Establishment and Structure
- The National Health Service (NHS) was established in 1948 as part of social reforms after World War II.
- The NHS in England, NHS Scotland, and NHS Wales were the original three systems, with Health and Social Care in Northern Ireland established separately.
- The founding principles of the NHS were comprehensive, universal, and free healthcare based on clinical need.
- The NHS provides a wide range of health services, with dental treatment and optical care being exceptions.
- In England, NHS patients have to pay prescription charges, although certain exemptions apply.
Size and Budget
- The combined budget of the four NHS services in 2015-16 was £136.7 billion.
- The NHS and related healthcare services employed around 1.6 million people in 2015-16.
- The total health sector workforce in the UK in 2014 was 2,165,043, making it the fifth largest employer globally.
- The NHS's significant market power in purchasing consumables influences global prices, particularly for medications.
- Some countries rely on the UK's assessments for their own decisions on state-financed drug reimbursements.
History
- Calls for a unified medical service can be traced back to the Minority Report of the Royal Commission on the Poor Law in 1909.
- A resolution proposed at the 1934 Labour Party Conference committed the party to establishing a State Health Service.
- Cross-party consensus emerged after the 1942 Beveridge Report recommended a comprehensive health service.
- Aneurin Bevan, appointed as Health Minister in 1945, played a significant role in shaping the NHS.
- The NHS was proposed in legislation for England and Wales in 1946, Scotland in 1947, and Northern Ireland in 1947.
Principles and Controversies
- The NHS was founded on the principles of meeting the needs of everyone, being free at the point of delivery, and based on clinical need.
- Charges for dentures, dentists, and glasses led to Aneurin Bevan's resignation from the Labour government in 1951.
- Prescription fees were introduced by Winston Churchill's Conservative government but abolished by Harold Wilson's government in 1965.
- The NHS has faced controversies and changes throughout its history.
- The NHS holds a significant place in British society, reflected in film, TV, cartoons, and literature.
Eligibility for Treatment
- Everyone living in the UK can use the NHS without paying the full cost, although charges for NHS dentistry and optometry apply.
- Most patients in England have to pay charges for prescriptions, with exemptions for certain groups.
- The eligibility for NHS services for overseas visitors has been a topic of discussion and policy considerations.
- Brexit has impacted the eligibility of EEA nationals for NHS services, subjecting them to similar restrictions as non-EEA, non-UK residents.
- The immigration health surcharge is relevant to the eligibility for NHS services for certain groups.
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom, comprising the National Health Service in England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland 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 a comprehensive range of health services, provided without charge for people ordinarily resident in 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.
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Taken together, the four services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion. In 2014, the total health sector workforce across the United Kingdom was 2,165,043 making it the fifth largest employer and 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 either copy the United Kingdom's model or directly rely on Britain's assessments for their own decisions on state-financed drug reimbursements.
