The one thing the English will never forgive the Germans for is 4 page
and there is also the small City Airport, which caters mainly for business travellers between London and north-western Europe.
There are plans for a fifth terminal at Heathrow, bigger than the other four combined. The aim is to double the capacity of Heathrow by the year 2015. However, while some British people may be proud at the prospect of Heathrow retaining its world number-one position, others are not so pleased. The problem is the noise (which British people tend to regard as an invasion of their privacy). Local farmers and the hundreds of thousands of people who live under Heathrow's flight path are objecting to the idea. The airport planners are arguing that the next generation of planes will be much quieter than present-day ones. Nevertheless, the plan is going to have to win a tough fight before it goes ahead.
Modern Britain makes surprisingly little use of its many inland were busy thoroughfares, and the profession of'waterman', the river equivalent of the London cabbie, was well-known. In the last hundred years transport by land has almost completely taken over. A few barges still go up and down the Thames through London, but are used mostly by tourists. Several attempts have been made to set up a regular service for commuters, but none has been a success so far. There is no obvious practical reason for this failure. It just seems that British people have lost the habit of travelling this way.
The story of goods transport by water is the same. In the nineteenth century, the network of canals used for this purpose was vital to the country's economy and as extensive as the modern motorway network. The vast majority of these canals are no longer used in this way. Recently the leisure industry has found a use for the country's waterways with the increasing popularity of boating holidays.
Question 167
> Monster jumbos
British Airways is one of the biggest airlines in the world. Its ambitious plans for the future include operating an enormous new kind of jumbo aircraft. This will not travel any faster than today's aircraft, but will be big enough for passengers to move around inside in rather the same way as they do on a ship. There will be no duty-free trolleys or meals coming round; instead, passengers will go to the bar, cafe or shop to get what they want. First class travellers will have sleeping cabins and a fully-equipped business area. But how many airports will be able to accomodate the new monsters of the sky?
QUESTIONS
1 The car is the preferred means of transport for most people in Britain. The same is probably true in your country. What effects has this had, in Britain and in your country?
3 Although freedom of movement (usually by car) is dear to the hearts of most British people, there is something even more dear to their hearts which makes the building of new roads a slow and difficult process. What is this? Does the objection to new roads, rail links and even airport terminals surprise you?
2 Many people in Britain are beginning to realize that other means of transport, apart from the car, should be used. What kinds of presently under-used means of transport are being revived in Britain, and where do people argue that money should be spent by the government instead of on building more new roads?
4 British individualism shows itself in many ways in the area of transport. Can you find examples in this chapter
> The origins of the welfare state in Britain
Before the twentieth century,
welfare was considered to be the responsibility of local communities. The 'care' provided was often very poor. An especially hated institution m the nineteenth century was the workhouse, where the old, the sick, the mentally handicapped and orphans were sent. People were often treated very harshly in workhouses, or given as virtual slaves to equally harsh employers.
During the first half of the twentieth century a number of welfare benefits were introduced These were a small old-age pension scheme (1908), partial sickness and unemployment insurance (1912) and unemployment benefits conditional on regular contributions and proof of need (1934) The real impetus for the welfare state came m 1942 from a government commission, headed by William Bevendge, and its report on 'social insurance and allied services' In 1948 the National Health Act turned the report's recommendations into law and the National Health Service was set up
The mass rush for free treatment caused the government health bill to swell enormously In response to this, the first payment within the NHS (a small fixed charge for medicines) was introduced in 1951. Other charges (such as that for dental treatment in 1952) followed.
18Welfare
Britain can claim to have been the first large country in the world to have accepted that it is part of the job of government to help any citizen in need and to have set up what is generally known as a 'welfare state'.
The benefits system
The most straightforward way in which people are helped is by direct payments of government money. Any adult who cannot find paid work, or any family whose total income is not enough for its basic needs, is entitled to financial help. This help comes in various ways and is usually paid by the Department of Social Security.
Anyone below the retirement age of sixty-five who has previously worked for a certain minimum period of time can receive unemployment benefit (known colloquially as 'the dole'). This is organized by the Department of Employment.
All retired people are entitled to the standard old-age pension, provided that they have paid their national insurance contributions for most of their working lives. After a certain age, even people who are still earning can receive their pension (though at a slightly reduced rate). Pensions account for the greatest proportion of the money which the government spends on benefits.
The government pension, however, is not very high. Many people therefore make arrangements during their working lives to have some additional form of income after they retire. They may, for instance, contribute to a pension fund (also called a 'superannuation scheme'). These are usually organized by employers and both employer and employee make regular contributions to them. A life insurance policy can also be used as a form of saving. A lump sum is paid out by the insurance company at around the age of retirement.
Some people are entitled to neither pension nor unemployment benefit (because they have not previously worked for long enough or because they have been unemployed for a long time). These people can apply for income support (previously called supplementary benefit) and if they have no significant savings, they will receive it. Income support is also sometimes paid to those with paid work but who need extra money, for instance because they have a particularly large family or because their earnings are especially low.
Social services and charities 169
A wide range of other benefits exist. For example, child benefit is a small weekly payment for each child, usually paid direct to mothers. Other examples are housing benefit (distributed by thelocalauthority, to help with rent payments), sickness benefit, maternity benefit and death grants (to cover funeral expenses).
The system, of course, has its imperfections. On the one hand, there are people who are entitled to various benefits but who do not receive them. They may not understand the complicated system and not know what they are entitled to, or they may be too proud to apply. Unlike pensions and unemployment benefit, claiming income support involves subjecting oneself to a 'means test'. This is an official investigation into a person's financial circumstances which some people feel is too much of an invasion of their privacy. On the other hand, there are people who have realized that they can have a higher income (through claiming the dole and other benefits) when not working than they can when they are employed.
The whole social security system is coming under increasing pressure because of the rising numbers of both unemployed people and pensioners. It is believed that if everybody actually claimed the benefits to which they are entitled, the system would reach breaking point. It has long been a principle of the system that most benefits are available to everybody who qualifies for them. You don't have to be poor in order to receive your pension or your dole money or your child benefit. It is argued by some people that this blanket distribution of benefits should be modified and that only those people who really need them should get them. However, this brings up the possibility of constant means tests for millions of households, which is a very unpopular idea (and would in itself be very expensive to administer).
Social services and charities
As well as giving financial help, the government also takes a more active role in looking after people's welfare. Services are run either directly or indirectly (through 'contracting out' to private companies) by local government. Examples are the building and running of old people's homes and the provision of 'home helps' for people who are disabled.
Professional social workers have the task of identifying and helping members of the community in need. These include the old, the mentally handicapped and children suffering from neglect or from maltreatment. Social workers do a great deal of valuable work. But their task is often a thankless one. For example, they are often blamed for not acting to protect children from violent parents. But they are also sometimes blamed for exactly the opposite — for taking children away from their families unnecessarily. There seems to be a conflict of values in modern Britain. On the one hand, there is the traditional
> The language of benefits
With the gradually increasing level of unemployment in the last quarter of the twentieth century, many aspects of unemployed life have become well-known in society at large. Receiving unemployment benefit is known as being 'on the dole' and the money itself is often referred to as 'dole money'. In order to get this money, people have to regularly present their UB40s (the name of the government form on which their lack of employment is recorded) at the local social security office and 'sign on' (to prove that they don't have work). They will then get (either directly or through the post) a cheque which they can cash at a post office. This cheque is often referred to as a 'giro'.
170 18Welfare
A poster advertising the Samaritans (see below)
> Some well-known charities
The Samaritans organization offers free counselling by phone, with anonymity guaranteed, to anybody who is in despair and thinking of committing suicide.
The Salvation Army is organized on military lines and grew out of Christian missionary work in the slums of London in the nineteenth century. It offers help to the most desperate and needy, for example, overnight accommodation in hostels for the homeless.
Barnado's, also founded in the nineteenth century, used to provide homes for orphaned children and still helps children in need.
MENCAP is a charity for the mentally handicapped and campaigns on their behalf.
> Getting medicine on the NHS
When medicine is needed, the doctor writes out a prescription which the patient then takes to a chemist's (that is, a pharmacy, but this word is used only by medical professionals). There is a charge for each prescription, which is the same regardless of the real cost of the medicine, although many categories of people are exempt.
respect for privacy and the importance placed by successive governments on 'family values'; on the other hand, there is the modern expectation that public agencies will intervene in people's private lives and their legal ability to do so.
Before the welfare state was established and the concept of'social services' came into being, the poor and needy in Britain turned to the many charitable organizations for help. These organizations were (and still are) staffed mostly by unpaid volunteers, especially women, and relied (and still do rely) on voluntary contributions from the public. There are more than 150,000 registered charities in the country today. Taken together, they have an income of more than £ 15 billion. Most of them are charities only in the legal sense (they are non-profit-making and so do not pay income tax) and have never had any relevance to the poor and needy. However, there are still today a large number which offer help to large sections of the public in various ways (o Some well-known charities).
Charities and the social services departments of local authorities sometimes co-operate. One example is the 'meals-on-wheels' system, whereby food is cooked by local government staff and then distributed by volunteers to the homes of people who cannot cook for themselves. Another example is the Citizens Advice Bureau (CAB), which has a network of offices throughout the country offering free information and advice. The CAB is funded by local authorities and the Department of Trade and Industry, but the offices are staffed by volunteers.
The national health service
The NHS (the national health service is commonly referred to by this abbreviation) is generally regarded as the jewel in the crown of the welfare state. Interestingly, it is very 'un-British' in the uniformity and comprehensiveness of its organization. When it was set up it did not, as was done in so many other areas of British public life, accommodate itself to what had already come into existence. Instead of entering into a partnership with the hundreds of existing hospitals run by charities, it simply took most of them over. The system is organized centrally and there is little interaction with the private sector. For instance, there is no working together with health insurance companies and so there is no choice for the public regarding which health insurance scheme they join. Medical insurance is organized by the government and is compulsory.
However, in another respect the NHS is very typically British. This is in its avoidance of bureaucracy. The system, from the public's point of view, is beautifully simple. There are no forms to fill in and no payments to be made which are later refunded. All that anybody has to do to be assured the full benefits of the system is to register with a local NHS doctor. Most doctors in the country are General Practitioners (GPs) and they are at the heart of the system. A visit to
the GP is the first step towards getting any kind of treatment. The GP then arranges for whatever tests, surgery, specialist consultation or medicine are considered necessary. Only if it is an emergency or if the patient is away from home can treatment be obtained in some other way.
As in most other European countries, the exceptions to free medical care are teeth and eyes. Even here, large numbers of people (for example, children) do not have to pay and patients pay less than the real cost of dental treatment because it is subsidized.
The modern difficulties of the NHS are the same as those faced by equivalent systems in other countries. The potential of medical treatment has increased so dramatically, and the number of old people needing medical care has grown so large, that costs have rocketed. The NHS employs well over a million people, making it the largest single employer in the country. Medical practitioners frequently have to decide which patients should get the limited resources available and which will have to wait, possibly to die as a result.
In the last few decades, the British government has implemented reforms in an attempt to make the NHS more cost-efficient. One of these is that hospitals have to use external companies for duties such as cooking and cleaning if the cost is lower this way. Another is that hospitals can 'opt out' of local authority control and become self-governing 'trusts' (i.e. registered charities). Similarly, GPs who have more than a certain number of patients on their books can choose to control their own budgets. Together these two reforms mean that some GPs now 'shop around' for the best-value treatment for their patients among various hospitals.
These changes have led to fears that commercial considerations will take precedence over medical ones and that the NHS system is being broken down in favour of private health care. And certainly, although pride and confidence in the NHS is still fairly strong, it is decreasing. There has been a steady rise in the number of people paying for private medical insurance (> Private medical care) in addition to the state insurance contribution which, by law, all employed people must pay.
In fact, though, Britain's health system can already claim cost-efficiency. The country spends less money per person on health care than any other country in the western world. One possible reason for this is the way that GPs are paid. The money which they get from the government does not depend on the number of consultations they perform. Instead, it depends on the number of registered patients they have — they get a 'capitation' allowance for each one. Therefore, they have no incentive to arrange more consultations than are necessary. It is in their interest that their patients remain as healthy as possible and come to see them as little as possible, so that they can have more patients on their books. The other possible reason is the British 'stiff upper lip'. In general, people do not like to make a big drama out of being ill. If the doctor tells them that there is nothing
There are a number of private
medical insurance schemes in the country. The biggest is BUPA. As you can see, such schemes are becoming increasingly popular. This is not because people believe that private treatment is any better than NHS treatment from a purely medical point of view. But it is widely recognized as being more convenient. NHS patients who need a non-urgent operation often have to wait more than a year, and even those who need a relatively urgent operation sometimes have to wait more than a month. Under private schemes, people can choose to have their operation whenever, and as soon as, they want. It is this which is their main attraction. The length of 'waiting lists' for operations within the NHS is one of the most hotly discussed public issues. Private patients sometimes use "pay beds' in NHS hospitals, which are usually in a separate room (NHS patients are usually accommodated in wards containing ten to twenty beds). There are also some hospitals and clinics which are completely private. These are sometimes called 'nursing homes'.
172 18 Welfare
> Nurses'uniforms
One of the most instantly recognizable uniforms in Britain is that conventionally worn by female nurses.
For years it has been widely criticized as out-of-date and sexist, promoting the image of nurses as brainless, sexy girls. The annual conference of the Royal College of Nursing always passes a resolution calling for the introduction of trousers. Skirts are said to result in back pain (and thousands of lost working days every year) as nurses struggle to keep their dignity while lifting heavy patients. The hat is also criticized as impractical.
It is probable that change isat last on the way.
> The emergency services
From anywhere in Britain, a person who needs emergency help can call '999' free of charge. The operator connects the caller to the fire service, the ambulance service, or the police.
to worry about, they are likely to accept this diagnosis. Partly as a result of this, British GPs prescribe significantly less medicine for their patients than doctors in other countries in Europe do.
When it was set up, the NHS was intended to take the financial hardship out of sickness - to offer people medical insurance 'from the womb to the tomb'. In this respect, despite the introduction of charges for some kinds of treatment, it can still claim to be largely successful.
The medical profession
Doctors generally have the same very high status in Britain that they have throughout the world. Specialist doctors have greater prestige than ordinary GPs, with hospital consultants ranking highest. These specialists are allowed to work part-time for the NHS and spend the rest of their time earning big fees from private patients. Some have a surgery in Harley Street in London, conventionally the sign that a doctor is one of the best. However, the difference in status between specialists and ordinary GPs is not as marked as it is in most other countries. At medical school, it is not automatically assumed that a brilliant student will become a specialist. GPs are not in any way regarded as second-class. The idea of the family doctor with persona knowledge of the circumstances of his or her patients was establishec in the days when only rich people could afford to pay for the service;
of a doctor. But the NHS capitation system (see above) has encouraged this idea to spread to the population as a whole.
Most GPs work in a 'group practice’. That is, they work in the sam building as several other GPs. This allows them to share facilities such as waiting rooms and receptionists. Each patient is registered with just one doctor in the practice, but this system means that, when his or her doctor is unavailable, the patient can be seen by one of the doctor's colleagues.
The status of nurses in Britain may be traced to their origins in the nineteenth century. The Victorian reformer Florence Nightingale became a national heroine for her organization of nursing and hospital facilities during the Crimean War in the 18^os. Because other, nurses have an almost saintly image in the minds of the British public;
being widely admired for their caring work. However, this image suggests that they are doing their work out of the goodness of their hearts rather than to earn a living wage. As a result, the nursing profession has always been rather badly paid and there is a very high turnover of nursing staff. Most nurses, the vast majority of whom are still women, give up their jobs after only a few years. The style of the British nursing profession can also be traced back to its origins. Born at a time of war, it is distinctively military in its uniforms, its clear-cut separation of ranks, its insistence on rigid procedural rules and its tendency to place a high value on group loyalty.
Question 173
> Alternative medicine
One reason why the British are, per person, prescribed the fewest drugs in Europe is possibly the common feeling that many orthodox medicines are dangerous and should only be taken when absolutely necessary. An increasing number of people regard them as actually bad for you. These people, and others, are turning instead to some of the forms of treatment which generally go under the name of 'alternative medicine'. A great variety of these are available (reflecting, perhaps, British individualism). However, the medical 'establishment' (as represented, for example, by the British Medical Association) has been slow to consider the possible advantages of such treatments and the majority of the population still tends to regard them with suspicion. Homeopathic medicine, for example, is not as widely available in chemists as it is in some other countries in northwestern Europe. One of the few alternative treatments to have originated in Britain are the Bach flower remedies.
QUESTIONS
1 In Britain, the only people who can choose
whether or not to pay national insurance contributions are the self-employed. More and more of them are choosing not to do so. Why do you think this is?
2 Would you say that the balance in Britain between welfare provided by the state and welfare offered by charities is different from that in your country? In Britain, does the balance appear to be a stable one, or is it shifting in favour of one or the other? Is the same true in your country?
3 From your reading of this chapter do you think that the British welfare state is successful in giving help to everybody who needs it? How many and what kinds of people do you think 'slip through the net' of care?
4 What, according to this chapter, are the main problems of the welfare state in modern Britain? Are similar problems encountered in your country? What solutions have been suggested or tried in Britain? Do you think they are the right ones?
5 How does the general status and public image of nurses in Britain compare with that of nurses in your country?
Almost everybody in Britain dreams of living in a detached house;
that is, a house which is a separate building. The saying, 'An English man's home is his castle* is well-known. It illustrates the desire for privacy and the importance attached to ownership which seem to be
at the heart of the British attitude to housing.
Houses, not flats
A large, detached house not only ensures privacy. It is also a status symbol. At the extreme end of the scale there is the aristocratic 'stately home' set in acres of garden. Of course, such a house is an unrealistic dream for most people. But even a small detached house surrounded by garden, gives the required suggestion of rural life which is dear to the hearts of many British people. Most people would be happy to live in a cottage, and if this is a thatched cottage, reminiscent of a pre-industrial age, so much the better.
Most people try to avoid living in blocks of flats (what the Americans call 'apartment blocks'). Flats, they feel, provide the least amount of privacy. With a few exceptions, mostly in certain locatior in central London, flats are the cheapest kind of home. The people who live in them are those who cannot afford to live anywhere else,
The dislike of living in flats is very strong. In the 1950s millions c poorer people lived in old, cold, uncomfortable nineteenth century houses, often with only an outside toilet and no bathroom. During the next twenty years many of them were given smart new 'high rise' blocks of flats to live in which, with central heating and bathrooms, were much more comfortable and were surrounded by grass open spaces. But people hated their new homes. They said they felt cut off from the world all those floors up. They missed the neigh-bourliness. They couldn't keep a watchful eye on their children playing down there in those lovely green spaces. The new high-rise blocks quickly deteriorated. The lifts broke down. The lights in the corridors didn't work. Windows got broken and were not repaired. There was graffiti all over the walls.
A thatched cottage: an idealized country ret
175 Houses,not flats
In theory (and except for the difficulty "with supervising children), there is no objective reason why these high-rise blocks (also known as 'tower blocks') could not have been a success. In other countries millions of people live reasonably happily in flats. But in Britain they were a failure because they do not suit British attitudes. The failure has been generally recognized for several years now. No more high-rises are being built. At the present time, only 4% of the population live in one. Only 20% of the country's households live in flats of any kind.
The most desirable home:
a detached house
The photo is from a builder's advertisement. Notice:
* the 'traditional' building materials of brick (the walls) and slate (the roof);
* the irregular, 'non-classical', shape, with all those little corners, making the house feel 'cosy' (see main text);
* the suggestion of a large front garden with a tree and bushes, evoking not
only the countryside but also giving greater privacy;
• that the garage (on the left) is hidden discretely away, so that it is not too obvious and doesn't spoil the rural feeling;
• that the front door is not even in the picture (the privacy criterion at work again).
