蘇州大學勞動與社會保障專業(yè)專業(yè)英語（內部資料）Professional English

1、Professional English Social AcademyWu Rao12022/9/12Social Insurance And Allied Services Report by Sir William Beveridge2022/9/13Authors IntroductionWilliam H. Beveridge（貝弗里奇）1909-1916年 勞工介紹所所長1919-1937年 倫敦經(jīng)濟學院院長1941年 受戰(zhàn)時內閣委托，負責起草戰(zhàn)后福利制度框架1942年 提交社會保險及相關服務被尊稱為“福利國家之父”2022/9/14貝弗里奇報告1944年英國戰(zhàn)時內閣發(fā)布社會保險白皮

2、書，基本接受了貝弗里奇報告的建議1945年工黨領袖艾德禮承諾實施該報告，擊敗丘吉爾，贏得大選1948年英國首相艾德禮宣布建成福利國家瑞典、芬蘭、挪威、法國、意大利等相繼效仿，二戰(zhàn)結束后在希特勒地堡中發(fā)現(xiàn)該報告及其評注2022/9/15General frameworkPart 1 Introduction and summary(19)Part 2 The principal changes Proposed and their reasons(63)Part 3 Three special problems(32)Part 4 The social security budget(20)Pa

3、rt 5 Plan for social security(39)Part 6 Social security and social policy(22)2022/9/16Part 1 Introduction and summaryThe committees survey and its resultsduty -survey -recommendSupervisor -the inter-departmental committeeOn social insurance and allied services2022/9/17 -Chairman:貝弗里奇 -Members ： 內務部、

4、勞動和兵役部、年金部、衛(wèi)生部、財政部、戰(zhàn)后重建委員會秘書處、關稅與消費稅部、 國民救助委員會、蘇格蘭衛(wèi)生部、 互助會和簡易人壽保險機構登記處的代表， 政府精算師2022/9/18Content -inter-relation of the schemes -a survey of the existing national schemes of social insurance and allied services, including workmens compensation 2022/9/19Survey and resultsThe history of development -P

5、oor Law - Workmens compensation -Pension Act -Unemployment Act -Compulsory health insurance2022/9/110Problems -dealt with separately -conducted by disconnected administrative organs -enact unfairly2022/9/111Three guiding principles of recommendationUse to the full the experience gathered in the past

6、, should not be restricted by consideration of sectional interests established in the obtaining of that experience2022/9/112Organization of social insurance should be treated as one part only of a comprehensive policy of social progress -Want -Disease -Ignorance -Squalor -Idleness2022/9/113Social se

7、curity must be achieved by co-operation between the state and the individual -means test2022/9/114The way to freedom from want Improvement of state insurance Adjustment of incomes2022/9/115Summary of plan for social securityMain feature -social insuranceFundamental principles -flat rate of subsisten

8、ce benefit -flat rate of contribution2022/9/116 -unification of administrative responsibility -adequacy of benefit -comprehensiveness -classificationMain provisions(6)2022/9/117The nature and viewpointBenefit in return for contributionEstablish the FundGive direct assistance to individuals in need20

9、22/9/118起草建議報告的方法英國不管部部長、國會議員格林伍德以戰(zhàn)后重建問題委員會主席的身份任命“部際協(xié)調委員會”及其主席貝弗里奇，并授權：“由于即將討論的議題具有很強的政策性，因此你可以讓這些部委代表在他們各自擅長的技術和管理領域充當你的顧問和助理，但他們的作用也就僅此而已。這意味著，最終提交的將是你個人的報告，由你單獨簽發(fā)，報告表述的觀點和建議將不受任何部門代表的影響。”最后，貝弗里奇報告也是由議會和內閣批準通過的，各個政府相關部門所起作用非常有限。2022/9/119節(jié)約行政的典范總共花了4625英鎊，其中，大約3150英鎊用于印刷、發(fā)行此報告及各有關單位備忘錄的合訂本2022/9/

10、120ExercisesIn Europe, the first sources of welfare assistance-family, friends, and the community-provided mutual aid. In time of need, the only recourse was this reliance on one another. If a familys food crop failed or the breadwinner became ill and unable to work, brothers, sisters, or2022/9/121

11、neighbors pitched in, knowing that they would receive the same assistance should they need it one day. Later, it became the duty of the church and of wealthy feudal lords to help the needy. During much of the Middle Ages, emphasis was placed on doing charitable works as a religious duty. -Elizabetha

12、n Poor Law2022/9/122Part 2 The principal changes proposed and their reasons 2022/9/123Change 1 Unification of contributionsIt means one insurance document a year for each of personsTwo effects -go into a social insurance fund -not reconcile with approved society2022/9/124Change 2 Unification of admi

13、nistrationThe main advantages (five points)It does not mean that the citizen must obtain all benefits in the same way or from the same place - Can obtain from voluntary or approved society -also obtain from industry insurance2022/9/125Change 3 Supersession of the present system of Approved Societies

14、 giving unequal benefits for equal compulsory contributions2022/9/126Approved societyConditions -financially and autonomous -charge with national health insurance in 19112022/9/127 Qualification -should not be conducted for profit -Its constitution should provide for its affairs being subject to the

15、 absolute control of its members2022/9/128Operation -If surplus, members will be given additional benefits, If deficiency, will notTypes -Friendly Societies with branches -Friendly societies without branches -Industrial Life Offices -Trade Union -Employers Provident Fund 2022/9/129Scale -About 800,

16、but some of these have branches which are separate financial units is about 6600 -Its range in membership from under 50 to the 3000 000,or 4000 000 2022/9/130Tendency - Friendly societies without branches and Industrial Life Offices are upgrading, others are stagnating even or declining2022/9/131The

17、 Disadvantages of Approved SocietyInsured persons are continually liable to change their place of work and residenceReduce charges on its own fund and referring any doubtful claims to some agencyDifferent procedures for determination of claims, different and often not well-known2022/9/132 as to appe

18、als, and different principles of decisionWithout systematic guidance through government when chose the society2022/9/133The advantage of approved societyIf in addition to the benefits of compulsory and the voluntary insurance he wishes to increase his provision against sickness by voluntary insuranc

19、e through a society giving sickness benefit, it is possible for him to obtain both the compulsory and the voluntary benefit through the same source2022/9/134Combination of compulsory health insurance with voluntary insurance for other purposes, such as sickness benefit through a Friendly Society or

20、Trade Union or funeral expenses through an Industrial Life Office, may make it possible for the combined insurance to be administrated at lower cost than if each was dealt with by a separate organization2022/9/135Reform proposalsTo maintain the policy of a National MinimumTo suppresses approved soci

21、etySet new basis for co-operation between state and Friendly society Charged by the Ministry of Social SecurityQualified to provide service( five points) 2022/9/136Industrial Life Office can not be included in compulsory insurance In any case, the state can not participate in voluntary insurance by

22、directly or indirectly2022/9/137Change 4Supersession of workmens compensation The history of workmens compensation The disadvantage of workmens compensation system2022/9/138Change 5 Separation of medical treatment from the administration of cash benefits and setting up of a comprehensive medical ser

23、vice for every citizen, covering all treatment and every form of disability under the supervision of the Health Department2022/9/139 National Health Service (NHS) The National Health Service is the collective name given to the four public health services of England, Scotland, Wales and Northern Irel

24、and as well as being the name of Englands NHS. 2022/9/140It was created in England and Wales by the National Health Service Act 1946, and in Scotland by the National Health Service (Scotland) Act 1947. In 1969, responsibility for the NHS in Wales was passed to the Secretary of State for Wales from t

25、he Secretary of State for Health who was thereafter just responsible for the NHS in England.2022/9/141PrehistoryBefore the National Health Service was created in 1948, patients were generally required to pay for their health care. Free treatment was sometimes available from teaching hospitals and ch

26、arity hospitals, such as the Royal Free Hospital. 2022/9/142Some local authorities operated local hospitals for local ratepayers (under a system originating with the Poor Law). Systems of health insurance usually consisted of private schemes such as Friendly Societies. 2022/9/143Under the National I

27、nsurance Act 1911, introduced by David Lloyd George, a small amount was deducted from weekly wages, to which was added contributions from the employer and the government.2022/9/144In return for the record of contributions, the workman was entitled to medical care (as well as retirement and unemploym

28、ent benefits) though not necessarily to the drugs prescribed.2022/9/145To obtain medical care, he registered with a doctor. Each doctor who participated in the scheme thus had a panel of those have made an insurance under the system, and was paid a capitation grant out of the fund calculated upon th

29、e number. (Lloyd Georges name survives in the Lloyd George envelopes in which most primary care records in England are stored, although today some working records in primary care are at least partially computerised). 2022/9/146This imperfect scheme only covered certain trades and occupations, and wa

30、s known as Lloyd Georges Ambulance Wagon. Moreover, due to cuts during the 1930s, many were unable to obtain treatment.2022/9/147Birth of the NHS In the aftermath of the Second World War, Clement Attlees Labour government created the NHS, based on the proposals of the Beveridge Report prepared in 19

31、42. 2022/9/148A White Paper was published in 1943 and was followed by considerable debate, and resistance organised by the British Medical Association, though in the final BMA ballot in May 1948, GPs and hospital doctors in Scotland voted in favour while their counterparts in England remained agains

32、t the new service2022/9/149The structure of the NHS in England and Wales was established by the National Health Service Act 1946 and in Scotland by the National Health Service (Scotland) Act 1947, with the new arrangements throughout the UK being launched on 5 July 1948. 2022/9/150This was driven by

33、 health and housing minister Aneurin Bevan, though he himself had responsibility for England and Wales, with the Secretary of State for Scotland having responsibility for NHS Scotland. The founding principles of the NHS called for its funding out of general taxation and not through national insuranc

34、e.2022/9/151Services would henceforth be provided by the same doctors and the same hospitals, but:services were provided free at the point of useservices were financed from central taxationeveryone was eligible for care (even people temporarily resident or visiting the country)2022/9/152Development

35、of the NHS The original structure of the NHS in England and Wales had three aspects, known as the tripartite system: (1)Hospital Services - 14 Regional Hospital Boards were created in England and Wales to administer the majority of hospital services. 2022/9/153 Beneath these were 400 Hospital Manage

36、ment Committees which administered hospitals. Teaching hospitals had different arrangements and were organised under Boards of Governors.2022/9/154 (2) Primary Care - GPs were independent contractors (that is they were not salaried employees) and would be paid for each person on their list. Dentists

37、, opticians and pharmacists also generally provided services as independent contractors. 2022/9/155Executive Councils were formed and administered contracts and payments to the contractor professions as well as maintaining lists of local practitioners and dealing with patient complaints. 2022/9/156C

38、ommunity Services - Maternity and Child Welfare clinics, health visitors, midwives, health education, vaccination & immunisation and ambulance services together with environmental health services were the responsibility of local authorities. This was a continuation of the role local government had h

39、eld under the Poor Law. 2022/9/157The 1970s also saw the end of the economic optimism which had characterised the 1960s and increasing pressures coming to bear to reduce the amount of money spent on public services and to ensure increased efficiency for the money spent2022/9/158Through the 1970s and

40、 1980s, it became clear that the NHS would never get the resources necessary to provide unlimited access to the latest medical treatments, especially in the context of an ageing population. This led to the beginning of a major process of reform, starting about 1980, which is still continuing in 2006

41、2022/9/159Reforms under the Thatcher governmentThe 1980s saw the introduction of modern management processes (General Management) in the NHS to replace the previous system of consensus management. This was outlined in the Griffiths Report of1983.2022/9/160This recommended the appointment of general

42、managers in the NHS with whom responsibility should lie. The report also recommended that clinicians be better involved in management. 2022/9/161 Financial pressures continued to place strain on the NHS. In 1987, an additional 101 million was provided by the government to the NHS. In 1988 the then P

43、rime Minister, Margaret Thatcher, announced a review of the NHS. 2022/9/162From this review and in 1989, two white papers Working for Patients and Caring for People were produced. These outlined the introduction of what was termed the internal market, which was to shape the structure and organisatio

44、n of health services for most of the next decade2022/9/163In 1990, the National Health Service & Community Care Act defined this internal market, whereby Health Authorities ceased to run hospitals but purchased care from their own or other authorities hospitals. 2022/9/164Certain GPs became fund hol

45、ders and were able to purchase care for their patients. The providers became independent trusts, which encouraged competition but also increased local differences.2022/9/165The Blair governments reformThese innovations, especially the fund holder option, were condemned at the time by the Labour Part

46、y. Opposition to what was claimed to be the Conservative intention to privatise the NHS became a major feature of Labours election campaigns.2022/9/166Labour came to power in 1997 with the promise to remove the internal market and abolish fundholding. In a speech given by the new Prime Minister, Ton

47、y Blair, at the Lonsdale Medical Centre on 9th December 1997, he stated that:2022/9/167The White Paper we are publishing today marks a turning point for the NHS. It replaces the internal market with integrated care. We will put doctors and nurses in the driving seat. The result will be that 1 billio

48、n of unnecessary red tape will be saved and the money put into frontline patient care2022/9/168For the first time the need to ensure that high quality care is spread throughout the service will be taken seriously. National standards of care will be guaranteed. 2022/9/169There will be easier and swif

49、ter access to the NHS when you need it. Our approach combines efficiency and quality with a belief in fairness and partnership. Comparing not competing will drive efficiency2022/9/170However in his second term Blair renounced this direction. He pursued measures to strengthen the internal market as p

50、art of his plan to modernise the NHS2022/9/171Driving these reforms have been a number of factors. They include the rising costs of medical technology and medicines, the desire to increase standards and patient choice, an ageing population, and a desire to contain government expenditure2022/9/172Sin

51、ce the National Health Services in Wales, Scotland and Northern Ireland are not controlled by the UK government, these reforms have increased the differences between the National Health Services in different parts of the United Kingdom2022/9/173Reforms have included (amongst other actions) the layin

52、g down of detailed service standards, strict financial budgeting, revised job specifications, reintroduction of fundholding ,closure of surplus facilities and emphasis on rigorous clinical and corporate governance2022/9/174In addition medical training has undergone an unsuccessful restructuring whic

53、h was so badly managed that the Secretary of State for Health was forced to apologise publicly. 2022/9/175Change 6 Recognition of housewives as a distinct insurance class of occupied persons with benefits adjusted to their special needs, including (a) in all cases marriage grant, maternity grant, wi

54、dowhood and separation provisions and retirement pensions; 2022/9/176 (b) if not gainfully occupied, benefit during husbands unemployment or disability (c) if gainfully occupied, special maternity benefit in addition to grant, and lower unemployment and disability benefits, accompanied by abolition

55、of the Anomalies Regulations for Married Women2022/9/177Change 7 Extension of insurance against prolonged disability to all persons gainfully occupied and of insurance for retirement pensions to all persons of working age, whether gainfully occupied or not2022/9/178Change 9 Assimilation of benefit a

56、nd pension rates for unemployment, disability, other than prolonged disability due to industrial accident or disease, and retirement2022/9/179Change 10 Assimilation of benefit conditions for unemployment and disability, including disability due to industrial accident or disease, in respect of waitin

57、g time2022/9/180Exercise 2Social welfare policy as we know it dates back to the beginning of the seventeenth century in Elizabethan England. English colonists who settled in north America brought with them many English welfare traditions. In the colonies, as in England, the earliest sources of welfare aid for the destitute were families, friends, and churches. 2022/9/181 Later, private charities emerged and local and state governments intervened as a last resort. As t