PUBH6003 Health Policy and Decision-Making Assessment

The scenario

The Second World War left the United Kingdom in ruins and in debt. In just three years later, on the 5th of July 1948, an historic moment occurred in British history to make healthcare no longer exclusive to those who could afford it but to make it accessible to everyone. The National Health Service (NHS) was launched by the then Minister of Health. This marked the birth of the National Health Service, funded from general taxation and available to all according to their clinical needs, regardless of income.

Serving over one and a half million patients and their families every day, the NHS is the biggest service of its kind in the world. It is universally regarded as a national treasure - the most remarkable achievement of post war Britain (BBC documentary “The NHS: A Difficult Beginning” in 2008). Yet, surprisingly, the NHS very nearly failed to happen at all. In the months leading to its launch, it was bitterly opposed by the very people its existence depended on - surgeons, nurses, dentists, and Britain's 20,000 doctors.

To get the NHS in place required the persistence and determination of one man - Nye Bevan, Labour's minister of health. The creation of the NHS in 1948 was the product of years of hard work and a motivation from various other figures who felt the existing healthcare system at that time was insufficient and needed to be revolutionised. If you are one of those who appreciate good healthcare systems, have you ever wondered what evidence played a critical role in informing this audacious policy innovation of its kind at the time of its formation?

Aneurin Bevan, Minister of Health, on the first day of the National Health Service, 5 July 1948 at Park Hospital, Davyhulme, near Manchester, (The Birth of the NHS by Jessica Brain 2021 https://www.historic-uk.com/HistoryUK/HistoryofBritain/Birth-of-the-NHS/ ).

Assessment task

Watch the BBC documentary “The NHS: A Diffiffifficult Beginning” in 2008, and evaluate the quality of evidence cri4cal for the forma4on of NHS in 1948. Other sources you may fifind useful;

• The history of NHS in eighth minutes https://youtu.be/adKM3cZV5oE
• The Birth of the NHS by Jessica Brain 2021 https://www.historicuk.com/HistoryUK/HistoryofBritain/Birth-of-the-NHS/
• The birth of Britain's National Health Service, welcome collection 2018 h7ps://wellcomecollec

The outline for your report for a quality assignment

1. Execu4ve summary: an overview of what the report is about and the structure.
2. Introduc4on should address what NHS was about and its importance from policy perspec4ve.
   1. Explain health related problems that were of public concern at the 4me when NHS was conceptualised.
   2. Discuss how the health-related problems you have iden4fified were being addressed by government and the policy gap (s) in addressing these problems?
   3. Describe what the “NHS” policy idea was about in addressing the policy gaps you have iden4fified at the 4me of its forma4on? Consider why NHS was so important at the 4me of its concep4on.
3. Analysis of policy actors involved in the forma4on of the NHS in Britain.
   1. Iden4fy the key policy actors (at least 3 suppor4ng and 3 opposing actors) and roles they played in moving the NHS policy forward or opposing its success?
   2. Map and analyse the relevant policy actors using a table of an actor map, and a stakeholder analysis matrix.
   3. Discuss the actors’ policy posi4on, their relevance to the success or failure of NHS and their power to inflfluence policy.
4. Evalua4on of quality of evidence that was cri4cal for the forma4on of NHS in 1948 (30 Marks).
   1. Map the types and quality of evidence that was used to suppor and / or oppose forma4on the NHS and appraise its quality. Use the evidence evalua4on matrix to map the evidence sources and appraise its quality as provided.
   2. Discuss the types and quality of evidence that was used to support and / or oppose forma4on of NHS and / or threaten its success. You are explaining your evalua4on of evidence as presented in the matrix.
   3. Discuss how the evidence was used by relevant policy actors you discussed in task 3 to support or oppose the forma4on of NHS in Britain. Consider the evidence ecosystem for policy impact framework which outlines the rela4onship between evidence genera4on and applica4on to policy ac4ons or policy cycle.