National Health Service

(abbr the NHS)

the British public service providing medical care that is paid for mainly by the government. British people have strong feelings about its importance, and it is always one of the top political issues in Britain. The National Health Service was introduced in 1946 by the Labour government as part of the welfare state system recommended in the Beveridge Report, and it came into operation in 1948. At first it provided free medical, dental and hospital services for everyone, but in the 1960s charges for medicines and dental services were introduced. Since then the cost of the NHS has continued to rise and governments have been forced to find new ways of paying for it. The Conservative government under Margaret Thatcher was accused of trying to privatize (= sell to private owners) the NHS after introducing hospital trusts and ‘fundholding’ (= a system allowing doctors to control how they spend their funds), and encouraging the growth of private medical services and private medical insurance. There are now fewer NHS dentists, but doctors and hospitals are still free of charge. See also private patient.

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▪ British agency

      in Great Britain, a comprehensive public-health service under government administration, established by the National Health Service Act of 1946 and subsequent legislation. Virtually the entire population is covered, and health services are free except for certain minor charges.

      The services provided are administered in three separate groups: general practitioner and dental services, hospital and specialist services, and local health authority services. General practitioners or family (family practice) physicians give primary medical care to a group of persons who register with them. These doctors and dentists operate their own practices but are paid by the government on a per capita basis (i.e., according to the number of people registered with them). Their services are organized locally by an executive council. Physicians are free to contract in or out of the service and may have private patients while within the scheme. hospital and specialist services are provided by professionals on government salaries working in government-owned hospitals and other facilities that are under the direction of regional authorities called hospital boards. Local health authority services provide maternity and child welfare, posthospital care, home nursing, immunization, ambulance service, and various other preventive and educational services. They may also operate family-planning clinics, as well as day nurseries for children.

      The National Health Service is financed primarily by general taxes, with smaller contributions coming from local taxes, payroll contributions, and patient fees. The service has managed to provide generally high levels of health care while keeping costs relatively low, but the system has come under increasing financial strain because the growth of medical technology has tended to make hospital stays progressively more expensive.

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