The British National Health Service

The British National Health Service (NHS) was set up in 1948 and was designed to provide equal basic health care, free of charge, for everybody in the country. Before this time health care had to be paid for by individuals.

Nowadays central government is directly responsible for the NHS although it is administered by local health authorities. About 83 per cent of the cost of health service is paid for by general taxation and the rest is met from the National Insurance contributions paid by those in work. There are charges for prescriptions and dental care but many people, such as children, pregnant women, pensioners, and those on Income Support, are exempt from payment.

Most people are registered with a local doctor (a GP, or General Practitioner) who is increasingly likely to be part of a health centre which serves the community.

As the population of Britain gets older, the hospital service now treats more patients than ever before, although patients spend less time in hospital. NHS hospitals – many of which were built in the nineteenth century – provide nearly half a million beds and have over 480,000 medical staff. The NHS is the biggest employer in Europe although Britain actually spends less per person on health care than most of her European neighbours.

During the 1980s there was considerable restructuring of the Health Service with an increased emphasis on managerial efficiency and the privatization of some services (for example, cleaning). In the 1990s a number of NHS reforms were introduced by the conservative and Labour governments including self-management of hospitals and a ‘market’ for patients who were referred to hospitals for treatment. Hospitals and GPs were given more financial responsibility. The political questions continue about how the NHS should be run, how much money should be provided to support it and where the money should come from.

IV. Answer the following questions to the text.

1. What was the original aim of the NHS and what used to happen before it began?

2. How is the NHS paid for?

3. What reforms have taken place in the NHS?

4. How does health care expenditure in Britain compare with other countries?

5. What are the advantages of free medical care?

V. Say whether the following sentences are true or false. If a statement is false, change it to make it true.

1. The National Health Service was founded in 1978.

2. Nowadays people have to pay for basic health care.

3. The NHS is administered by local health authorities.

4. Most of the cost of the health service comes from general taxation.

5. As the population gets older, patients spend more time in hospitals.