and failed to give the greatest assistance to the poorest families. Under the Child Benefit Act of 1975, the tax allowance and family allowance were both abolished and replaced by the unified child benefit described above. There was a further review of the benefit system in 1985, which changed the detailed workings of several benefits in 1988 but which left the basic structure intact.

Welfare aspects of housing Under the Housing (Homeless Persons) Act of 1977 (which amended older legislation), local authorities have a statutory obligation in certain circumstances to find housing for homeless families Partly for that reason, they own a substantial stock of housing for rent and maintain waiting lists and allocate housing according to need. Health and welfare In England the NHS (National Health Service) is the responsibility of the secretary of state for health, who is answerable to Parliament The secretaries of state for Wales, Scotland, and Northern Ireland are responsible for the NHS in their respective countries. Medical care under the NHS lias a tripartite structure of primary care, hospitals, and community health care. Everyone can be registered with a general practitioner(family doctors), who provides preventive and curative care and who refers patients to hospital and specialist services. All consultations with a general practitioner under the NHS are free. The other major types of primary medical care are dentistry and pharmaceutical and op-thalmic services, the only services of the NHS for which charges are levied, though people under 16, past retirement, or with low incomes are usually exempt Everyone else must pay charges that are below the full cost of the services involved Under the Department of Health in England are 14 regions, under which are 193 districts, whose major responsibility is to run the hospital service. (Health authorities in Scotland, Wales, and Northern Ireland are the responsibilities of the respective secretaries of state. ) Hospitals absorb more than two-thirds of the NHS budget. All hospital treatment under the NHS is free, including consultations with doctors, nursing, drugs, and intensive care, whatever the type of medical problem and however long the hospital stay. Hospital doctors are paid a salary rather than a fee for service but can combine salaried work for the NHS with private practice. The Community Health Service has three functions; preventive health services; liaison with the local authority, especially over matters of public health; and cooperation with local authority personal social service departments, to enable health and personal care to be dealt with together wherever possible. Individuals can register with any NHS general practitioner in their area who is prepared to add them to his or her list of patients. Anyone maychange to another doctor. Except in emergencies, patients are referred to a hospital by their general practitioner, allowing an element of patient choice Apart from the charges mentioned, treatment under the NHS is free to the patient. The service is almost entirely funded from government revenues, less than 5 percent of NHS revenue coming from charges. The NHS budget is determined by negotiation between the Treasury and the spending departments, as modified by subsequent discussion in the Cabinet. The division of money throughout the United Kingdom is partly constrained by a formula designed to improve the geographic distribution of medical resources, the NHS is a system of private medical care both for primary care and hospital treatment, the sector remains small(only about 5 percent of the total expenditure). Most private care is financed by voluntary private medical insurance Reforms of the NHS in the 1970s and '80s. Problems. Resources are scarce, many hospital buildings are old; there are waiting lists for nonurgent conditions; the distribution of health care by social class and by region is less equal than many would wish; and management needs to be improved. But the advantages. The NHS is very inexpensive The system is able to direct resources toward specific regions and specific types of care Treatment is free, whatever the extent and duration of illness; no one is denied treatment because of low income, and no one goes in fear of financial ruin.