Martin D. Moore

drives to control costs and increase efficiency in the health service – as well as by neoliberal critiques of state and economy – the Thatcher and Major administrations substantially remade the dynamics of the NHS. Inspired by the novel concept of internal markets in public services, extensive reforms converted health authorities from planning and management bodies into state-funded healthcare purchasers, and transformed hospitals and community care agencies into trusts that secured finance through procuring contracts from purchasing bodies. 1 In primary care, larger

in Managing diabetes, managing medicine
Abstract only
Jane M. Adams

the BSF focused on gaining funding for spa treatment through the NHI scheme. Although this was not achieved, free treatment at English spas was made available to all under arrangements put in place on the introduction of the NHS in 1948. From the mid-nineteenth century the English spas had developed through collaboration between a network of stakeholders which included specialist medical practitioners and other workers, charitable institutions, local authorities, spa managers and private investors. These local networks, which supported the development of both

in Healing with water
The scientific study of Egyptian mummies, initial phase, 1973–79
Alan Curry

A pioneering team of academics, medical consultants and scientists was brought together by Rosalie David in 1973 to scientifically investigate Egyptian artefacts and mummies in the Manchester Museum collection. In addition, an inadequately documented mummy in poor condition (Mummy 1770) was selected to be unwrapped and investigated internally. Several new scientific techniques were to be utilised in these studies including computer tomography (CAT scanning), electron microscopy (TEM, SEM and analytical EM) and radiocarbon dating. In addition, established techniques were also used, such as histological examination of mummified tissues to look for evidence of disease, conventional X-ray examination, dental studies, fingerprinting, entomological and parasitological studies, analysis of the textiles used to wrap mummies and reconstruction of skulls and faces. The recreated facial features of Mummy 1770 was one of the highlights of the project and this was undoubtedly due to the skills of team-member Richard Neave. As little was known about the exact process of mummification, some experimental mummification processes were tried on dead laboratory rats and mice. This initial phase of the Manchester Mummy project lasted from 1973 until 1979 and overall it was a great success giving many new insights into ancient Egyptian life, diseases and customs. The results of the various investigations were published in scientific papers, several books and a number of films (including one for the BBC Chronicle series). Sadly, it is unlikely that all aspects of this project could be repeated today, particularly using NHS facilities.

in Mummies, magic and medicine in ancient Egypt
New Labour and public sector reform
Eric Shaw

conduct of those employed within the public sector. For example Richard Titmuss (an adviser to the 1964–70 Labour government) expressed anxiety that as the social services became ‘more complex, more specialized and subject to a finer division of labour’ the role of professionals would grow and ‘collectively, more power may come to reside in the hands of these interests’ (quoted in Perkin 1986: 14). Similarly, Brian Abel-Smith (a close associate of Titmuss) mulling over his experiences as a ministerial adviser lamented that within the NHS ‘the crucial power still rests

in In search of social democracy
Open Access (free)
Martin D. Moore

Britain than elsewhere in terms of national policy. 25 The NHS's universal coverage, combined with its collectivisation of financial risk across a national population, certainly provided British clinicians with an effective foundation on which to innovate and share models of chronic disease care in practice. 26 However, these same features also undermined the political cache of ‘chronic disease’ until later in the century. 27 There were some movements in this direction before the 2000s, and diabetes once again provided an important component of such policy. 28 As

in Managing diabetes, managing medicine
Abstract only
Alex Mold

doctors towards them, their lateness, their ineptitude and absence of humanity. Patients also complained about the over-administration of remedies, which was strongly linked to over-charging.9 Coordinated systems that dealt with patient complaints, as opposed to individuals complaining about their treatment, are, however, a more recent invention. Before the NHS, contributor representatives within pre-war voluntary hospital governing bodies were able to put forward patient complaints. Common complaints, notes Martin Gorsky, revolved around waiting lists, visiting times

in Making the patient-consumer
Open Access (free)
George Campbell Gosling

, founder of the King's Fund, 1879 There was only one area of the pre-NHS hospital system which genuinely saw private healthcare operating on a commercial basis. This was the parallel provision made for middle-class patients, the likes of ‘George’ from Your Very Good Health , in the British hospital of the early twentieth century. Since admission of middle-class patients was commonly seen as a threat to

in Payment and philanthropy in British healthcare, 1918–48
Peter Triantafillou and Naja Vucina

concern. It is a health time bomb with the potential to explode over the next three decades … Unless this time bomb is defused the consequences for the population’s health, the costs to the NHS and losses to the economy will be disastrous. (Department of Health, 2003, p. 44) Donaldson found it necessary to address this national problem with a wide range of initiatives ranging from more intense local monitoring of the prevalence of obesity, regulation of food products and labelling, training of health professionals in providing advice on obesity control, the singling

in The politics of health promotion
A national ethics committee and bioethics during the 1990s
Duncan Wilson

influence by the mid 1990s, he was also dismayed by the fact that the government only convened inquiries into new procedures such as IVF, gene therapy and xenotransplants, and left the governance of clinical treatment to doctors. This reflected the way in which the Conservative challenge to medical paternalism had ‘evaporated’ by the late 1980s, following claims that giving patients and outsiders a greater say in medical treatment would ‘destabilise’ the NHS.117 Medicine continued to be largely self-regulating and the far-reaching ‘inspectorate’ that Kennedy had

in The making of British bioethics
Open Access (free)
Gareth Millward

receiving first dose of MMR before 24 months in London, rest of England and Scotland, 1999–2000, 2015–16. Source : England 1999–2000 to 2004–5: Health and Social Care Information Centre, ‘NHS Immunisation Statistics: England, 2004–05’ (accessed 23 August 2017); England 2006–16: NHS Digital, ‘NHS Immunisation Statistics: England, 2015–16’ (London, September 2016). Scotland: Information Services Division Scotland, ‘ Trends in immunisation uptake by quarter, calendar and financial year

in Vaccinating Britain