National Health Service

NHS. Officially started 5 July 1948 and is part of the Welfare State implemented after the Second World War. The aim of the NHS is “providing a comprehensive range of health services to all in need” (Ham, 5) - from "Cradle to Grave", as the slogan has it, financed by taxes. To concern all people and not only ninety per cent of the population as many doctors wished, Bevan had “to persuade the medical profession” (ibid. 14) first. The Department of Health keeps an eye on the NHS and besides the general taxation and other cash limits supports the service financially. (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 dif-ferent financial structure of its health service. Britain is also the only country that “had a na-tional health system offering total coverage and [is] funded primarily by taxation rather than contractual social insurance” (Harris, 44, 46f.). But since the 1990s the different lacks in per-forming 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 Europe-an average of 8 per cent of GDP. (Smith, 5) The assignment of the Department of Health, which is important for the NHS is to ensure that the decided goals of the service become true and on the other hand that at least the mini-mum standards and universality are kept up and reinforced (Department of Health, 2008c). The aim therefore is to achieve protected standards and to create local freedom for managers. (Smith, 7f.) Furthermore, the Department of Health sets a lot of NHS system reforms adapt-ing them to the NHS Plans with further goals; “modernise all elements of the health care sys-tem […] improving system outcomes […] and productivity […]” (Smith, 16). However, the reforms always applied to; “[i]mproved strategic purchasing (commissioning) of health ser-vices; enhanced choice of provider for patients; increased plurality of health care providers, including the development of […] private providers; […] and changes to employee contracts to raise quality and productivity” (ibid. 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 is the main body of the Department of Health. Furthermore, the NHS England is an independent organi-sation which is responsible for “the priorities and direction of the NHS and to improve health and care outcomes for people in England” (NHS Choices). Another important part of the NHS structure are the Clinical commissioning groups, which take care of their local health care services. (ibid.) 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.