National Health Service is a collective name used for each of four health services in England, Scotland, wales and Northern Ireland. NHS was established in 1948 after Second World War as a major social reform. Today National Health Service provides a comprehensive range of services in all the four countries of UK. The national health services are free for the residents of UK, apart from dental and optical care services. Each of the UK’s health system operates independently and is accountable to the relevant government. NHS Wales was originally the part of the same structure as England but later the powers were transferred to Secretory of States for Wales in 1969.
The NHS started work on 5th July 1948. From its early days the cultural history of NHS has shown a prominent place in British society e.g. in Olympics opening ceremony of 2012. In this event NHS was described as an institution which unites the nation more than any other.
History of NHS
The NHS was created under National Health Service Act 1946. Dr Benjamin Moore a Liverpool physician was probably the first person to use the words of National Health Service. He established the State Medical Service Association. Its first meeting was held in 1912 and continued to exist. Before the National Health Service patients were generally required to pay for their medical treatment and health care facilities. Free treatment was available only at voluntary hospitals.
Calls for a unified medical care system can be dated back to minority report of the Royal commission on the poor Law in 1909. Beveridge report in 1942 recommended the creation of a rehabilitation service and health care system for the prevention and cure of disease. When the Labour Party won elections in 1945, Aneurin Bravin was appointed as Health Minister. He was the man behind the audacious campaign which leads NHS to the form it is present today. The NHS was born out of the idea that health care should be provided to all regardless of wealth and social position. See list of best liver cancer hospital in the world.
Bevan launched NHS on 5th July 1948. It had three basic principles as its core.
- It meets the need of everyone.
- It will be free at the point of delivery.
- It should be based at clinical need, not the ability to pay.
Each of the UK’s four National Health System has their own history. In the early years the NHS Scotland and Health and social care in Northern Ireland HSC were separate from National Health Service NHS whereas the National Health Service in Wales was combined with England until 1969. Here is list of top 10 luxury rehab centers in Miami USA.
Eligibility for treatment
UK residents are not charged for their medical treatment excluding dental treatment. The dentistry does have standard charges in each of the four health services in UK. Some of the patients in England have to pay for prescriptions though most of them are exempted. Regarding the non-UK residents e.g. visitors, tourists, etc., the NHS is free at the point of use, for emergency treatment and general practitioner. The services of NHS are also free of cost for people with the right to medical care in European Economic Area. The EEA nation is also entitled to NHS services using European Health Insurance Card. People of countries which have reciprocal arrangements also qualify for free treatment under NHS. See vaginal mesh link for treatment guidelines.
The new overseas visitor hospital charging regulations are introduced in 2015. According to these regulations people, who are coming to stay in UK for more than six months may be required to pay an immigration health surcharge at the time of visa application. They will then be entitled to NHS treatment on the same basis as a resident.
Ordinarily a non-resident of UK is generally not entitled to free hospital treatment except refugees. People who are not entitled to free treatment are asked to pay the charges in advance or sign a written undertaking to pay except for emergency treatment. People not ordinarily residents may be subject to an interview to prove their eligibility for free treatment before a non-emergency treatment.
Financial sources and Funding
Taken together the four National health services have employed around 1.6 million people with a combined budget of £136.5 billion. National health Service systems of the UK countries are 98.8% funded from National Taxation and National Insurance Contributions. There is a small contribution of amount charged from patients for some specific services. Approximately 10% of GDP is spent on health and it is mostly spent on public health sector. National taxation is a major contributor of money to pay for the NHS.
When NHS was established in 1948, it had a budget of £437 million. In 1955, 11.2 % of the public service budget were being spent on health. It was raised to 27.9% in 2016. Some 60% of the NHS budget is used to pay the staff. A further 20% pays for the drug and necessary medication supplies. The rest of 20% splits among buildings, training cost and medical equipment. Around 80% of health the budget is distributed by local trusts in line with particular health priorities in their areas.
Since 2010, there has been a cap of 1% on pay rises. The Union of doctors, nurses and other health care professionals have raised their voices to end the cap on health services pay. They claim that the cap is damaging the health care system. The pay rise is likely to be below to the level of inflation. There appears to be a support for higher taxation, and people are willing to pay more income tax if the money is guaranteed to be paid on National Health Service. Read article for causes of yeast infection.
Raise in Social Care Cost
According to a research by Liverpool University and University College London, social care will cost more in future and higher investments are needed. Professor Helen Stocks Lampard of Royal College of General practitioners has said that to ensure that our patients are living longer with a good quality health, we need a properly funded, and properly staffed health care system with hospitals, general practice and social care systems all working together. In the best interest of delivering safe care to all our patients, all departments should communicate well with each other.
In 2017, there were 691,000 nurses are registered in UK. A figure 1783 less than the year 2016. However, this is the first time that nursing number have fallen. The reasons behind are poor working conditions and work load, also dissatisfaction from pay rise and benefits. Experts are continuously warning that staffing shortages are endangering the sustainability of NHS. Doctors, health workers and midwives are also in shortage. Some general practitioners are loosing sleep because of high work load. They worry work may have lead them to miss something important that may put the patient’s health at a risk. Many a times junior doctors are forced to do work beyond what they have been trained for. This is a stressful and dangerous situation putting patient at a risk.
There has been increasing policy related and work oriented divergence between the four National Health services in the UK. However, statistics released in December 2017 shows that less 9% patients are waiting for more than four hours in Scotland while comparatively the figure raised to 155% in England.
National Health Service and Privatisation
Although NHS outsources the equipment and products it use for dentistry, pharmacy and optical care practice and GP services. However, the outsourcing of hospitals has always been a controversial matter. According to BMA service two-third of doctors are unhappy and uncomfortable about private sector providing their services in NHS. The BMA believes that it is important that private sector should be raised to the same standards as NHS. Recommendations are there for the improvement.
Effect of Brexit
The plan to exit from European Union will effect physicians from EU countries. Many of these physicians are feeling uncomfortable and are planning to leave UK if Brexit happens. They have doubts and feel it difficult for them and their families to live in UK. A survey regarding the Brexit effects has shown that 60% EU physicians are considering to leave. A large number of EU staff working in UK, which includes doctors and nurses have left UK last year. NHS relies on the contributions of EU staff and this drop may lead to serious consequences for patients and their families. This drop in figure led to calls to reassure European workers about their future in UK. EU nurses registering to work in the UK are down to a figure of 96% since the Brexit vote, aggravating a shortage of nurses in the health care system.
Cyber Attacks on NHS
A major cyber attack was occurred On May 2012 within a large no of NHS computer systems causing a disruption among NHS institutions across England and Scotland. It was reported that 25 NHS trusts were effected. Among the effected trusts most are located in London, Nottingham, Glasgow, Blackpool and York.