Developing Health and Social Care under the Reforms of Tony Blair and Clement Attlee, Prime Ministers of Great Britain and Northern Ireland

Journal of Allied Health, Spring 2004 by Graham, Iain

THE FOLLOWING ARTICLE, "Developing Health and Social Care under the Reforms of Tony Blair and Clement Attlee, Prime Ministers of Great Britain and Northern Ireland," hy lain Graham, is the inaugural offering of a new feature for the Journal entitled intemational Perspectives. Our partner in this first effort is the Consortium of Institutes of Higher Education in Health and Rehabilitation in Europe (COHERE), which has its headquarters in Gent, Belgium. Including institution memhers from 14 European countries, COHERE has as its statement of philosophy: The "development of quality of higher education for the health care professions will be enhanced hy international cooperation . . . including the addition of an international/European dimension to the educational activities of its members." COHERE also includes its multidisciplinary makeup as one of its major strengths, and members believe that education of the new generation of health care professionals must be interdisciplinary and international. Some of the goals that member institutions of higher education espouse include reinforcement of respective curricula, mutual recognition of educational programs, student and staff mobility among member countries, common standards for quality education, joint development and dissemination of new programs, and cooperation in educational innovation and research.

We live in an era of globalization, and the health care domain is no exception to this trend. Graduates from health profession programs, in the United States and across the world, will be challenged to provide health care services to a growing diverse, international population at home and abroad. Health care practitioners in the United States will need to begin to understand and evaluate international models of service delivery and plan for universal standards of care. Integration of an international perspective in the Journal of Allied Health is a beginning acknowledgment that we in the United States are part of a larger world of health care. Our challenge is not just to practice in an interdisciplinary manner, but to practice as part of an international community.

LAURIE SHERWEN, PhD

School of Health Professions

Hunter Colleege

New Ybrb, New york

In July 1948, the British National Health Service (NHS) was introduced by then Prime Minister Clement Attlee with the aim of offering "free" medical treatment for the entire British population from cradle to grave. Since then, the British public have come to see the NHS and its free health care as a fundamental human right and a corner' stone to their democracy, and subsequent governments have been understandably reluctant to change or reform this popular program. Yet, funding issues, as well as societal changes and technological advances, are threatening the way the NHS performs. While the NHS was intended to be a flexible and responsive service, its restrictive practice culture and attitudes of staff, organizational flaws, and funding issues often work against patients' interests and government ideas of health policy. This paper outlines how the Blair Government has attempted to alter health and social care within the UK and to fundamentally change how the NHS works, with particular effect on its staff. J Allied Health. 2004; 33:42-46.

DURING SUMMER 2003, the British press dedicated many inches of news column to comparing the Prime Ministership of Tony Blair with that of another reformist, Clement Attlee, who had been elected as head of a Labour government at the end of World War II. Understanding the position taken by these Prime Ministers with regard to health care is central to understanding health care within the hearts and minds of the British people and how the values and beliefs of these Prime Ministers were influenced.

The British National Health Service (NHS) plays a crucial role, not only in delivering a health service, but also in representing a fundamental aspect of freedom for the British people. The various pressures facing the NHS are set to increase in the future, however, challenging this notion. Societal changes and technologic advances are threatening the way the NHS performs. What both Labour governments wanted in their management of the NHS was to create a flexible and responsive service, which is harnessed to sustainability and meeting the challenges. Restrictive practice culture and attitudes of staff, organizational flaws and funding issues often work against patients' and users' interests and the ideas of government health policy, however.

Both Prime Ministers set about reforming the structures and systems of care delivery, while realizing that tackling functions of the health care workforce would present difficult obstacles. Changes must be accomplished without belittling the commitment and sacrifices made by NHS staff every day of their working lives-a challenging dilemma. It is perhaps because of this dilemma that government reform between the stewardship of Mr. Attlee and Mr. Blair has focused on structural reform above all other, hoping perhaps that culture and attitude somehow would fall into the correct place. Such changes have to be achieved and managed if reform is to be successful.1