单词 | national health service |
释义 | National Health ServiceNational Health ServiceorNational HealthNational Health ServiceNational Health ServiceNational Health ServiceNational 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:
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.:
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 ServiceNHSNational 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 ServiceBritish medicine The 50+-yr-old UK government agency that controls the British form of socialized medicine. See Fund holding, Total purchasing.National Health ServiceNational Health Service |
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