February 1974 United Kingdom general election
The February 1974 United Kingdom general election was held on the 28th day of that month. The Labour Party, led by former Prime Minister Harold Wilson made moderate gains, but was short of an overall majority; the Conservative Party, led by incumbent Edward Heath lost 37 seats, but achieved a higher share of the vote than Labour. This resulted in a hung parliament, Wilson became Prime Minister for a second time after Heath resigned due to being unable to form a coalition. Labour won 301 seats, 17 short of a majority; this election saw Northern Ireland diverging from the rest of the United Kingdom, with all twelve MPs elected being from local parties, following the decision of the Ulster Unionists to withdraw support from the Conservative Party in protest over the Sunningdale Agreement. The Scottish National Party achieved significant success in this election, they increased their share of the popular vote in Scotland from 11% to 22% and their number of MPs rose from 1 to 7. There were the first Plaid Cymru MPs to be elected in a general election in Wales.
Although the incumbent Conservative government of Edward Heath polled the most votes by a small margin, the Conservatives were overtaken in terms of seats by Harold Wilson's Labour Party due to a more efficiently-distributed Labour vote, the decision by Ulster Unionist MPs not to take the Conservative whip. The two largest parties both lost a considerable share of the popular vote to the Liberals under Jeremy Thorpe who polled two and a half times the share of the national vote that they had achieved in the previous election, but with over six million votes, only 14 Liberal MPs were elected. There had been some media expectation. Heath did not resign as Prime Minister. Assuming that Northern Ireland's Unionist MPs could be persuaded to support a Conservative government on confidence matters over one led by Wilson, he entered into negotiations with Thorpe to form a coalition government. Thorpe, never enthusiastic about supporting the Conservatives, demanded major electoral reforms in exchange for such an agreement.
Unwilling to accept such terms, Heath resigned and Wilson returned for his second stint as Prime Minister of the United Kingdom. Labour did not have enough seats to combine with another party to achieve an overall majority; this made the formation of a stable government in this Parliament a practical impossibility. Wilson was expected from the outset to call another general election before long, this happened in October that year; the election night was covered live on the BBC, was presented by Alastair Burnet, David Butler, Robert McKenzie and Robin Day. Prominent members of Parliament who retired or were defeated at this election included Gordon Campbell, Bernadette McAliskey, Enoch Powell, Richard Crossman, Tom Driberg and Patrick Gordon Walker, it was the first of two United Kingdom general elections held that year, the first election to take place after the United Kingdom became a member of the European Communities on 1 January 1973 and the first election since the Second World War not to produce an overall majority in the House of Commons for the winning party.
On Thursday 7 February it was announced that Prime Minister Edward Heath had asked the Queen, in New Zealand for the 1974 British Commonwealth Games at the time, to dissolve Parliament, in order for a general election to take place on 28 February. The severe economic circumstances in which the election was held promoted both The Sun and the Daily Mirror to characterise it as a "crisis election". On 10 February the National Union of Mineworkers, went on strike. Jim Prior wrote that the miners had been "as quiet and well-behaved as mice"; the three-day week continued throughout the election. The low profile of the miners' strike allowed worries over inflation to dominate the election. On 15 February it was announced that the Retail Price Index showed a 20% increase in prices over the previous year. On 21 February the Pay Board released a report on miners' pay, which unexpectedly revealed that they were paid less in comparison with other manufacturing workers, contrary to the claims of the National Coal Board.
This came as a severe blow to the Conservative position, led to accusations that the National Coal Board did not understand its own pay system and the strike was unnecessary. Four days there was further bad news for Heath and his party, with the latest trade figures showing that the current account deficit for the previous month had been £383 million—the worst in recorded history. Heath claimed the figures confirmed "the gravity of the situation" and the need for a new mandate, prompting Roy Jenkins to quip: "He thinks a still worse result would have given him a still stronger claim."One of the most unexpected and explosive events of the campaign was when the outspoken Conservative MP Enoch Powell, who had announced that he could not stand for re-election on the Conservative manifesto, urged people to vote against Heath, because of the latter's policy toward the European Economic Community. In a speech in Birmingham on 23 February, Powell claimed the main issue in the campaign was whether Britain was to "remain a democratic nation... or whether it will become one province in a new Europe super-state".
Healthcare in Greater Manchester
10 Clinical Commissioning Groups - one for each of Greater Manchester's metropolitan boroughs - organise the delivery of NHS services within Greater Manchester. The chief executive of the corresponding local authorities are to take over the CCG accountable officer role on a phased dual basis, forming a “single commissioning function” integrated with local government; the Manchester Joint Hospitals Advisory Board was created in 1935 and reconstituted as the Manchester and Stretford Joint Hospitals Advisory Board in 1942. It included representatives of the Public Health Committee, the Hospital Council, Manchester University and the Medical Officer of Health. Harry Platt pioneered the development of Orthopedic surgery in Manchester in the 1930s and the joint board built a new orthopaedic block at Manchester Royal Infirmary in 1936, seen as a national example for effective coordination between the voluntary and statutory sectors; the North West Emergency Medical Service was run on a regional basis, not the case in other areas.
From 1947 to 1974 NHS services in Greater Manchester were managed by the Manchester Regional Hospital Board, which covered the boroughs of Buxton and Glossop and the urban districts of New Mills and Whaley Bridge. The first chair of the Board was Sir John Stopford Vice Chancellor of Manchester University. In 1974 the Boards were replaced by Regional Health Authorities; the whole of the newly created Greater Manchester came under the North Western RHA. Regions were reorganised in 1996 and Greater Manchester came under the North West Regional Health Authority. Greater Manchester from 1974 had 12 District health authorities, one for each of the smaller boroughs and three covering Manchester itself; the District Health Authorities took over responsibility for many of the health services managed by local authorities including vaccination, health centres, family planning, school health, health visiting and home nursing. In 1994 4 new District health authorities were established covering Bury and Rochdale, West Pennine and Trafford, while Wigan was unchanged.
12 Primary care trusts were established covering the whole of the county in 2002: Ashton and Wigan. They were managed by the Greater Manchester Strategic Health Authority until 2006 and by the North West SHA from 2002 until 2013; the CCGs took on the responsibilities of the former PCTs on 1 April 2013. The three clinical commissioning groups for Manchester decided in September 2016 that they would merge in April 2017; the North West Commissioning support unit's work was transferred to Greater Manchester Support Services, hosted by Oldham Clinical Commissioning Group in 2016. Greater Manchester was one of the 4 areas chosen to trial the integration of specialised commissioning run by NHS England centrally, in September 2016. In 2017 Trafford, Wigan and Oldham agreed to effective mergers with the council’s social care departments. Although they will still exist as statutory bodies the council chief executives will take over the CCG accountable officer role; this has happened in Tameside. Manchester Health and Care Commissioning has been established through a partnership agreement between Manchester City Council and the CCG, although it has its own accountable officer.
The Tameside CCG still includes Glossop, not, as far as local government is concerned, in Greater Manchester, but has been part of the Manchester health economy since 1947. The decision made in July 2015 about acute surgery in Greater Manchester taken by the 12 CCGs with the support of the 10 local authorities was explicitly determined by the interests of patients in High Peak. There were 486 general practices in Greater Manchester in 2018. About 3 million patients are registered. Hope Citadel Healthcare in Oldham was found to be outstanding by the Care Quality Commission in 2016. There are more than 700 community pharmacies. Out-of-hours services are provided by GO To DOC in Manchester and Oldham, Salford Royal NHS Foundation Trust in Salford, Bolton NHS Foundation Trust in Bolton, Bardoc in Bury and Rochdale, Mastercall in Stockport and Trafford and Bridgewater Community Healthcare NHS Foundation Trust in Wigan. Community care is provided by the hospital trusts in Manchester, Tameside Bridgewater Community Healthcare NHS Foundation Trust.
Hospice care is provided by St Ann's Hospice. A programme which provided more than 50,000 extra GP appointments in central Manchester and Heywood and Middleton in 2014 brought a 3% reduction in accident and emergency activity and is to be rolled out across the conurbation. An investment of £41 million over 4 years was announced in February 2017 which promised access to a GP seven days a week across the conurbation. Healthwatch was set up under the Social Care Act 2012 to act as a voice for patients. There is a Healthwatch for each of the ten boroughs. J Lancelot Burn was appointed Medical Officer of Health for Salford in 1941. Mental health was one of his priorities and he was unusual in his view that the community, rather than an institution, was the natural care environment, he developed community resources including a therapeutic social club, a women’s day centre and collaboration with the University of Manchester’s Department of Social and Preventive Medicine. He appointed Mervyn Susser to be head of Salford City Council's mental health department in 1957.
Susser organised Mental Welfare Officers around GP practices so that each GP had a known officer and sent copies of patients’ progress reports to their GP. He appointed Hugh Freeman
Health and Social Care Act 2012
The Health and Social Care Act 2012 is an Act of the Parliament of the United Kingdom. It provides for the most extensive reorganisation of the structure of the National Health Service in England to date, it removed responsibility for the health of citizens from the Secretary of State for Health, which the post had carried since the inception of the NHS in 1948. It abolished NHS primary care trusts and Strategic Health Authorities and transferred between £60 billion and £80 billion of "commissioning", or health care funds, from the abolished PCTs to several hundred "clinical commissioning groups" run by the general practitioners in England but a major point of access for private service providers. A new executive agency of the Department of Health, Public Health England, was established under the Act on 1 April 2013; the proposals are the result of policies of the Secretary of State for Health, Andrew Lansley. Writing in the BMJ, Clive Peedell compared the policies with academic analyses of privatisation and found "evidence that privatisation is an inevitable consequence of many of the policies contained in the Health and Social Care Bill".
Lansley said that claims that the government is attempting to privatise the NHS are "ludicrous scaremongering". The proposals contained in the Act are some of the coalition government's most controversial. Although glanced at in the Conservative Party's manifesto in 2010, they were not discussed during the general election campaign that year and were not contained in the Conservative–Liberal Democrat coalition agreement, which mentioned the NHS only to commit the coalition to a real-term funding increase every year. Within two months of the election a white paper was published, outlining what the Daily Telegraph called the "biggest revolution in the NHS since its foundation"; the bill was introduced in the House of Commons on 19 January 2011. In April 2011 the government announced a "listening exercise", halting the Bill's legislative progress until after the May local elections; the "listening exercise" finished by the end of that month. The Bill received Royal Assent on 27 March 2012; the proposals in the Act were not discussed during the general election campaign in 2010 and were not contained in the Conservative – Liberal Democrat coalition agreement of 20 May 2010, which declared an intention to "stop the top-down reorganisations of the NHS that have got in the way of patient care".
However, within two months a white paper outlined what the Daily Telegraph called the "biggest revolution in the NHS since its foundation". The white paper and Excellence: Liberating the NHS, was followed in December 2010 by an implementation plan in the form of Liberating the NHS: legislative framework and next steps. McKinsey & Company who have been influential in the British Department of Health for many years was involved in the discussions around the Bill; the bill was introduced into the House of Commons on 19 January 2011 and received its second reading, a vote to approve the general principles of the Bill, by 321-235, a majority of 86, on 31 January 2011. The Act had implications for the entire NHS. NHS primary care trusts and Strategic Health Authorities were abolished, with projected redundancy costs of £1 billion for around 21,000 staff. £60 to £80 billion worth of commissioning will be transferred from PCTs to several hundred clinical commissioning groups run by GPs. Around 3,600 facilities owned by PCTs and SHAs will transfer to NHS Property Services, a limited company owned by the Department of Health.
When the white paper was presented to Parliament the Secretary of State for Health, Andrew Lansley, told MPs of three key principles: patients at the centre of the NHS changing the emphasis of measurement to clinical outcomes empowering health professionals, in particular GPs. The white paper set out the following timetable. By April 2012 it proposed to: establish the independent NHS Commissioning Board establish new local authority health and well-being boards develop Monitor as an economic regulator; the Bill foresaw all NHS trusts becoming, or being amalgamated into, foundation trusts. The Bill abolished the existing cap on trusts' income from non-NHS sources, which in most cases was set at a low single-digit percentage. Under the Bill's provisions the new commissioning system would be expected to be in place by April 2013, by which time SHAs and PCTs would be abolished; the Bill was analysed by Stephen Cragg of Doughty Street Chambers, on behalf of the 38 Degrees campaign, who concluded that "Effectively, the duty to provide a national health service would be lost if the Bill becomes law, would be replaced by a duty on an unknown number of commissioning consortia with only a duty to make or arrange provision for that section of the population for which it is responsible."
It replaces a “duty to provide” with a “Duty to promote”. After an increase in opposition pressure, including from both rank-and-file Liberal Democrats and the British Medical Association, the government announced a "listening exercise" with critics. On 4 April 2011 the government announced a "pause" in the progress of the Bill to allow the government to'listen and improve' the proposals; the Prime Minister, David Cameron, said "the status quo is not an option" and many within his and Nick Clegg's coalition said that certain aspects of the Bill, such as the formation of Clinical commissioning groups, were not only not open for discussion, but already too far along the path to completion to be stopped. Cameron insisted that the Act was part of his "Big Society" agenda and that it would not alter the fundamental principles of the NHS. Part of the "listening exercise" saw th
The BMJ is a weekly peer-reviewed medical journal. It is one of the world's oldest general medical journals. Called the British Medical Journal, the title was shortened to BMJ in 1988, changed to The BMJ in 2014; the journal is published by the global knowledge provider BMJ, a wholly owned subsidiary of the British Medical Association. The editor in chief of The BMJ is Fiona Godlee, appointed in February 2005; the journal began publishing on 3 October 1840 as the Provincial Medical and Surgical Journal and attracted the attention of physicians around the world through its publication of high-impact original research articles and unique case reports. The BMJ's first editors were P. Hennis Green, lecturer on the diseases of children at the Hunterian School of Medicine, its founder and Robert Streeten of Worcester, a member of the PMSA council; the first issue of the British Medical Journal was 16 pages long and contained three simple woodcut illustrations. The longest items were the editors' introductory editorial and a report of the Provincial Medical and Surgical Association's Eastern Branch.
Other pages included a condensed version of Henry Warburton's medical reform bill, book reviews, clinical papers, case notes. There were 2 1⁄2 columns of advertisements. Inclusive of stamp duty it cost 7d, a price which remained until 1844. In their main article and Streeten noted that they had "received as many advertisements for our first number, as the most popular Medical Journal, after seventeen years of existence."In their introductory editorial and statements and Streeten defined "the main objects of promotion of which the Provincial Medical and Surgical Journal is established". Summarised, there were two clear main objectives: the advancement of the profession in the provinces and the dissemination of medical knowledge. Green and Streeten expressed interest in promoting public well-being as well as maintaining'medical practitioners, as a class in that rank of society which, by their intellectual acquirements, by their general moral character, by the importance of the duties entrusted to them, they are justly entitled to hold'.
The BMJ published the first centrally randomised controlled trial. The journal carried the seminal papers on the causal effects of smoking on health and lung cancer and other causes of death in relation to smoking. For a long time, the journal's sole competitor was The Lancet based in the UK, but with increasing globalisation, The BMJ has faced tough competition from other medical journals The New England Journal of Medicine and the Journal of the American Medical Association; the BMJ is an advocate of evidence-based medicine. It publishes research as well as clinical reviews, recent medical advances, editorial perspectives, among others. A special "Christmas Edition" is published annually on the Friday before Christmas; this edition is known for research articles which apply a serious academic approach to investigating less serious medical questions. The results are humorous and reported by the mainstream media; the BMJ has an open peer review system. About half the original articles are rejected after review in-house.
Manuscripts chosen for peer review are first reviewed by external experts, who comment on the importance and suitability for publication, before the final decision on a manuscript is made by the editorial committee. The acceptance rate is less than 7% for original research articles; the BMJ is included in the major indexes PubMed, MEDLINE, EBSCO, the Science Citation Index. The journal has long criticised the misuse of the impact factor to award grants and recruit researchers by academic institutions; the five journals that as of 2008 have cited The BMJ most are The BMJ, Cochrane Database of Systematic Reviews, The Lancet, BMC Public Health, BMC Health Services Research. As of 2008, the five journals that have been cited most by articles published in The BMJ are The BMJ, The Lancet, The New England Journal of Medicine, Journal of the American Medical Association and Cochrane Database of Systematic Reviews. In the 2018 Journal Citation Reports, The BMJ's impact factor was 23.295 in 2017, ranking it fourth among general medical journals.
According to the Web of Science, the following articles have been cited the most often: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. "Establishing a standard definition for child overweight and obesity worldwide: international survey". BMJ. 320: 1240–3. Doi:10.1136/bmj.320.7244.1240. PMC 27365. PMID 10797032. "Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, stroke in high risk patients". BMJ. 324: 71–86. January 2002. Doi:10.1136/bmj.324.7329.71. PMC 64503. PMID 11786451. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. "Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study". BMJ. 321: 405–12. Doi:10.1136/bmj.321.7258.405. PMC 27454. PMID 10938048; as of 2014, the most viewed article on The BMJ website is: Schultz WW, van Andel P, Sabelis I, Mooyaart E. "Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal".
BMJ. 319: 1596–600. Doi:10.1136/bmj.319.7225.1596. PMC 28302. PMID 10600954. In 1974, Dr. Elaine Murphy submitted a brief case report under her husband's name John which suggested a condition known as Cello Scrotum, a fictional condition which affected male ce