National Health Service

National Health Service (NHS) (UK) The public health service established under the 1946 National Health Service Act. This act applied to England and Wales, with separate legislation being passed for Scotland and Northern Ireland. The legislation had been opposed by many medical practitioners, who feared that it would threaten their professional independence and private practice. However, the Minister of Health, Aneurin Bevan, skilfully pushed the plans through Parliament, making some concessions to doctors by allowing private practice to continue. The Act took effect from July 1948, and established a comprehensive health service aimed at diagnosing and treating illness. The vast majority of hospitals, as well as general practitioners, joined the scheme, which was to be administered by regional health authorities. One of its main principles was that treatment should be free at the point of delivery. Therefore, the NHS was funded partly from national insurance, but mainly from taxation. This principle was modified in 1951, when Hugh Gaitskell introduced prescription charges covering half the cost of adult spectacles and dentures. This caused Bevan to resign from the cabinet. Charges have been steadily increased, and their range extended.

In the 1960s a hospital building scheme was instituted, but rising costs have caused problems for all governments, as a result partly of the NHS being successful in prolonging expectation of life, and partly of the increase in the number of treatments possible. In 1989–90 the NHS was reorganized by Thatcher's government, which instituted a controversial internal market to increase efficiency through competition. During the governments of John Major and the first Blair government, public spending on the NHS increased only insignificantly in real terms, despite the greater costs of treating an ageing population. It became an important issue in the 2001 elections, and in 2002 Blair staked the future of his second government on improving the NHS. He announced an effective income tax rise (in the form of national insurance contributions) and pledged unprecedent increases in funding to bring public spending on health up to the EU average.

Medicare