National Health Service

The National Health Service (NHS) was founded by Aneurin Bevan on 5th July 1948. The aim of the public health service is “providing a comprehensive range of health services to all in need” (Ham, 5). But to concern all people and not only ninety percent of the population as many doctors wished, Bevan had to persuade the medical profession first (ibid. 14). The greater part of the NHS obtains the funding from general taxation and is financially supported by the Department of Health which also controls the service. The budget of the Department of Health is set for a three-year period, within it has to meet the expenditure on training, research and capital. Additionally, the NHS receives annual cash limits for its different parts (Smith, 5). In the early 1970s Britain has spent less than any other European country on health care, health benefits and pensions due to the different financial structure of its health service. Britain is also the only country that had a national health system which is funded by taxation rather than by contractual social insurance (Harris, 44, 46f). But since the 1990s the different lacks in performing of the NHS became clear in case of the health outcomes and responsiveness, meaning very long waiting time, the government decided in 2000 to adapt the spending of the European average of 8 per cent of GDP (Smith, 5).

The function of the Department of Health in which spending decisions and policy are made by ministers, is inevitable within the NHS. Its assignment is to ensure on the one hand that the visions of the NHS become reality and on the other hand that entitlements, minimum standards and universality are retained and strengthened (Department of Health, 2008c). The aim therefore is to move to a regulated system in which local decision-makers have local freedom and specific standards are protected as well as guaranteed (Smith, 7f). Furthermore, the Department of Health sets a lot of NHS system reforms adapting them to the NHS Plans which require a modernisation of all elements of the health care system. But the aspect of national taxation and low user charges always stayed untouched. However, the reforms always applied to enhanced choice of health care providers for patients, concerning plurality and the development of private providers; changes of employee contracts to raise quality and productivity; improved strategic purchasing of health services (Smith, 16). But next to the Department of Health there are also other organisations belonging to the NHS structure in England.

The Secretary of State for Health which is an important part of the structure has the responsibility for the work of the Department of Health. Besides, the Department of Health is supported by 23 public bodies and agencies. Furthermore, the NHS England is an independent organisation which is responsible for health and care outcomes for people in England which they ensure by giving the NHS priorities and directions. Another important part of the NHS structure are the Clinical commissioning groups, which take care of the planning and commissioning of their local health care services (NHS Choices). There are many other smaller organisations belonging to the NHS structure but these were the most important ones.

The National Health Service is still evolving and is modernised with every new reform.

Bibliography

Department of Health. High Quality Care for All: NHS Next Stage Review Final Report (Lord Darzi's review), Command paper 7432. London: Department of Health, 2008c. <https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/228836/7432.pdf>.

Ham, Christopher. Health Policy in Britain. The Politics and Organisation of the National Health Service. 5th ed. Hampshire: Palgrave Macmillan, 2004.

Harris, Jose. "Enterprise and the Welfare State: A Comparative Perspective." Terry Gourvish, Alan O’Day (ed.) Britain since 1945. Hampshire: MacMillan Education Ltd, 1991.

NHS Choices. The NHS in England. The NHS Structure. <http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspx>. Accessed 3rd July 2017.

Smith, P. and M. Goddard. “The English National Health Service: An Economic Health Check.” OECD Economics Department Working Papers No. 716. Paris: OECD Publishing, 2009.