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:

it has the largest client group for social welfare since it provides care for people at all stages of the LIFE COURSE; and
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.:

the right to contract out of the NHS for private medicine;
independence from some aspects of the NHS management structure for teaching hospitals;
the right of the individual practitioner to prescribe whatever treatment he or she considered appropriate (clinical autonomy);
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.

National Health Service

NHS

National Health Service. Launched in 1948, the NHS has grown to become the largest publicly funded healthcare system in the world. It is run by the UK Department of Health and politically accountable to central Government. The NHS provides free care to all eligible individuals living in any of the four countries (England, Northern Ireland, Scotland and Wales). The NHS (which includes Health and Social Care in Northern Ireland, NHS [England], NHS Scotland, and NHS Wales) is the fourth largest employer in the world (after the Chinese Army, Wal-Mart and the Indian Railways).

NHS(S)

Abbreviation for:
NHS (Scotland)

National Health Service

British medicine The 50+-yr-old UK government agency that controls the British form of socialized medicine. See Fund holding, Total purchasing.

单词	national health service
释义	National Health Service National Health Service or National Health n (Medicine) (in Britain) the system of national medical services since 1948, financed mainly by taxation. Abbreviation: NHS National Health Service The British system of free or low-cost medical and dental treatment for qualifying people, paid for by taxation. National Health Service 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: it has the largest client group for social welfare since it provides care for people at all stages of the LIFE COURSE; and 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.: the right to contract out of the NHS for private medicine; independence from some aspects of the NHS management structure for teaching hospitals; the right of the individual practitioner to prescribe whatever treatment he or she considered appropriate (clinical autonomy); 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. National Health Service NHS National Health Service. Launched in 1948, the NHS has grown to become the largest publicly funded healthcare system in the world. It is run by the UK Department of Health and politically accountable to central Government. The NHS provides free care to all eligible individuals living in any of the four countries (England, Northern Ireland, Scotland and Wales). The NHS (which includes Health and Social Care in Northern Ireland, NHS [England], NHS Scotland, and NHS Wales) is the fourth largest employer in the world (after the Chinese Army, Wal-Mart and the Indian Railways). NHS(S) Abbreviation for: NHS (Scotland) National Health Service British medicine The 50+-yr-old UK government agency that controls the British form of socialized medicine. See Fund holding, Total purchasing. National Health Service National Health Service Most commonly called the NHS. The collective name for the publicly-funded health care systems in the United Kingdom. The governments of Northern Ireland, Scotland and Wales operate their NHS systems independently, while the UK government controls the NHS in England. Each NHS system is funded entirely by the government and provides most services free of charge for patients. Critics contend that the NHS is too expensive for taxpayers and that inefficiency has led to long wait times for medical care. However, it has remained popular among many people in the UK. AcronymsSeeNHS
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