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|Revision Package: |
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|Principles of Governance |
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|Population |
|Healthcare (Singapore and UK) |
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To what extent is anticipating change and staying relevant the reason for successful governance of Singapore? Explain your answer. [12m]

|Para |Content |
|Para 1 |Singapore’s continued success is dependent on anticipating change and staying relevant to a large extent. However, there are also |
| |other important principles that a government must uphold in order to be successful. It must also follow meritocracy and reward |
|Introduction - |people for their hard work and ability. It must also maintain good and capable leadership. |
|Make your stand. | |
|Para 2 |One of the factors that can contribute to the success of Singapore is for the government to be able to anticipate change and stay |
| |relevant. The government must have foresight. It must anticipate problems before we are affected by the problem and find |
|Explain the given |solutions. For example, our government knew that there is no guarantee that Malaysia will renew the water contract after it |
|principle – |expires. Therefore, the government has come up with backup plans like NEWater and water desalination plants to meet our water |
|Anticipating |demand. By anticipating such change, Singapore need not be dependent on others but be more self-sufficient and handle challenges in|
|Change And Staying|a more effective manner. Another example of staying relevant is Singapore’s decision to built Integrated Resorts. We were willing |
|Relevant. |to take calculated risks & come up with the creative & innovative idea of integrated resorts to capture more tourists who would |
| |otherwise go to nearby places like Genting Highland where casinos are found. Due to this effort to stay relevant, we can overcome |
| |competition from places like Genting Highlands and also create more revenue and jobs for Singapore and Singaporeans. This is one |
| |reason for successful governance of Singapore. |
|Para 3 |Practicing meritocracy and rewarding people for their ability and hard work is another important factor for maintaining the success |
| |of Singapore. For example, Singapore offers education incentives such as Edusave Scholarship and Merit Bursary for best academic |
|Explain another |talents regardless of their race, religion, socio economic background or connection to important people. Another example is the |
|principle – Reward|monetary Progress Package given out to all citizens. This is a way in which the government shares surplus revenue with all citizens|
|for Work |as a form of reward for hard work. Rewarding people for hard work and ability has been instrumental in nurturing talents and |
| |capable leaders who are able to drive the country. Moreover, when people realize that the government is fair and meritocratic in |
| |rewarding hard work, they will be motivation to do their best and contribute towards the good of the country. This is one reason for|
| |successful governance of Singapore. |

|Is “Anticipate Change and Stay Relevant” the most important principle of governance that enables good governance in Singapore? Explain your answer.|
|[12] |
|I agree that “Anticipate Change and Stay Relevant” is the most important principle of governance that enables good governance in Singapore to a |
|small extent. leaders must also be forward looking and have foresight. They must be able to anticipate change and stay relevant. For example, |
|anticipating that Malaysia may not renew our water contract when it expires, our leaders have already come up with NEWater and water desalination |
|plants are also being built. Also anticipating that we may lose our tourist market to neighbouring countries if we do not have casinos in |
|Singapore, our leaders also have decided to built 2 integrated resorts to capture the changing and growing tourist market. If we have such |
|leaders, our country will be stable as we are able to be self-sufficient and able to face competition. Having leaders who are willing to take |
|calculated risks and come up with new creative and innovative ideas can move Singapore towards greater prosperity. Leaders with foresight are also|
|able to anticipate problems before we are affected and find solutions. |
| |
|I think that having morally upright leadership in the government would be the most important principle of governance that enables good governance |
|in Singapore. The government must carefully choose and train leaders. It is important to choose leaders based on talent, ability and character, |
|especially honesty and incorruptibility. They must have the moral courage to make right/ practical/ workable decisions even though they may not be|
|popular. For example the leaders in Singapore made a decision to implement the ERP system even though it was unpopular because they needed to do |
|something about traffic congestions that were getting worse. If we have such leadership, the people will have confidence and respect for the |
|government and this in turn will bring about political stability. Such leadership will also be able to overcome any challenges that may arise and |
|lead Singapore to next stage of development. |
|Lastly, the leaders must also up hold meritocracy. Meritocracy is about recognising and rewarding hard work, talents and ability of people, |
|regardless of race, religion, socio economic background, connection to important people etc. For example, the government rewards the hard work of |
|citizens by the sharing surplus revenue with everyone by means of the Progress Packages given out. Education scholarships and merit bursaries are |
|also given out for best academic talents irregardless of race or religion. When people are rewarded for their hard work and treated fairly, they |
|will be motivated to do their best for the nation. Having meritocracy will also help to nurture good talents and capable leaders who can bring the|
|nation forward. |
|Among the 3 factors discussed, I feel that having morally upright leaders is most important principle of good governance because that is the most |
|basic/ fundamental factor. Morally upright leaders will have the moral courage to make the right decisions and they will also be able to uphold |
|meritocracy. These leaders would also design and implement policies that are sound. They will find ways to engage the people to get their feedback.|
|Therefore, “Leadership is Key” is the most foundation of all the other principles of good governance. |

|Para 4 |It is indeed also very crucial to select good leaders if we want Singapore to continue being successful. We need leaders who have |
|Explain one more |good character traits such as moral courage and integrity. They must be honest and incorruptible. In Singapore, corruption in not |
|principle – Good |tolerated. For example, an official at Spore Embassy in Beijing who was caught for accepting bribes was jailed in 2003. When we |
|Leadership |have incorruptible leaders, the nation’s resources and finances will be used for the good of the nation and the country will be able|
| |to prosper. The people will also support the government as they will gain confidence in the government and have respect for the |
| |government. The leaders must also be able to make right and practical decisions even though they may not be popular. For example, |
| |our leaders enforced the vehicle quota system even though it was very unpopular. However, it was the right decision which managed |
| |to control traffic congestion in Singapore. When we have such leaders who are able to make right decisions, there will be stability|
| |in country and we will be able to solve problem effectively. This is one reason for successful governance of Singapore. |
|Para 5 |Among the 3 principles discussed, I feel that Good Leadership would be the most crucial for continued success of Singapore. If we |
|Weight the |have good leaders, they would surely have the capacity to anticipate change and value the importance of staying relevant. |
|relative |Similarly, good and honest leaders are also needed to reward hard work and practise meritocracy. Good leadership is the basic |
|importance of the |foundation of the government and with this, other aspects of good governance would fall in place naturally. |
|3 principles of | |
|governance and say| |
|which is most | |
|crucial for | |
|success. | |

Adapted from Siglap Secondary School 4E5N Prelims 2010

To what extent is Singapore’s stability dependent on having morally upright leaders in the government? Explain your answer. [12m]

|Para |Content |
|Para 1 |To ensure the stability of the nation, the government has to be guided by sound principles such as having good |
| |leadership, being forward looking and upholding meritocracy. Among these I think having morally upright leadership in |
|Introduction - |the government would be most critical for the stability of the nations. |
|Make your stand. | |
|Para 2 |To sustain stability, the government must carefully choose and train leaders. It is important to choose leaders based |
| |on talent, ability and character, especially honesty and incorruptibility. They must have the moral courage to make |
|Explain Given |right/ practical/ workable decisions even though they may not be popular. For example the leaders in Singapore made a |
|Factor – Morally |decision to implement the ERP system even though it was unpopular because they needed to do something about traffic |
|Upright Leaders. |congestions that were getting worse. If we have such leadership, the people will have confidence and respect for the |
| |government and this in turn will bring about political stability. Such leadership will also be able to overcome any |
| |challenges that may arise and lead Singapore to next stage of development. |
|Para 3 |Other then being morally upright, leaders must also be forward looking and have foresight. They must be able to |
| |anticipate change and stay relevant. For example, anticipating that Malaysia may not renew our water contract when it |
|Explain another |expires, our leaders have already come up with NEWater and water desalination plants are also being built. Also |
|factor – Forward |anticipating that we may lose our tourist market to neighbouring countries if we do not have casinos in Singapore, our |
|Looking Leaders. |leaders also have decided to built 2 integrated resorts to capture the changing and growing tourist market. If we have |
| |such leaders, our country will be stable as we are able to be self-sufficient and able to face competition. Having |
| |leaders who are willing to take calculated risks and come up with new creative and innovative ideas can move Singapore |
| |towards greater prosperity. Leaders with foresight are also able to anticipate problems before we are affected and find|
| |solutions. |

|Para 4 |Lastly, the leaders must also up hold meritocracy. Meritocracy is about recognising and rewarding hard work, talents |
| |and ability of people, regardless of race, religion, socio economic background, connection to important people etc. For|
|Explain one more |example, the government rewards the hard work of citizens by the sharing surplus revenue with everyone by means of the |
|factor – Leader |Progress Packages given out. Education scholarships and merit bursaries are also given out for best academic talents |
|Upholding |irregardless of race or religion. When people are rewarded for their hard work and treated fairly, they will be |
|Meritocracy. |motivated to do their best for the nation. Having meritocracy will also help to nurture good talents and capable |
| |leaders who can bring the nation forward. |
|Para 5 |Among the 3 factors discussed, I feel that having morally upright leaders is most critical for stability because that is|
|Weigh the relative|the most basic/ fundamental factor. Morally upright leaders will have the moral courage to make the right decisions and|
|impact of the 3 |they will also be able to uphold meritocracy. |
|methods and say | |
|which is more | |
|important for | |
|stability of | |
|nation. | |

How far is pro-family policy the most effective way of solving the manpower shortage in Singapore? Explain your answer. [12m]

|Introduction |I agree to a small extent that pro-family policy is the most effective way of solving the manpower shortage in|
| |Singapore. Since the 1980s, the Singapore government has tried various ways to manage the problem of manpower |
| |shortage. Some of these measures include pro-family measures, foreign talent policy, and the extension of |
| |retirement age. I feel that the foreign talent policy is the most successful so far. |
|Given factor |To promote more births in Singapore, the government ‘Have 3 or More if you can afford it’ policy allowed |
| |couples can use their Medisave to pay for the delivery charges of the first 3 children. This scheme was |
| |slightly successful and led to a slight increase in population between 1986 and 1988, from 1.48 in 1986 to |
| |1.96 in 1988. Part of this was due to 1988 being the Dragon Year which Chinese consider as an auspicious year |
| |for having babies. However, this was still below our replacement target of 2.1. So, pro-family incentives in |
| |2004 such as income tax relief, working mother subsidy to families with up to 4 children and a 5 day working |
| |week, were introduced to attract some couples to have more babies. In 2004, Singapore recorded one of the |
| |lowest fertility rates among developing countries. Hence, although many measures were rolled out, the 3 child|
| |policy did not really help to promote a credible increase in population. |
|Second factor |The second strategy is to promote the foreign talent policy. The policy is more successful with foreigners |
| |contributing to 1% of the 2.8% population growth in 2000. Relaxing immigration policy and providing subsidised|
| |housing and education package made it easier for foreign talents to live and work in Singapore. By making it |
| |easier for foreigners to work and live in Singapore, the government hoped that some of these individuals would|
| |develop an attachment to the nation and take up permanent citizenship or residence. This did help to increase |
| |the country’s population. In fact, the government now hopes to attract more foreigners to make up for the |
| |declining birth rate as Singapore aims to increase its population from 4 million to 6 million. Therefore, |
| |foreign talent policy is success in helping Singapore meet its labour shortage problem. |
|Third factor |The third strategy is to extend retirement age. With the projection that Singapore’s population will age |
| |rapidly over the next 30 years, by 2030, about 19% of the population will be over the age of 65 years. These |
| |people could remain as contributing members to society. With Singaporeans living longer than before because |
| |of improved health and nutrition, bought about the increase in the standard of living and the development of |
| |medical science, the older generation could be encouraged to work longer beyond the age of retirement. While |
| |the retirement age is now set at 62, they encouraged to work beyond the years. In addition, employers are |
| |also encouraged to give opportunities to this group of people as they have valuable skills, knowledge, talent |
| |and work experience, adding value to the any organizations. However, not everyone is keen to work beyond the |
| |retirement age and there is no compulsory law to ensure that these workers continue to stay in the workforce. |
| |Therefore, this strategy is only successful to a small extent. |
|Conclusion |In conclusion, the government measures to increase population after 1980s were largely unsuccessful. After |
| |1988, the number of babies per woman fell steadily to 1.59 in 2000. Despite public campaigns on the joys of |
| |parenthood, married couples opted to have not more than 2 children. These resulted in fewer babies being born |
| |despite the pro-family incentives given after 1980s. So, the policy was largely unsuccessful as it failed to |
| |have any lasting impact on the population growth rate until today. Birth rates continue to dip. Even the baby |
| |bonus scheme of 2001 that gives monetary incentives for giving birth to more children failed to promote |
| |population growth. Extending the retirement age is the least effective as not many of those who have reached |
| |the retirement age have a healthy savings account in the CPF to enjoy their retirement. Hence, working beyond|
| |retirement age may not be attractive for them. Attracting foreign talent is at present the most effective |
| |strategy for Singapore to overcome its manpower needs. With Singapore being an attractive globalised country |
| |to live and set up a family as well as the positive tone established by the government to embrace our |
| |international friends, more foreign talents would like to come to Singapore to make a livelihood. |

Here are three ways in which our far-sighted government has been trying to increase the population of Singapore to sustain its national development:
Financial incentives for larger families
Pro-family measures
Attracting foreign talents

Explain all three methods and conclude which do you think can be the most effective in increasing the population of Singapore and sustaining national development. [13m]

|Para |Content |
|Para 1 |By the late 1980s, the government realised that the population was dwindling and that they needed to do |
|Introduction - Make |something about it if they wanted to sustain its national development. Thus the government came up with many |
|your stand. |strategies including financial incentives for larger families, pro-family measures and even attracting foreign |
| |talents. Among these, I feel that pro-family measure can be most effective in increasing the population of |
| |Singapore. |
|Para 2 |From a 2 child policy, the government now encourages 3 or more kids if citizens can afford it. They now allow |
| |use of Medisave to pay for delivery charges. Parents also received income tax relief for 2nd, 3rd & 4th child. |
|Explain Given Factor|Subsidy for childcare and baby bonuses were also given out. Such measures make it more affordable to have kids |
|No 1: Financial |and thus encourage couples to have more children. The number of babies born have increased slightly but still |
|Incentives. |below target. |
|Para 3 |Money is not the only issue for young couples. With careers becoming very important, time for family and lack |
| |of childcare facilities are also big issues. Thus the government has come up with many pro-family measures. |
|Explain Given Factor|They equalised medical claims and now both father and mother can make medical claims for their children. To |
|No 2: |encourage grandparents to help out with childcare, grandparent caregiver relief of $3000 in tax relief is given |
|Pro-family Measures.|out to couples if grandparents help to look after kids. The government also introduced the 5-Day Work week in |
| |Civil Service for better work-life balance. Paid maternity leave is also increased from 8 weeks to 12 weeks. |
| |Due to these measures, more people are encouraged to start a family because now as they can have more time for |
| |family and more avenues for childcare. |

|Para 4 |The government could not only depend on citizens to increase in population. Another option the government |
| |utilised was to import skilled and talented foreigners to become Permanent Residents (PR). They relaxed |
|Explain Given Factor|immigration policies for easier entry and provided subsidised housing. Attractive education package for the |
|No 3: |kids of these foreigners is also provided. This has helped to increase the total population of Singapore and |
|Attracting Foreign |boost the quantity and quality of available manpower. It has also helped to make Singapore a more cosmopolitan |
|Talents. |city. |
|Para 5 |I feel that inviting foreign talents is good but we cannot be too dependent on foreigners to sustain our |
|Weigh the relative |development because they may not be rooted to Singapore and leave when better prospects are available to them. |
|impact of the 3 |Financial incentives are also good but money alone does not motivate people to have children. Parents are more |
|factors and say |concerned about lack of quality time that they can spend with their children because both parents are usually |
|which is most |working and too busy for family. Thus I feel that pro-family measures will be most effective in encouraging |
|effective. |people to have more children. |

How far do you agree that the government’s decision to promote population growth in the 1980s was due to economic factors? Explain your answer. [12m]

|Given Factor |I agree to a large extent that the government’s decision to promote population growth in the 1980s was due |
| |to economic factors. A small population will hinder Singapore’s growth and development because there will be|
| |fewer people driving the economy. By the 1980s, Singapore was facing a serous labour shortage. It would |
| |mean that Singapore would not have enough talented people to sustain its development. Compared to larger |
| |countries with huge labour markets, a small population would mean that Singapore would be less attractive to|
| |investors. This prompted the government to re-look its population control in the 1980s to reverse the |
| |declining trend. |
|Another Factor |Another reason for the government’s decision to promote population growth in the 1980s was prompted by the |
| |concerns over an ageing population. With fewer babies born each year, there would be fewer young people in |
| |the population. The number of old people would be proportionately larger. Consequently we would end up |
| |with an ageing population. As the population ages, more resources would need to be diverted to take care of|
| |the needs of an ageing society. This means that less resource are available for use in other areas of the |
| |country’s development. |
|Third Factor |The third reason for government’s decision to promote population growth in the 1980s was due to defence. |
| |With a declining birth rate, there would be fewer men to recruit for National Service. This would weaken |
| |Singapore’s defence force. Hence, the Singapore government needs to promote population growth. |
|Conclusion |In conclusion, I think that the most important reason is due to economic factor. With a small population, |
| |Singapore will not be able to sustain its development. Companies will find it difficult to employ suitable |
| |workers and may relocate. The economy of the country may decline. This is made worse by the increasing |
| |proportion of aged people in the country. Hence, I think that the government’s decision to promote |
| |population growth is largely due to economic concerns. |

Here are three ways in which our government has tried to control traffic congestion: Park-and-Ride scheme Electronic road pricing Vehicle quota system

|Para |Content |
|Para 1 |Singapore government has tried many methods to control traffic congestion on Singapore roads. Among the 3 given |
|Introduction - Make |methods, I think Vehicle Quota systems was most effective. |
|your stand. | |
|Para 2 |The Park and Ride scheme allows cars to be parked outside the CBD for a discounted rate. Additional car parks were |
| |built just out CBD areas and near MRT stations. From these carparks, the motorist would use public transport to |
|Explain Given Method|enter the city area. Shuttle buses were also arranged from the car parks to the CBD. The scheme was a failure |
|1 – Park and Ride |because people found it troublesome to drive half way and then take public transport. They either switch totally to |
|Scheme |public transport or drove into city before 7.30 to avoid paying extra charges. Therefore, the Park-and-Ride scheme |
| |had not been very successful. |
|Para 3 |Another method is the implementation of Electronic Road Pricing (ERP). Under the ERP system, motorists have to pay to|
| |enter the CBD area. ERP is also extended to major highways in Singapore and motorists also have to pay to use these |
|Explain the Given |highways. ERP system makes use of improved technology and electronic sensors. Payment is automatically deducted |
|Method 2 – |from the cash card when a vehicle passes through a gantry. The ERP system is also effective in controlling |
|Electronic Road |congestion not only in the CBD but also major highways leading to the CBD as it is becoming more and more expensive |
|Pricing |to drive into the CBD as more and more ERP gantries are set up every year. It really discourages people from driving|
| |into the CBD during the peak hours. The number of car entering CBD and the major highways have reduced since the |
| |introduction of the ERP system. Therefore, ERP has been effective in controlling traffic congestion. |

|Para 4 |The third method is to introduce the vehicle quota system. As Singaporeans became wealthier, more people could afford|
| |cars and the demand for new cars was increasing. So the government also introduced the Vehicle Quota System whereby |
|Explain Given Method|motorists have to bid for limited number of Certificate of Entitlement (COE) every month. Motorists would need a COE|
|3 – Vehicle Quota |in order to own a car. The COE costs between $10, 000 and $15,000, depending on the size of the car, and would only |
|System |be valid for a 10 year period. This made car ownership very expensive and unaffordable to many. This system was |
| |also very unpopular but was very effective in controlling the car population thus also the congestion on roads. |
|Para 5 |Among the 3 methods, I think the vehicle quota system and COE was most effective in controlling congestion. The Park|
|Weight the relative |and Ride scheme was not successful in deterring people from driving into town. The ERP system is somewhat more |
|effectiveness of the|effective as it made it more expensive to drive into town and thus discouraged people from driving into town. |
|3 methods and say |However, I think the vehicle quota system is most effective as it managed to control the total population of cars in |
|which is the most |Singapore. The impact of the Park and Ride Scheme and ERP was limited to the CBD and highways but the vehicle quota |
|effective. |system has an impact on the entire Singapore as only limited number of car were made available for sale and they were|
| |expensive to own and not everyone could afford and own a car. |

To what extent is the effectiveness of Singapore’s healthcare policies dependent on the government? Explain your answer. [12m]

|Introduction |I agree to a great extent that the effectiveness of Singapore’s healthcare policies is most dependent on the|
| |Government. Other groups that are can influence the effectiveness include individual and community. |
|Given Factor |The effectiveness of Singapore's healthcare polices is dependent on the government as they set in place |
| |certain policies, such as subsidies and Medifund, which ensure that healthcare is affordable to the people, |
| |thus meeting their healthcare needs. Different rates of government subsidies are given according to the |
| |different classes of wards in hospitals, and thus Class C wards receive the most in subsidies. This |
| |therefore ensures that the lower-income groups can afford proper healthcare. Medifund is also introduced as |
| |a way to provide help to those who are not able to pay for healthcare. It started off with a fund of $200 |
| |million and the interest earned from the fund is given to public hospitals to provide help to needy |
| |patients. In ensuring that subsidies are given to all and free healthcare is given to |
| |economically-disadvantaged Singaporeans, the government thus ensures that its healthcare policies reach out |
| |to all who need it on a fair basis.. |
|Another factor |The effectiveness of Singapore's healthcare policies is also dependent on the individual as self-reliance is|
| |an important part, and this is reflected in Medisave and Medishield. A portion of the salary an individual |
| |receives is put in their Central Provident Fund (CPF), and out of this sum, another portion is put into |
| |their Medisave accounts. This can be used to pay hospital bills and certain medical treatment when needed. |
| |MediShield is a national healthcare insurance scheme and this is paid for from Singaporeans' Medisave. This |
| |allows Singaporeans to pay for large medical bills which Medisave does not cover. Therefore, the individual |
| |is important for Singapore's healthcare policies to be effective as it is their salaries from their work |
| |which enable Medisave and MediShield to work. |

|Third factor |Singapore's healthcare policies are also dependent on the community as they provide healthcare support |
| |services which cater to the needs of specific groups of people. This is because some patients who are |
| |discharged from hospitals may still need medical care, and voluntary welfare organisations thus take over |
| |the role of providing healthcare. The Home Nursing Foundation, for example, is a charitable, non-profit |
| |organization that provides quality and affordable home nursing services for the needy and elderly sick in |
| |Singapore. Thus, the community plays an important part in Singapore's healthcare policies as they ensure |
| |that people who are discharged from hospitals ad who need subsidized and long-term treatment continue to |
| |receive due healthcare. |
|Conclusion |I feel that the effectiveness of Singapore's healthcare policies is very dependent on the government. This |
| |is because it is the government which introduces all the policies that enable the individual and the |
| |community to play their part in meeting the healthcare needs of the people. Medisave and MediShield, while |
| |requiring the salaries of the people to work, are still ultimately implemented by the government and if the |
| |government withdraws its support, these two policies will not be effective anymore. Similarly, the voluntary|
| |welfare organisations are also relying on funds provided by the government to sustain them. Therefore, |
| |because the effectiveness of the community and the individual in healthcare is ultimately reliant on the |
| |government, the effectiveness of Singapore's healthcare policies is very dependent on the government. |

To what extent was rising health care costs for the government the reason for Britain to move away from providing free healthcare? Explain your answer. [12m]

|Para |Content |
|Para 1 |The British government started providing free health care to all citizens with the good intention of taking care of |
| |the welfare of all citizens. However, over the years the government had to move away from providing the free |
|Introduction - |services and started to slowly privatize the health care system. There were several reasons for this. Other then |
|Make your stand. |the rising cost of providing free health care, the efficiency and quality of the health care services were also |
| |dropping. However I feel that the rising costs and resulting demands on the government and people is the key factor |
| |for moving away from providing free health care. |
|Para 2 |As health care was provided free, the demand was too high and the government could not cope with the demand for |
| |health care services. Doctors also recommended treated without bothering about cost for government and government |
|Explain Given |spending on health care increased a lot. To make up for the additional money needed, the government had to collect |
|Factor – Rising |more and more taxes to cover health care expenditure. National insurance tax of about 8% was introduced for all |
|Health Care Costs.|working people (over and above 10% to 40% income tax) and the money would be used to provide the welfare benefits. |
| |This was not good for the people as working people were over taxed and this discouraged people from being |
| |hardworking! Rising health care costs is also not good for the government as this would mean that they would have |
| |less revenue to spend on other areas of improvement for the nation. |
|Para 3 |The British government was also forced to move away from free health care services because the demand of providing |
| |free health care kept increasing especially with the growing number of elderly and smaller number of tax paying |
|Explain another |people. There were also not enough doctors, nurses and facilities. Hospitals and staff were also not efficient and |
|factor – Poor |did not bother about cost cutting because the hospitals were fully funded by government. This situation then forced |
|Efficiency of |the British government to introduce privatisation within the NHS. They began to contract out services like laundry, |
|Health Care. |cleaning and cooking to private companies. Private companies have to be more efficient as they have to worry about |
| |making profits. |

|Para 4 |Another reason for the British government to move away from free health care services is because the quality of the |
| |free health care service provided was also dropping. People started complaining about poor standards. There were |
|Explain one more |long queues and patients had to wait a long time before they received medical treatment. There were also shortage of|
|factor – Poor |beds. Many hospitals also did not have proper equipments |
|Quality of Health | |
|Care. | |
|Para 5 |Rising health care costs is the root cause of the problem. Lack of quality is in fact a subsequent effect of not |
|Weigh the relative|having enough money. Moreover, rising costs and the resulting increase in taxes was also destroying motivation among|
|impact of the 3 |the working people to continue working hard. Thus the government was forced to put an end to providing free health |
|methods and say |care. |
|which is more | |
|responsible for | |
|moving away from | |
|providing free | |
|health care. | |

To what extent was rising health care costs for the government the reason for Britain to move away from providing free healthcare? Explain your answer. [12m]

|Introduction |The British government started providing free health care to all citizens with the good intention of taking |
| |care of the welfare of all citizens. However, over the years the government had to move away from providing|
| |the free services and started to slowly privatize the health care system. There were several reasons for |
| |this. Other then the rising cost of providing free health care, the efficiency and quality of the health |
| |care services were also dropping. However I feel that the rising costs and resulting demands on the |
| |government and people is the key factor for moving away from providing free health care. |
|Given factor |As health care was provided free, the demand was too high and the government could not cope with the demand |
| |for health care services. Doctors also recommended treated without bothering about cost for government and |
| |government spending on health care increased a lot. To make up for the additional money needed, the |
| |government had to collect more and more taxes to cover health care expenditure. National insurance tax of |
| |about 8% was introduced for all working people (over and above 10% to 40% income tax) and the money would be|
| |used to provide the welfare benefits. This was not good for the people as working people were over taxed |
| |and this discouraged people from being hardworking! Rising health care costs is also not good for the |
| |government as this would mean that they would have less revenue to spend on other areas of improvement for |
| |the nation. |
|Another factor |The British government was also forced to move away from free health care services because the demand of |
| |providing free health care kept increasing especially with the growing number of elderly and smaller number |
| |of tax paying people. There were also not enough doctors, nurses and facilities. Hospitals and staff were |
| |also not efficient and did not bother about cost cutting because the hospitals were fully funded by |
| |government. This situation then forced the British government to introduce privatisation within the NHS. |
| |They began to contract out services like laundry, cleaning and cooking to private companies. Private |
| |companies have to be more efficient as they have to worry about making profits. |
|Third factor |Another reason for the British government to move away from free health care services is because the quality|
| |of the free health care service provided was also dropping. People started complaining about poor |
| |standards. There were long queues and patients had to wait a long time before they received medical |
| |treatment. There were also shortage of beds. Many hospitals also did not have proper equipments |
|Conclusion |Rising health care costs is the root cause of the problem. Lack of quality is in fact a subsequent effect |
| |of not having enough money. Moreover, rising costs and the resulting increase in taxes was also destroying |
| |motivation among the working people to continue working hard. Thus the government was forced to put an end |
| |to providing free health care. |
| | |