129-463: A rape crisis centre , also known as a sexual assault crisis centre or sexual assault referral centre ( SARC ), is a specialised centre to support victims of rape or other sexual assault , both in the immediate aftermath of the assault and in the months and sometimes years following the attack. They are usually situated in a secure location and employ a multidisciplinary team of practitioners to provide medical, psychological, and practical support to
258-822: A "unified medical service" can be dated back to the Minority Report of the Royal Commission on the Poor Law in 1909. Somerville Hastings , President of the Socialist Medical Association , successfully proposed a resolution at the 1934 Labour Party Conference that the party should be committed to the establishment of a State Health Service. Following the 1942 Beveridge Report 's recommendation to create "comprehensive health and rehabilitation services for prevention and cure of disease", cross-party consensus emerged on introducing
387-403: A 2002 study of undetected rapists, says that compared with non-rapists, both undetected and convicted rapists are measurably more angry at women and more motivated by a desire to dominate and control them, are more impulsive, disinhibited, anti-social, hypermasculine , and less empathic. Sexual aggression is often considered a masculine identity characteristic of manhood in some male groups and
516-542: A 3.4% increase in funding every year to 2024, which would allow it to receive an extra £20bn a year in real terms funding. [dead link] There is concern that a high proportion of this money will go to service NHS debts rather than for improved patient care. In June 2018, it was reported that there were calls for the government to write off the NHS debt. Saffron Cordery of NHS Providers said that hospitals needed help to do their work without being up in deficit, as two-thirds were in
645-512: A National Health Service of some description. Conservative MP and Health Minister, Henry Willink later advanced this notion of a National Health Service in 1944 with his consultative White Paper "A National Health Service" which was circulated in full and short versions to colleagues, as well as in newsreel. When Clement Attlee 's Labour Party won the 1945 election he appointed Aneurin Bevan as Health Minister . Bevan then embarked upon what
774-399: A case. RCCs are further separated from mainstream organisations by their consistent efforts to reform how these organisations respond to rape, primarily through the provision of training in appropriate rape definitions and responses. RCCs may receive funding from a number of sources and funding can vary greatly for each RCC depending on its location, if it is affiliated with a host agency, and
903-495: A comprehensive range of health services , provided without charge for residents of the United Kingdom apart from dental treatment and optical care. In England , NHS patients have to pay prescription charges ; some, such as those aged over 60, or those on certain state benefits, are exempt. Taken together, the four services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion. In 2024,
1032-445: A crime solely committed by men against women. In 2012, they changed their definition from "The carnal knowledge of a female forcibly and against her will" to "The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim." The updated definition still excluded from the definition of rape men forced to penetrate women, which
1161-441: A definition of rape that did not use the word 'consent': "a physical invasion of a sexual nature committed on a person under circumstances which are coercive ." Marital rape, or spousal rape, is non-consensual sex in which the perpetrator is the victim's spouse. It is a form of partner rape , domestic violence , and sexual abuse. Once widely accepted or ignored by law, marital rape is now denounced by international conventions and
1290-537: A dishonest woman. Victims may react in ways they did not anticipate. After the rape, they may be uncomfortable/frustrated with and not understand their reactions. Most victims respond by 'freezing up' or becoming compliant and cooperative during the rape. These are common survival responses of all mammals. This can cause confusion for others and the person assaulted. An assumption is that someone being raped would call for help or struggle. A struggle would result in torn clothes or injuries. Dissociation can occur during
1419-401: A form of sexual violence . The CDC lists other acts of coercive, non-consensual sexual activity that may or may not include rape, including drug-facilitated sexual assault , acts in which a victim is made to penetrate a perpetrator or someone else, intoxication where the victim is unable to consent (due to incapacitation or being unconscious), non-physically forced penetration which occurs after
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#17327938375961548-612: A lot of coverage in the media. The Welsh and UK governments announced a partnership on 23 September 2024 to reduce NHS waiting lists in England and Wales during the Labour Party Conference in Liverpool. This collaboration aimed to share best practices and tackle common challenges. Previously, Eluned Morgan rejected a Conservative proposal for treating Welsh patients in England. The Welsh Conservatives welcomed
1677-454: A means of male bonding. This is particularly evident among soldiers, as gang rape accounts for about three quarters or more of war rape , while gang rape accounts for less than a quarter of rapes during peacetime. Commanders sometimes push recruits to rape, as committing rape can be taboo and illegal and so builds loyalty among those involved. Rebel groups who have forced recruitment as opposed to volunteer recruits are more involved in rape, as it
1806-612: A mix of paid staff and trained volunteers, and are run with the support of or collaboration with local councils, police forces, and corporate sponsors. Edinburgh Rape Crisis is one of Scotland's largest centres. However, as of April 2023 rape crisis centres across the UK have had to close waiting lists owing to shortage of funds and staff. Rape Crisis Northern Ireland, located in Belfast , covers Northern Ireland . The first American rape crisis centers (RCCs) were formed in several states throughout
1935-422: A number of categories, and they may describe the relationship of the perpetrator to the victim and the context of the sexual assault. These include date rape , gang rape , marital rape , incestual rape , child sexual abuse , prison rape , acquaintance rape , war rape and statutory rape . Forced sexual activity can be committed over a long period of time with little to no physical injury. Lack of consent
2064-465: A number of not-for-profit centres focusing on different groups, such as Māori women , or male victims, some explicitly named rape crisis centre, such as Wellington Rape Crisis . There are local and national help lines. In South Africa, Thuthuzela Care Centres have become a model for best practice in care after sexual assault. The name is derived from the Xhosa word thuthuzela , meaning "comfort". In
2193-506: A perpetrator against a victim without their consent . The definition of rape is inconsistent between governmental health organizations, law enforcement, health providers, and legal professions. It has varied historically and culturally. Originally, rape had no sexual connotation and is still used in other contexts in English. In Roman law , it or raptus was classified as a form of crimen vis , "crime of assault". Raptus referred to
2322-665: A person is pressured verbally (by intimidation or misuse of authority to force to consent), or completed or attempted forced penetration of a victim via unwanted physical force (including using a weapon or threatening to use a weapon). The Veterans Health Administration (VHA) has implemented universal screening for what has been termed "military sexual trauma" ( MST ) and provides medical and mental health services free of charge to enrolled veterans who report MST (Title 38 United States Code 1720D; Public Law 108–422). Some countries or jurisdictions differentiate between rape and sexual assault by defining rape as involving penile penetration of
2451-410: A person under circumstances which are coercive". In other cases, the term rape has been phased out of legal use in favor of terms such as sexual assault or criminal sexual conduct . Some countries criminalize non-consensual condom removal ( "stealthing" ), where one partner removes (or intentionally damages) their condom during sex without telling the other partner; the rationale is that consent
2580-407: A person who is incapable of giving valid consent, such as one who is unconscious , incapacitated, has an intellectual disability , or is below the legal age of consent ( statutory rape ). The term rape is sometimes casually inaccurately used interchangeably with the term sexual assault . The rate of reporting, prosecuting and convicting for rape varies between jurisdictions. Internationally,
2709-415: A rape or sexual assault. They are able to conduct a focused medical-legal exam. If such a trained clinician is not available, the emergency department has a sexual assault protocol that has been established for treatment and the collection of evidence. Staff are also trained to explain the examinations in detail, the documentation and the rights associated with the requirement for informed consent . Emphasis
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#17327938375962838-493: A risk of injecting drugs. Acquiring sexually transmitted infections increases the risk of acquiring HIV. The belief that having sex with a virgin can cure HIV/AIDS exists in parts of Africa. This leads to the rape of girls and women. The claim that the myth drives either HIV infection or child sexual abuse in South Africa is disputed by researchers Rachel Jewkes and Helen Epstein. Society's treatment of victims has
2967-405: A role in rationalization of rape. These include the idea that power is reserved to men whereas women are meant for sex and objectified, that women want forced sex and to be pushed around, and that male sexual impulses and behaviors are uncontrollable and must be satisfied. For females, victim-blaming correlates with fear. Many rape victims blame themselves. Female jurors might look at the woman on
3096-525: A sense of invulnerability); giving the appearance of consent (in cases of acquaintance rape); and thrill from planning and the use of the condom as an added prop. Concern for the victim is generally not considered a factor. Those who have been raped have relatively more reproductive tract infections than those who have not been raped. HIV can be transmitted through rape. Acquiring AIDS through rape puts people at increased risk for psychological problems. Acquiring HIV through rape may lead to behaviors that create
3225-764: Is also higher if people around the survivor ignore (or are ignorant of) the rape or blame the rape survivor. Most people recover from rape in three to four months, but many have persistent PTSD that may manifest in anxiety, depression, substance abuse, irritability, anger, flashbacks, or nightmares. In addition, rape survivors may have long-term generalised anxiety disorder , may develop one or more specific phobias , major depressive disorder , and may experience difficulties with resuming their social life and with sexual functioning. People who have been raped are at higher risk of suicide. Men experience similar psychological effects of being raped, but they are less likely to seek counseling. Another effect of rape and sexual assault
3354-453: Is always required prior to treatment unless the person who was assaulted is unconscious, intoxicated or does not have the mental capacity to give consent. Priorities governing the physical exam are the treatment of serious life-threatening emergencies and then a general and complete assessment. Some physical injuries are readily apparent such as bites , broken teeth, swelling , bruising , lacerations and scratches. In more violent cases,
3483-533: Is believed the recruits start with less loyalty to the group. In Papua New Guinea , urban gangs such as Raskol gangs often require new members to rape women as part of their initiation. Perpetrators of sex trafficking and cybersex trafficking allow or carry out rape for financial gain and/or sexual gratification. Rape pornography , including child pornography , is created for profit and other reasons. There have been instances of child sexual abuse and child rape videos on Pornhub . One metric used by
3612-418: Is determined by sampling of body fluids from the mouth, throat, vagina, perineum , and anus . Victims have the right to refuse any evidence collection. Victims advocates ensure the victims' wishes are respected by hospital staff. After the physical injuries are addressed and treatment has begun, then forensic examination proceeds along with the gathering of evidence that can be used to identify and document
3741-720: Is especially the case in cultures where female virginity is highly valued and considered mandatory before marriage; in extreme cases, rape victims are killed in honor killings . In the US, victims' rights include the right to have a victims advocate preside over every step of the medical/legal exam to ensure sensitivity towards victims, provide emotional support, and minimize the risk of re-traumatization. Victims are to be informed of this immediately by law enforcement or medical service providers. Emergency rooms of many hospitals employ sexual assault nurse/forensic examiners (SAN/FEs) with specific training to care for those who have experienced
3870-675: Is estimated that about 5% of male-on-female rapes result in pregnancy. When rape results in pregnancy, abortion pills can be safely and effectively used to end a pregnancy up to 10 weeks from the last menstrual period. National Health Service The National Health Service ( NHS ) is the umbrella term for the publicly funded healthcare systems of the United Kingdom , comprising the NHS in England, NHS Scotland and NHS Wales . Health and Social Care in Northern Ireland
3999-521: Is generally recognized as the academic definition of rape. However, it recognized any gender of victim and perpetrator and that rape with an object can be as traumatic as penile/vaginal rape. The bureau further describes instances when the victim is unable to give consent because of mental or physical incapacity. It recognizes that a victim can be incapacitated by drugs and alcohol and unable to give valid consent. The definition does not change federal or state criminal codes or impact charging and prosecution on
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4128-478: Is increasingly criminalized. Still, in many countries, marital rape either remains legal or is illegal but widely tolerated and accepted as a husband's prerogative. In 2006, the UN Secretary-General's In-depth study on all forms of violence against women stated that (pg 113): "Marital rape may be prosecuted in at least 104 states. Of these, 32 have made marital rape a specific criminal offense, while
4257-405: Is key to the definition of rape. Consent is affirmative "informed approval, indicating a freely given agreement" to sexual activity. It is not necessarily expressed verbally, and may instead be overtly implied from actions, but the absence of objection does not constitute consent. Lack of consent may result from either forcible compulsion by the perpetrator or an inability to consent on the part of
4386-399: Is more likely to be valid. The sooner that samples are obtained after the assault, the more likely that evidence is present in the sample and provides valid results. Once the injuries of the patient have been treated and she or he is stabilized, the sample gathering will begin. Staff will encourage the presence of a rape/sexual assault counselor to provide an advocate and reassurance. During
4515-592: Is placed on performing the examinations at a pace that is appropriate for the person, their family, their age, and their level of understanding. Privacy is recommended to prevent self-harm . Many rapes do not result in serious physical injury. The first medical response to sexual assault is a complete assessment. This general assessment will prioritize the treatment of injuries by the emergency room staff. Medical personnel involved are trained to assess and treat those assaulted or follow protocols established to ensure privacy and best treatment practices. Informed consent
4644-545: Is regardless of whether they derive a salary or wage from the organisation, or receive any type of funding or assistance from the organisation for the purposes of working overseas. This is in recognition of the fact that most missionaries would be unable to afford private health care and those working in developing countries should not effectively be penalised for their contribution to development and other work. Those who are not ordinarily resident (including British citizens who may have paid National Insurance contributions in
4773-669: Is significantly correlated to the desire to be held higher in esteem among male peers. Sexually aggressive behavior among young men has been correlated with gang or group membership as well as having other delinquent peers. Gang rape is often perceived by male perpetrators as a justified method of discouraging or punishing what they consider as immoral behavior among women – for example, wearing short skirts or visiting bars. In some areas in Papua New Guinea , women can be punished by public gang rape, usually through permission by elders. Gang rape and mass rape are often used as
4902-463: Is the phenomenon of RCCs moving toward more professionalisation and hierarchy and away from the radical activism that defines their roots. Many RCCs, rather than being freestanding collectives, are incorporated into the mainstream organisations that they once worked against, such as hospitals or other social services agencies. These trends are related to the political climate and also the availability of government money to fund their activities. Despite
5031-412: Is the stress created in those who study rape or counsel the survivors. This is called vicarious traumatization . The presence or absence of physical injury may be used to determine whether a rape has occurred. Those who have experienced sexual assault yet have no physical trauma may be less inclined to report to the authorities or to seek health care. While penetrative rape generally does not involve
5160-592: Is the umbrella body for centres in that province. Vancouver Rape Relief & Women's Shelter is Canada's longest-running rape crisis centre. In Ireland, the Dublin Rape Crisis Centre, a national service, provides a range of services, including a 24-hour helpline, counselling services, accompanying victims to court, and outreach services, along with provision of training and advocacy work. In New Zealand ( Māori : Aotearoa ), groups to support victims of rape and sexual abuse were set up during
5289-873: The Australian Capital Territory ; Yarrow Place in South Australia . In Victoria , the Sexual Assault Services Victoria (SASVic, formerly CASA Forum) is the umbrella body for Centres Against Sexual Assault , or CASAs, located across the state. In the Northern Territory , there are a number of Sexual assault referral centres (SARCs) which provide support, education, and advocacy. There is only 24/7 access to medical, legal and counselling information at Darwin and Alice Springs SARCs. In Western Australia there are five Sexual Assault Support Services in
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5418-491: The European Health Insurance Card . Those from other countries with which the UK has reciprocal arrangements also qualify for free treatment. Since 6 April 2015, non-EEA nationals who are subject to immigration control must have the immigration status of indefinite leave to remain at the time of treatment and be properly settled, to be considered ordinarily resident. People not ordinarily resident in
5547-459: The Global Forum for Health Research shows that victim-blaming concepts are at least partially accepted in many countries. Women who have been raped are sometimes deemed to have behaved improperly. Usually, these are cultures where there is a significant social divide between the freedoms and status afforded to men and women. "Rape victims are blamed more when they resist the attack later in
5676-583: The Institute for Fiscal Studies had stated a 5% real-terms increase was needed for real change. Paul Johnson of the IFS said the 3.4% was greater than recent increases, but less than the long-term average. In July 2016, health experts said the money would "help stem further decline in the health service, but it's simply not enough to address the fundamental challenges facing the NHS, or fund essential improvements to services that are flagging." In November 2018, it
5805-486: The Office for Budget Responsibility said that "the rising trend in health and social care spending and pensions will be adding something like another £75 billion spending over the next five years, £150 billion, potentially over the next decade" as if treatments are available to keep people alive longer, then people will want them. In July 2022, The Telegraph reported that the think tank Civitas found that health spending
5934-476: The 'Centre for Health Economics' at the University of York found that between 2004/05 and 2016/17 the productivity of the NHS has increased nearly two and a half times as quickly as the larger economy. Between 2010 and 2017, there was a cap of 1% on pay rises for staff continuing in the same role. Unions representing doctors, dentists, nurses and other health professionals have called on the government to end
6063-549: The 1970s, and in 1986 "Rape Crisis and Related Groups" (RCRG) were established. These groups were run by trained volunteers, and provided immediate crisis support as well as ongoing counselling; judicial advocacy work; and help for victims in their dealings with police, doctors, Accident Compensation Corporation , and the Department of Social Welfare . Over time, the number of support groups first grew, and then declined, largely through lack of funding and changing legislation. RCRG
6192-516: The EEA coming to the UK for a temporary stay of more than six months are required to pay an immigration health surcharge at the time of visa application, and will then be entitled to NHS treatment on the same basis as a resident. This includes overseas students with a visa to study at a recognised institution for six months or more, but not visitors on a tourist visa. In 2016 the surcharge was £200 per year, with exemptions and reductions in some cases. This
6321-608: The EU holding a valid European Health Insurance Card and persons from certain other countries with which the UK has reciprocal arrangements concerning health care can get emergency treatment without charge. The NHS is free at the point of use, for general practitioner (GP) and emergency treatment not including admission to hospital, to non-residents. People with the right to medical care in European Economic Area (EEA) nations are also entitled to free treatment by using
6450-451: The GP's health and that of their patients at risk. The Royal College of Physicians surveyed doctors across the UK, with two-thirds maintaining patient safety had deteriorated during the year to 2018: 80% feared they would be unable to provide safe patient care in the coming year while 84% felt that increased pressure on the NHS was demoralising the workforce. In June 2018, at a time when the NHS
6579-698: The NHS England published the NHS Long Term Plan . The Guardian reported that data for 2020 suggests a change, and that the doctors' trade union and professional association , the BMA , say this was largely due to raised spending during the pandemic and the effect of Covid on the whole economy, since the GDP of the UK dropped more than that of all other G7 nations. The BMA also said in December 2022 that
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#17327938375966708-400: The NHS experienced "historical underfunding and under-resourcing" during the ten years before COVID. The King's Fund maintains The investment in services started in 2021 was badly needed, but despite it restoring key services and performance standards will require years. Shortages of workers and growing staff numbers experiencing burnout and thinking of leaving the NHS may stop progress. If
6837-446: The NHS has among the lowest numbers of doctors, nurses and hospital beds per capita in the western world. In May 2018, it was said that nurses within the NHS said that patient care was compromised by the shortage of nurses and the lack of experienced nurses with the necessary qualifications. In June 2018 it was reported that the NHS performed below average in preventing deaths from cancer, strokes and heart disease. In September 2018 it
6966-738: The NHS. The NHS is the largest employer in Europe, with one in every 25 adults in England working for the NHS. As of February 2023, NHS England employed 1.4 million staff. Nursing staff accounted for the largest cohort at more than 330,000 employees, followed by clinical support staff at 290,000, scientific and technical staff at 163,000 and doctors at 133,000. In June 2018, the Royal College of Physicians calculated that medical training places need to be increased from 7,500 to 15,000 by 2030 to take account of part-time working among other factors. At that time there were 47,800 consultants working in
7095-442: The UK are in general not entitled to free hospital treatment, with some exceptions such as refugees . People not ordinarily resident may be subject to an interview to establish their eligibility, which must be resolved before non-emergency treatment can commence. Patients who do not qualify for free treatment are asked to pay in advance or to sign a written undertaking to pay, except for emergency treatment. People from outside
7224-464: The UK can use the NHS without being asked to pay the full cost of the service, though NHS dentistry and optometry do have standard charges in each of the four national health services in the UK. In addition, most patients in England have to pay charges for prescriptions though some patients are exempted. Aneurin Bevan , in considering the provision of NHS services to overseas visitors wrote, in 1952, that it would be "unwise as well as mean to withhold
7353-456: The UK had increased by more than any country despite the significant drop in national income due to the COVID pandemic. The Labour Government elected in 2024 stated that their policy was that the "NHS is broken". They announced an immediate stocktake of current pressures and the reasons for them led by Labour peer Lord Ara Darzi. This was to be followed by development of a new "10 year plan" for
7482-456: The UK of which 15,700 were physicians. About 20% of consultants work less than full-time. Brexit , in 2020, was predicted to affect medical practitioners from EU countries who worked in the NHS, accounting for more than 1-in-10 doctors at the time. A 2017 survey suggested 60% of these doctors were considering leaving, with a record 17,197 EU staff leaving the NHS in 2016. The figures led to calls to reassure European workers over their future in
7611-1323: The UK, sexual assault referral centres or SARCs exist across the country, funded and run by the National Health Service . Their staff comprise specifically-trained doctors, nurses, and other support staff. The first SARC was established in 1986 at St Mary's Hospital in Manchester , as St Mary's Sexual Assault Referral Centre or SARC. In the 1990s, there were two more SARCs established, REACH in Northumbria and STAR in West Yorkshire . There are also crisis centres run as charitable organisations, overseen by umbrella organisations Rape Crisis England & Wales and Rape Crisis Scotland. They not only work to end sexual assault and abuse, but also provides specialist information and support to anyone who has been affected by any other form of sexual violence and abuse in England and Wales . They act as an umbrella organisation for 39 member rape crisis centres as of 2023. The member organisations, such as Northamptonshire Rape Crisis, are typically independent charities staffed by
7740-491: The UK. A study by the Centre for Progressive Policy called for NHS trusts to become "exemplar employers" by improving social mobility and pay especially for those "trusts in poorer places where they can play a particularly large role in determining the economic wellbeing of the local population." They found the NHS to be " a middle ranking employer in comparison to other large organisations and falls short on social mobility and
7869-411: The US, the criminalization of marital rape started in the mid-1970s, and in 1993 North Carolina became the last state to make marital rape illegal. In many countries, it is not clear if marital rape may or may not be prosecuted under ordinary rape laws. In the absence of a marital rape law, it may be possible to bring prosecution for acts of forced sexual intercourse inside marriage by prosecuting, through
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#17327938375967998-472: The WHO to determine the severity of global rates of coercive, forced sexual activity was the question "Have you ever been forced to have sexual intercourse against your will?" Asking this question produced higher positive response rates than being asked, whether they had ever been abused or raped. The WHO report describes the consequences of sexual abuse: Frequently, victims may not recognize what happened to them
8127-503: The abduction of a woman against the will of the man under whose authority she lived, and sexual intercourse was not a necessary element. Other definitions of rape have changed over time. The International Criminal Tribunal for the former Yugoslavia considered rape as a crime that required coercion or force or threat of force against the victim or a third person. Until 2012, the Federal Bureau of Investigation (FBI) considered rape
8256-590: The absence of an objection to sexual activity. This can lead to the presumption of consent. Duress may be actual or threatened force or violence against the victim or someone close to the victim. Even blackmail may constitute duress. Abuse of power may constitute duress. For instance, in the Philippines, a man commits rape if he engages in sexual intercourse with a woman "By means of fraudulent machination or grave abuse of authority" . The International Criminal Tribunal for Rwanda in its landmark 1998 judgment used
8385-427: The assault. Memories may be fragmented especially immediately afterwards. They may consolidate with time and sleep. A man or boy who is raped may be stimulated and even ejaculate during the experience of the rape. A woman or girl may orgasm during a sexual assault. This may become a source of shame and confusion for those assaulted along with those who were around them. Trauma symptoms may not show until years after
8514-546: The cap on health service pay, claiming the cap is damaging the health service and damaging patient care. In 2017, the pay rise was likely to be below the level of inflation and to mean a real-terms pay cut. In 2017, the House of Commons Library research predicted that that real-terms NHS funding per head was to fall in 2018–19, and stay the same for two years afterwards. In January 2018, The Guardian reported that GPs faced excessive workloads throughout Britain and that this put
8643-426: The country in the early 1970s, largely by women associated with the second-wave feminist movement . Central to second-wave feminism was the practice of consciousness raising , which allowed groups of women to speak openly about their experiences with sexual violence and the shortcomings of law enforcement, health care providers, and the criminal justice system to effectively and constructively respond to survivors.Among
8772-592: The department is making 4,000 training positions available for GPs every year, which help create an extra 50 million appointments annually. In 2023, a report revealed that NHS staff had faced over 20,000 sexual misconduct from patients from 2017 to 2022 across 212 NHS Trusts. Some of the claims included rape, sexual harassment, stalking, and sexualised remarks at staff from patients. In the report, female staff members were told by hospitals to continue caring for patients even after there were issues regarding abuse or harassment without further safeguards in place. Other parts of
8901-492: The fact that RCCs now more closely resemble mainstream organisations, they still occupy an important place in the anti-rape movement. When dealing with rape survivors, the fact that RCCs have no interest other than in providing emotional support and assistance to survivors distinguishes them from physicians who are primarily concerned with treating injuries, law enforcement officers who are primarily concerned with ascertaining facts, or prosecutors who primarily concerned with building
9030-467: The federal, state, or local level; it rather means that rape will be more accurately reported nationwide. Health organizations and agencies have also expanded rape beyond traditional definitions. The World Health Organization (WHO) defines rape as a form of sexual assault , while the Centers for Disease Control and Prevention (CDC) includes rape in their definition of sexual assault; they term rape
9159-512: The first of many controversies over changes to the NHS throughout its history. From its earliest days, the cultural history of the NHS has shown its place in British society reflected and debated in film, TV, cartoons and literature. The NHS had a prominent slot during the 2012 London Summer Olympics opening ceremony directed by Danny Boyle , being described as "the institution which more than any other unites our nation". Everyone living in
9288-498: The first was the Washington D.C. Rape Crisis Center, founded in 1972 by women identifying with the radical branch of the women's movement. The D.C. RCC published a pamphlet entitled "How to Start a Rape Crisis Center", which provided a model for other early RCCs to follow. While the goals of RCCs have remained largely unchanged since their creation in the 1970s, they have undergone a number of structural changes. Among these changes
9417-663: The free service from the visitor to Britain. How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors? For if the sheep are to be separated from the goats both must be classified. What began as an attempt to keep the Health Service for ourselves would end by being a nuisance to everybody." The provision of free treatment to non-UK-residents, formerly interpreted liberally, has been increasingly restricted, with new overseas visitor hospital charging regulations introduced in 2015. Citizens of
9546-597: The incidence of rapes recorded by the police during 2008 ranged, per 100,000 people, from 0.2 in Azerbaijan to 92.9 in Botswana with 6.3 in Lithuania as the median . Worldwide, reported instances of sexual violence , including rape, are primarily committed by males against females. Rape by strangers is usually less common than rape by people the victim knows, and male-on-male prison rapes are common and may be
9675-417: The injuries. Such evidence -gathering is only done with the complete consent of the patient or the caregivers of the patient. Photographs of the injuries may be requested by staff. At this point in the treatment, if a victims' advocate had not been requested earlier, experienced social support staff are made available to the patient and family. If the patient or the caregivers (typically parents) agree,
9804-504: The least reported forms of rape. Widespread and systematic rape (e.g., war rape ) and sexual slavery can occur during international conflict. These practices are crimes against humanity and war crimes . Rape is also recognized as an element of the crime of genocide when committed with the intent to destroy, in whole or in part, a targeted ethnic group. People who have been raped can be traumatized and develop post-traumatic stress disorder . Serious injuries can result along with
9933-413: The legal system, only trained medical personnel can obtain evidence that is admissible during a trial. The procedures have been standardized. Evidence is collected, signed, and locked in a secure place to guarantee that legal evidence procedures are maintained. This carefully monitored procedure of evidence collection and preservation is known as the chain of evidence . Maintaining the chain of evidence from
10062-407: The medical exam, evidence of bodily secretions is assessed. Dried semen that is on clothing and skin can be detected with a fluorescent lamp. Notes will be attached to those items on which semen has been found. These specimens are marked, placed in a paper bag, and are marked for later analysis for the presence of seminal vesicle-specific antigen. Though technically, medical staff are not part of
10191-853: The medical examination, testing, and tissue sampling from its origin of collection to court allows the results of the sampling to be admitted as evidence. Photography is often used for documentation. Some physical effects of the rape are not immediately apparent. Follow up examinations also assess the patient for tension headaches , fatigue , sleep pattern disturbances, gastrointestinal irritability, chronic pelvic pain, menstrual pain or irregularity, pelvic inflammatory disease, sexual dysfunction, premenstrual distress, fibromyalgia, vaginal discharge, vaginal itching, burning during urination, and generalized vaginal pain. The World Health Organization recommends offering prompt access to emergency contraceptive medications which can significantly reduce risk of an undesired pregnancy if used within 5 days of rape; it
10320-400: The medical team utilizes standardized sampling and testing usually referred to as a forensic evidence kit or " rape kit ". The patient is informed that submitting to the use of the rape kit does not obligate them to file criminal charges against the perpetrator. The patient is discouraged from bathing or showering to obtain samples from their hair. Evidence gathered within the past 72 hours
10449-700: The needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay. Three years after the founding of the NHS, Bevan resigned from the Labour government in opposition to the introduction of charges for the provision of dentures, dentists, and glasses ; resigning in support was fellow minister and future Prime Minister Harold Wilson . The following year, Winston Churchill 's Conservative government introduced prescription fees. However, Wilson's government abolished them in 1965; they were later re-introduced but with exemptions for those on low income. These charges were
10578-451: The new funding is to be efficiently used the NHS will need a comprehensive and fully funded workforce strategy to ensure future supply of staff. In March 2022, Rishi Sunak doubled the annual efficiency target for the NHS in England. The 2.2 per cent target would deliver annual savings of saving of £4.75 billion. At the same time the additional Covid funding is being removed in 2022–23. At the same time Sir Charles Bean , recently leader of
10707-592: The new partnership as overdue, while Plaid Cymru criticized it as insufficient for addressing deeper issues within the Welsh NHS. There was a concern that a disorderly Brexit might have compromised patients' access to vital medicines. In February 2018, many medical organisations planned for a worst-case Brexit scenario because "time is running out" for a transition deal to follow the UK's formal exit that occurred in March 2019. Pharmaceutical organisations working with
10836-467: The number of GPs has fallen by 1,622. Some family doctors have 2,500 patients each, forcing patients to attend A&E instead. Certain regions have fewer than 50 GPs per 100,000 people, while other regions have more than 70, presenting a challenge to the NHS's founding principle of equal treatment. A growing number of family doctors are reporting unsustainable workloads, and many have chosen to work part-time. A Health and Social Care spokesperson said that
10965-544: The official historian of the NHS, Charles Webster , called an "audacious campaign" to take charge of the form the NHS finally took. Bevan's National Health Service was proposed in Westminster legislation for England and Wales from 1946 and Scotland from 1947, and the Northern Ireland Parliament 's Public Health Services Act 1947. NHS Wales was split from NHS (England) in 1969 when control
11094-420: The past) are liable to charges for services. There are some other categories of people who are exempt from the residence requirements such as specific government workers and those in the armed forces stationed overseas. In 2016, the systems were 98.8% funded from general taxation and National Insurance contributions, plus small amounts from patient charges for some services. As of 2016, about 10% of GDP
11223-538: The patients. In wards which had not closed staff sometimes worked under stress due to staff shortages. It was also predicted then, that Brexit was likely to aggravate those problems. In November 2019, it was reported that due to the shortage of nurses the NHS was then relying on less qualified staff like healthcare assistants and nursing associates. For the period between 2010 and 2018 the Health Foundation funded research by Birmingham University said there
11352-425: The personal relationship between doctor and patient. Conservative MPs voted in favour of their amendment to Bevan's Bill to maintain local control and ownership of hospitals and against Bevan's plan for national ownership of all hospitals. The Labour government defeated Conservative amendments and went ahead with the NHS as it remains today; a single large national organisation (with devolved equivalents) which forced
11481-549: The potential to exacerbate their trauma. People who have been raped or sexually assaulted are sometimes blamed and considered responsible for the crime. This refers to the just world fallacy and rape myth acceptance that certain victim behaviors (such as being intoxicated, flirting or wearing sexually provocative clothing) may encourage rape. In many cases, victims are said to have "asked for it" because of not resisting their assault or violating female gender expectations. A global survey of attitudes toward sexual violence by
11610-660: The rape encounter rather than earlier (Kopper, 1996), which seems to suggest the stereotype that these women are engaging in token resistance (Malamuth & Brown, 1994; Muehlenhard & Rogers, 1998) or leading the man on because they have gone along with the sexual experience thus far. Finally, rape victims are blamed more when they are raped by an acquaintance or a date rather than by a stranger (e.g., Bell, Kuriloff, & Lottes, 1994; Bridges, 1991; Bridges & McGr ail, 1989; Check & Malamuth, 1983; Kanekar, Shaherwalla, Franco, Kunju, & Pinto, 1991; L'Armand & Pepitone, 1982; Tetreault & Barnett, 1987), which seems to evoke
11739-413: The rape, avoiding things associated with the rape, numbness, and increased anxiety and startle response . The likelihood of sustained severe symptoms is higher if the rapist confined or restrained the person, if the person being raped believed the rapist would kill them, the person who was raped was very young or very old, and if the rapist was someone they knew. The likelihood of sustained severe symptoms
11868-423: The rape. This can be perpetrated by the rapist, friends, or relatives of the rapist. The intent can be to prevent the victim from reporting the rape. Other reasons for threats against those assaulted is to punish them for reporting it, or of forcing them to withdraw the complaint. The relatives of the person who has been raped may wish to prevent "bringing shame" to the family and may also threaten them. This
11997-448: The real Living Wage", and ranked trusts using a 'good employer index'. Ambulance trusts were ranked worst. On 6 June 2022, The Guardian said that a survey of more than 20,000 frontline staff by the nursing trade union and professional body, the Royal College of Nursing , found that only a quarter of shifts had the planned number of registered nurses on duty. The NHS is facing a shortage of general practitioners . From 2015 to 2022,
12126-615: The regions, and a SARC in Perth . Most of the state and territory services have a help line providing advice, and there is also a national 24/7 help line, 1800RESPECT. In Canada, the networks of rape crisis centres are provincially- and territorially-based, but there is a national body named the Canadian Association of Sexual Assault Centres (CASAC). In Ontario , the Ontario Coalition of Rape Crisis Centres (OCRC)
12255-419: The remaining 20% split between buildings, equipment, training costs, medical equipment, catering and cleaning. Nearly 80% of the total budget is distributed by local trusts in line with the particular health priorities in their areas. When the NHS was launched in 1948 it had a budget of £437 million (equivalent to £20.07 billion in 2023). In 2016–2017, the budget was £122.5 billion. In 1955/56 health spending
12384-414: The remaining 74 do not exempt marital rape from general rape provisions. Marital rape is not a prosecutable offense in at least 53 States. Four States criminalize marital rape only when the spouses are judicially separated. Four States are considering legislation that would allow marital rape to be prosecuted." Since 2006, several other states have outlawed marital rape (for example Thailand in 2007 ). In
12513-437: The report showed that staff were pressured into not reporting grievances. In June 2023, the delayed NHS Long term Workforce Plan was announced, set up to train more doctors and nurses and create new roles within the health service. In 2024, multiple NHS hospitals started mandating radiographers to ask all male patients aged 12 to 55 if they were pregnant. This policy was instated as part of an 'inclusivity' drive and received
12642-482: The risk of pregnancy and sexually transmitted infections . A person may face violence or threats from the rapist, and, sometimes, from the victim's family and relatives. The term rape originates from the Latin rapere (supine stem raptum ), "to snatch, to grab, to carry off". In Roman law, the carrying off of a woman by force, with or without intercourse, constituted "raptus". In Medieval English law
12771-659: The same term could refer to either kidnapping or rape in the modern sense of "sexual violation". The original meaning of "carry off by force" is still found in some phrases, such as "rape and pillage", or in titles, such as the stories of the Rape of the Sabine Women and The Rape of Europa or the poem The Rape of the Lock , which is about the theft of a lock of hair. Rape is defined in most jurisdictions as sexual intercourse , or other forms of sexual penetration , committed by
12900-467: The sexual assault occurred. Immediately following a rape, the survivor may react outwardly in a wide range of ways, from expressive to closed down; common emotions include distress, anxiety, shame, revulsion, helplessness, and guilt. Denial is not uncommon. In the weeks following the rape, the survivor may develop symptoms of post-traumatic stress syndrome and may develop a wide array of psychosomatic complaints. PTSD symptoms include re-experiencing of
13029-454: The stereotype that victims really want to have sex because they know their attacker and perhaps even went out on a date with him. The underlying message of this research seems to be that when certain stereotypical elements of rape are in place, rape victims are prone to being blamed." Commentators state: "individuals may endorse rape myths and at the same time recognize the negative effects of rape." A number of gender role stereotypes can play
13158-590: The total health sector workforce across the United Kingdom was 1,499,368 making it the seventh largest employer and second largest non-military public organisation in the world. When purchasing consumables such as medications, the four healthcare services have significant market power that influences the global price, typically keeping prices lower. A small number of products are procured jointly through contracts shared between services. Several other countries directly rely on Britain's assessments for their own decisions on state-financed drug reimbursements. Calls for
13287-431: The transfer of ownership of hospitals from local authorities and charities to the new NHS. Bevan's principle of ownership with no private sector involvement has since been diluted, with later Labour governments implementing large scale financing arrangements with private builders in private finance initiatives and joint ventures. At its launch by Bevan on 5 July 1948 it had at its heart three core principles: That it meet
13416-500: The type of host agency. RCCs housed in hospitals and county social service and health agencies generally have more funding than those situated in mental health centres, battered women's shelters, and legal-justice organisations. Rape Rape is a type of sexual assault involving sexual intercourse , or other forms of sexual penetration , carried out against a person without their consent . The act may be carried out by physical force, coercion , abuse of authority , or against
13545-480: The use of a condom, in some cases a condom is used. The use of a condom significantly reduces the likelihood of pregnancy and disease transmission , both to the victim and the rapist. Rationales for condom use include: avoiding contracting infections or diseases (particularly HIV), especially in cases of rape of sex workers or in gang rape (to avoid contracting infections or diseases from fellow rapists); eliminating evidence, making prosecution more difficult (and giving
13674-489: The use of other criminal offenses (such as assault based offenses), the acts of violence or criminal threat that were used to obtain submission. Consent may be complicated by law, language, context, culture and sexual orientation. Studies have shown that men consistently perceive women's actions as more sexual than they intend. In addition, verbalized "no" to sex may be interpreted as "keep trying", or even "yes" by offenders. Some may believe that when injuries are not visible,
13803-411: The vagina, or solely penetration involving the penis, while other types of non-consensual sexual activity are called sexual assault. Scotland, for example, emphasizes penile penetration, requiring that the sexual assault must have been committed by use of a penis to qualify as rape. The 1998 International Criminal Tribunal for Rwanda defines rape as "a physical invasion of a sexual nature committed on
13932-423: The victim (such as people who are asleep, intoxicated or otherwise mentally compromised). Sexual intercourse with a person below the age of consent , i.e., the age at which legal competence is established, is referred to as statutory rape. In India, consensual sex given on the false promise of marriage constitutes rape. Duress is the situation when the person is threatened by force or violence and may result in
14061-480: The victim may need to have gunshot wounds or stab wounds treated. The loss of consciousness is relevant to the medical history. If abrasions are found, immunization against tetanus is offered if 5 years have elapsed since the last immunization. After the general assessment and treatment of serious injuries, further evaluation may include the use of additional diagnostic testing such as x-rays , CT or MRI image studies and blood work. The presence of infection
14190-532: The victim. Rape crisis centres typically provide medical, practical, and emotional support to the victim in the aftermath of rape, sexual assault or sexual abuse . In Australia, there are a number of state- and territory-based rape crisis centres, such as Full Stop Australia (the first in Australia, founded as Sydney Rape Crisis Collective in 1971) in New South Wales ; Canberra Rape Crisis Centre in
14319-456: The witness stand and believe she had done something to entice the defendant. In Chinese culture, victim-blaming is often associated with the crime of rape, as women are expected to resist rape using physical force. Thus, if rape occurs, it is considered to be at least partly the woman's fault, and her virtue is called into question. In many cultures, those who are raped have a high risk of suffering additional violence or threats of violence after
14448-603: The woman must have consented. If a man solicits sex from another man, the pursuer may be regarded as virile. The WHO states that the principal factors that lead to the perpetration of sexual violence against women, including rape, are: No single facet explains the motivation for rape; the underlying motives of rapists can be multi-faceted. Several factors have been proposed: anger , power , sadism , sexual gratification, or evolutionary proclivities . However, some factors have significant causal evidence supporting them. American clinical psychologist David Lisak , co-author of
14577-413: The year to 2018. It was also said that some expressed doubt over whether May could carry out this proposed increase in funding. The next day, Health Secretary Jeremy Hunt backed the extra £20bn annual increase in NHS funding and responded to criticism by stating that taxation would be used to carry out the funding and that details would be revealed at the next budget. In June 2018 it was reported that
14706-454: Was 11.2% of the public services budget. In 2015/16 it was 29.7%. This equates to an average rise in spending over the full 60-year period of about 4% a year once inflation has been taken into account. Under the Blair government spending levels increased by around 6% a year on average. Between 2010 and 2017 spending growth was constrained to just over 1% a year. A 2019 report said that a study by
14835-417: Was born out of the ideal that healthcare should be available to all, regardless of wealth. Although being freely accessible regardless of wealth maintained Henry Willink 's principle of free healthcare for all, Conservative MPs were in favour of maintaining local administration of the NHS through existing arrangements with local authorities fearing that an NHS which owned hospitals on a national scale would lose
14964-588: Was costing about £10,000 per household in the UK. This, they said, reflected the third highest share of GDP of any nation in Europe. This was said to show that the UK "has one of the most costly health systems – and some of the worst outcomes". The findings were made before the government increased health spending significantly, with a 1.25% increase in National Insurance , in April 2022. Civitas said this showed evidence "runaway" spending as health spending in
15093-496: Was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 (NHS Wales /GIG Cymru was founded in 1969) as part of major social reforms following the Second World War . The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides
15222-556: Was given to protected sex and not to unprotected sex, making the subsequent act non-consensual and therefore illicit; for such cases, United Kingdom, Switzerland, New Zealand have enacted rape convictions, while Australia, Canada, Germany saw convictions for sexual assault; California considers it sexual battery . Victims of rape or sexual assault come from a wide range of genders , ages, sexual orientations , ethnicities, geographical locations, cultures, and degrees of impairment or disability. Incidences of rape are classified into
15351-482: Was increased to £400 in 2018. The discounted rate for students and those on the Youth Mobility Scheme will increase from £150 to £300. From 15 January 2007, anyone who is working outside the UK as a missionary for an organisation with its principal place of business in the UK is fully exempt from NHS charges for services that would normally be provided free of charge to those resident in the UK. This
15480-547: Was insufficient and falling NHS capital spending that put patient care and put staff productivity at risk. The Health Foundation said that £3.5 billion more a year would be required to get capital spending to the OECD average. Spending limits were effecting service efficiency, and patient care. Shortages of equipment and equipment failures had an impact as did relying on ageing diagnostic equipment. In 2018, British Prime Minister Theresa May announced that NHS in England would receive
15609-699: Was passed to the Secretary of State for Wales . According to one history of the NHS, "In some respects the war had made things easier. In anticipation of massive air raid casualties, the Emergency Medical Service had brought the country's municipal and voluntary hospitals into one umbrella organisation, showing that a national hospital service was possible." Webster wrote in 2002 that "the Luftwaffe achieved in months what had defeated politicians and planners for at least two decades." The NHS
15738-542: Was rape. Some may remain in denial for years afterwards. Confusion over whether or not their experience constitutes rape is typical, especially for victims of psychologically coerced rape. Women may not identify their victimization as rape for many reasons such as feelings of shame, embarrassment, non-uniform legal definitions, reluctance to define the friend/partner as a rapist, or because they have internalized victim-blaming attitudes. The public often perceives these behaviors as 'counterintuitive' and, therefore, as evidence of
15867-551: Was reported that Cancer Research UK maintained that more NHS cancer personnel were needed to enable the UK to catch up The NHS in England was expanding early diagnosis services with the goal of increasing the proportion of cancers diagnosed early (at stages 1 and 2) from 53% to 75% in the decade to 2028. In September 2018, it was reported that the NHS was the first health service in Europe to negotiate coverage for novel CAR-T cancer therapy, with agreement reached within 10 days of its European marketing authorisation. On 7 January 2019,
15996-517: Was reported that death rates from breast cancer were falling faster in Britain than in any other of the six largest countries in Europe, and were estimated then to have improved beyond the European average. In October 2018, according to Breast Cancer Care , 72% of NHS trusts across the UK did not provide dedicated specialist nurses for patients with incurable breast cancer." In September 2019 it
16125-479: Was reported that staff shortages at histology departments were delaying diagnosis and start of treatment for cancer patients. In England and Scotland cancer wards and children's wards have to close because the hospital cannot attract sufficient qualified doctors and nurses to run the wards safely. In November 2018 it was reported that cancer patients and child patients were having to travel very long distances to get treatment and their relatives had to travel far to visit
16254-610: Was run as a collective , and was underpinned by a feminist philosophy, which clashed with neo-liberal ideologies which came to the fore in the 21st century. By 2000 there were only 25 functioning rape crisis centres, and the national office in Wellington was closed. By 2018 there were only six such centres. As of 2023, the Sexual Abuse Assessment and Treatment Service (SAATS) is a national service providing medical assistance to sexual assault victims. There are
16383-480: Was short of doctors, foreign doctors were forced to leave the UK due to visa restrictions. A study reported in November 2018 found that a fifth of doctors had faced bullying from seniors in the previous year due to pressure at work. In May 2018 it was reported that the NHS was under-resourced compared to health provisions in other developed nations. A King's Fund study of OECD data from 21 nations, revealed that
16512-540: Was spent on health and was the most spent in the public sector. In 2019, the UK spent roughly 10.2% of GDP on healthcare compared to 11.7% in Germany and 11.1% in France. The money to pay for the NHS comes directly from taxation. The 2008/09 budget roughly equated to a contribution of £1,980 per person in the UK. Some 60% of the NHS budget is used to pay staff. A further 20% pays for pharmaceuticals and other supplies, with
16641-501: Was thought that inflation may erode the real value of this funding increase. As part of the 2018 funding increase the UK Government asked the NHS in England to produce a 10-year plan as to how this funding would be used. In September 2019, it was reported that cancer survival rates in the UK had been rising fast but probably still lagged behind the best results internationally, mainly because of late diagnosis. In March 2019 it
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