National Health Service

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Related to National Health Service: National Health Service Corps

National Health Service

(in Britain) the system of national medical services since 1948, financed mainly by taxation

National Health Service (NHS)

the system of health care provided for all citizens by the UK government.

In 1948, after more than a century of public health reform, and in the centenary year of the first Public Health Act, the National Health Service was established. It occupies a unique position in British society because:

  1. it has the largest client group for social welfare since it provides care for people at all stages of the LIFE COURSE; and
  2. more than any other welfare institution established as a result of the BEVERIDGE REPORT of 1942, the NHS embodies the welfare principle – care as a social service rather than a market commodity. It is the subject of political debate because of New Right theories about the state and the responsibilities of individuals, and it is the subject of academic discussions concerning the power of the medical profession and the nature of illness and health in the UK.

The NHS was set up to provide a fully comprehensive service of curative and preventative medicine for physical and mental illness. The service was to be free at the point of treatment in accordance with the patient's medically defined needs. The means-test principle of eligibility was abolished and the service was funded centrally from insurance and taxation. Its architects believed that the NHS would mop up the pool of ill health and that full employment would combine with the other agencies of the welfare state to lead to higher standards of health and a long-term fall in demand for health services. This has not happened. Rising costs, changes in health expectations, changes in the pattern of disease, demographic change and the persistence of class-related illness (see BLACK REPORT) have resulted in high levels of demand. The balance of supply favours the acute, hospital, interventionist sector at the expense of the community, disability and geriatric sector. Garner (1979) refers to this as the ‘no hope, no power’ paradigm. These ‘Cinderella’ patients have no power themselves and no powerful medical interests ranged on their behalf. Their conditions require care rather than cure. In a profession where success is associated with high-technology medicine, conditions which hold out little hope of scientific advance or breakthrough are unattractive to ambitious doctors.

The development of the medical profession in the UK is inseparable from the history of the NHS since it guaranteed the medical monopoly and secured a number of professional rights, i.e.:

  1. the right to contract out of the NHS for private medicine;
  2. independence from some aspects of the NHS management structure for teaching hospitals;
  3. the right of the individual practitioner to prescribe whatever treatment he or she considered appropriate (clinical autonomy);
  4. systems of payment and administration which confirmed the status differentials between hospital doctors and general practitioners, consultants and the rest of the medical profession.

In the 1990s, the NHS has undergone reform. An internal market has been created with the intention of increasing the efficiency of service delivery and enhancing patient choice. The main change has been the institutionalization of a split between purchaser (Health Authority) and provider (hospitals, general practitioner and other services) with providers competing for service contracts. Hospitals and general practitioners have been encouraged to become ‘trusts’ or ’fundholders, i.e. units which function independently of Health Authority control. Other changes have involved the provision of a ‘patient's charter’, attempts to introduce performance-related pay for clinical staff, and decisions to abolish regional (but not District) Health Authorities. Critics of these changes are essentially anxious that the resort to market criteria is undermining the founding principle of the NHS (provision of care on the basis of need) with one that looks instead to costs and purchasing power.

References in periodicals archive ?
National polls consistently name the National Health Service as the thing that makes most people proud to be British.
To learn more about the National Health Service Corps loan repayment program or scholarship program, visit: NHSC.
The National Health Service is the largest provider of healthcare in the UK and provides a growing demand for MediQuip's products.
We are proud to provide the necessary technology, manufacturing capability and other resources to assist the National Health Service in its efforts to protect individuals from the threat of a flu pandemic," said Joy Amundson, corporate vice president and president of Baxter's BioScience business.
That's what the National Health Service is supposed to be about ( and anything else is little more than a political gimmick.
This new book opens with a survey of hospital buildings and projects since the inception of the National Health Service in 1947.
JOIN US: Julie Liggins (left) and Lesley Hines set up a stall at Nuneaton's Asda to give away lots of information leaflets on varied careers within the National Health Service during a nationwide Jobs Shop Day.
This is good to hear, as standards in the National Health Service are poor.
Starting out in 1972 as a physician in the National Health Service Corps in New Mexico, I came to Washington several years later and had the opportunity to run the program during the Carter administration.
The Napoleonic government did not set up a national health service along the lines first suggested by the Poverty Committee in 1791, but it did establish effective control over the hospital system, promote free vaccinations for smallpox, support new initiatives such as nursing homes and infirmaries as substitutes for hospitalization, and renovate hospitals in order to insure cleanliness, orderliness, and single beds for patients.
Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today announced that the number of participants in the National Health Service Corps (NHSC) has nearly tripled.
APHA has announced its support for the National Health Service Corps, which faced an end to funding at the end of September due to budget constraints.

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