National Health Service

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The National Health Service (NHS) is the United Kingdom's nationalized health care system. It was established in 1948 as part of Clement Attlee's post-World War II Labour government's socialist program, and has been supported (at least publicly) by politicians of every party since then. The wealthy in Britain typically use private health insurance, for which there are tax breaks,[1] while the general public and some politicians use the NHS system.[2]

As pharmaceutical companies began rationing drugs since 2008, the British healthcare system faces drug stortages in 2012. Officials within their health care system warned about a severe shortage of pharmaceuticals, putting patients' lives at risk.[3]

The NHS is nominally funded out of "National Insurance contributions", a form of personal taxation comparable to the US Social Security system, albeit capped below average earnings. The NHS revenue stream is, in theory, entirely separate in operation from income tax.[4] In practice, the NHS is funded from general taxation, and is accepted by the British electorate as being funded in this way. All prescription medicines (however not over-the-counter ones) are available for a low standard fee in England. Prescriptions are entirely free of charge in Wales.[5] NHS treatment is available to all residents of the UK. Most services, including complex and expensive surgical procedures and drugs, are free at the point of use, and those that are not (such as the provision of glasses and dental care) are free to people on low incomes. This ensures that everyone is able to be treated, no matter what their individual wealth or means may be.[6] "Private" (i.e. non-NHS) doctors and hospitals do exist in Britain, but fewer than 10% of Britons choose to buy private health insurance in preference to using the NHS. (The big exception to this is in the area of dental care: NHS dentists are relatively difficult to find in many areas, and many people are forced to "go private", even if uninsured.)

The NHS is Britain's largest direct and indirect employer with 1.3 million workers. It is not, despite maverick MEP Daniel Hannan's assertion, the second largest employer in the world.[7] This cradle-to-grave entitlement costs Britain $158 billion (USD) per year. Britain’s Conservative former Prime Minister David Cameron was looking to reform the state-run health-care system, which he called "second-rate" due to the program’s massive cost and lackluster performance.[8]


Official figures published in 2009 revealed that more than 230,000 patients are being forced to wait more than 18 weeks for hospital treatment.[9] As a result of its comprehensive coverage, the resources of the NHS have been consistently tightly stretched for many years, leading to lengthy waiting lists for everything from dental work to surgery. This was the case in the 1980s and 1990s in particular. Since 1997, the NHS has benefited from substantially increased spending under the Labour Party, but there is a perception among many in Britain that the extra money has not been well spent or delivered appropriate improvements. Read more about "Delay, Denial and Dilution, The Impact of NHS Rationing on Heart Disease and Cancer." [10]

Poor quality care

One million NHS patients have been the victims of appalling care in hospitals across Britain, according to a major report released Aug. 27, 2009. In the last six years, says the Patients Association, hundreds of thousands have suffered from poor standards of nursing, often with 'neglectful, demeaning, painful and sometimes downright cruel' treatment. [11] Many critics, including Daniel Hannan, have expressed serious concern over the failure of the NHS in providing Britain with an acceptable health care. Criticism included the immense wasteful costs of the NHS, shortage of doctors and other vital employees, lack of available care, and poor quality of facilities and care.

However, in 2009, according to the OECD's Health Data report, Britain was found to spend less public money per capita on health provision than the USA, despite NHS care being free at the point of need for all citizens, and the USA system requiring citizens to also pay for private insurance. Life expectancy in the USA is less than that in Britain.[12]


National Institute for Health and Clinical Excellence (NICE) proudly boasts of "Developing a series of national clinical guidelines to secure consistent, high quality, evidence based care for patients." NICE is responsible for giving advice which effectively rations the supply of government provided treatments and drugs. It does this by a careful and complicated consideration of Quality Adjusted Life Years (the QALY), taking into account how a particular treatment affects this figure on average. Ultimately the number of dollars per QALY is what dictates whether a medicine is then made available via the NHS. These decisions are inevitably controversial at times and some even go so far as to accuse them of denying life saving medication.[13]

All party support

The NHS is supported by politicians of all parties in the UK, but is widely regarded as the child of the Labour Party, and inspires particular affection in the supporters of this party. All post World War II governments have consistently supported the National Health Service. British voters take great pride in what they regard as the free provision of basic human needs such as healthcare and schooling. Many politicians including Margaret Thatcher have worked to reform the National Health Service and make it more efficient.[14] However, perhaps due to its overwhelming size and entrenched popularity, this has continued to be a difficult and controversial task.

See also


  8. Prime Minister Cameron plans to reform Britain’s government-run health-care system, The Daily Caller, Jaunuary 17, 2011
  9. BURNHAM FORGETS 230,000 ON LIST, Daily Express UK, August 14, 2009
  10. Rationing PDF Report
  11. Rebecca Smith, "'Cruel and neglectful' care of one million NHS patients exposed," Telegraph (London) 27 Aug 2009
  12. [1]
  13. END NHS INJUSTICE, The Northern Echo, July 2, 2010

External links