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The principle that distinguishes a national health service from all other forms of medical and health care delivery is that it is a delivery system accountable, through the body politic; to the population it serves.

Introduction

The preceding statement articulates the intent and focus of the British National Health Service (NHS). As we wend our way through the various health care systems in this paper, we should note that the NHS has historically been characterized as “a health model for the entire worldve. At the same time, the NHS has been vilified for being underfinanced, overly centralized, and creating potentially life-threatening patient queues. Regardless of how the current system is assessed, the NHS, like all health care systems, emerged as the result of politically motivated interests as well as historically significant events.

The National Health Service Act (England and Wales) of 1946 aimed to introduce a comprehensive health service designed to secure enhancement in the bodily and psychological wellbeing as well as the prevention, identification and treatment of the diseases or sickness. Before this, government responsibility (at local and national levels) for individuals’ health and welfare was much more limited. There was no centralized, co-ordinated set of health services as there is today. For instance, before the NHS, hospital services were provided by a patchwork of voluntary (charitable) foundations, municipal (local government-run0 hospitals, and private hospitals and clinics.

The NHS, which began treating patients in July 1948, was a landmark in health policy in two important ways. First, it was a centralized and government-dominated style of policy-making, despite the power of the medical profession to shape and alter policies locally. This traditional pattern of uniformity and control of the NHS by the Department of Health in London is now giving way to less centralized approach- not least because of the introduction of devolved administrations in Northern Ireland, Scotland and Wales. However, compared with health systems in North America and in most European countries, it remains a uniquely uniform and centralized health service. Second, the introduction of the NHS represented a landmark because it was among the most socialistic and radical policies in the post-1945 Labour government’s welfare state programme.

The NHS formed a central pillar in the welfare state’s ambition to provide equal care for everyone ‘from the cradle to grave’. However, the NHS not only represented fairness, equality and freedom from the worry of not being able to afford medical treatment, it also represented a turning point in policy about where the responsibility lay for people’s health and health care. Along with the benefits of a ‘free’ National Health Service came the assumption that it was now primarily the states responsibility to look after people and take responsibility for their health.

Although health care in England can be traced to the development of hospitals in the tenth century ,the National Health Service has its historical origins in the emergence of “friendly societies” during the nineteenth century. These societies are characterized as “a natural growth of associations of persons, often earning their livelihood in a similar fashion, who paid money into a common fund for some form of insurance purpose.” In addition to the friendly societies, the Poor Law Amendment Act of 1834 was intended to provide the poor and the sick with health care. As the industrial revolution progressed throughout the nineteenth century, rural populations were increasingly forced into urban centers. Because of this movement, the government became more concerned with public health issues such as sanitation. As a result, “a central authority-a central board of health under the Privy council” was established to address the increasing knowledge of disease patterns.

In addition to ensuring universal coverage, the newly created NHS provided “hospital treatment, freely available for the whole population and financed by insurance contributions” Physicians, however, were less than enthusiastic about the NHS. As a result, concessions, such as allowing them to maintain private practice and not requiring them to become salaried civil servants, were included[4]. Organizationally, the NHS consisted of “a tiered system of central administration, regional hospital boards, local health authorities and executive councils, and a tripartite of providers: hospital, community, and family practice services” (5). The bill creating the NHS was passed in 1946, but it was not officially implemented until July 5, 1948. The NHS is an entitlement that ensures a number of rights to UK citizens. These rights include the following:

  • To be registered with a general practitioner (GP)
  • To be referred to as a consultant acceptable to him or her where the GP thinks it necessary; and
  • To receive emergency medical care at any time.

Originally, the NHS was divided into three major components under the auspices of the minister of health: regional hospital boards, local health authorities, and executive councils.

As with all health care systems, the NHS continues to experience structural change. The first major reorganization of the system occurred in 1974 with the objective of increasing the efficiency of the service delivery. In the process, the three original components were to be “replaced by a structure of complete integration combining all these sectors into one comprehensive organization.” These reorganization efforts resulted in the creation of regional health authorities (formerly the regional hospital boards) and area health authorities (formerly the local authorities). The executive councils remained but were put under the control of the Family Practitioner Committee that was directly responsible to the Department of Health and Social Services . 

Further reorganization of the NHS occurred throughout the 1980s and 1990s. In 1982, the area health authorities (which were created in 1974) were eliminated. Concomitantly, private health care opportunities increased through the efforts of the conservative Thatcher government. By the mid-1980s, 10% of the population was covered by private insurance.

The second change was a new management style. A 1983 document by Roy Griffiths, director of a supermarket chain, outlined a management structure for the NHS. This structure would incorporate general mangers at all levels of the NHS and reduce the role of doctors and nursing representatives in the decision-making process.

The third change involved an increased private sector within the health care community. Growth in this sector has been limited but consistent with social class position. Interestingly, the movement toward a large role for the private sector has had the effect of solidifying the medical community’s support for the NHS. Perhaps most important is the impact the private sectors has had on the long-term care. Here, the private, and voluntary, sectors became the largest producers of institutional long stay care for the elderly by 1987.

Conclusion

As have been reflected above, there were several short term significance that the National Health Service brought to the people of United Kingdom. The paper has reflected on NHS having some significance on the lives of women, it led to an improved health for the nation, improved medical knowledge as well as treatment, the reorganization and restructuring of the healthcare system as well as the change in the role of government. The indicative started by the then secretary Aneurin Bevan was born in Manchester; many did not think that it was to be a huge success in terms of healthcare provision. Today, NHS stands out for its noble principles which uplift the presence of healthcare service being accessible to all people and financed entirely from taxation. Despite the major progress brought by NHS in the health sector, there are several challenges that have been met with one of them being that some people feel that NHS has not done enough, and that the budget allocation being allocated should not be the case. However, the majority feel that NHS achieved a great milestone in the short duration after its inception.


 

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