[1]One of the major achievements of the Atlee’s government was the introduction of the National Health Service in 1948. This service aimed to provide medical services to every citizen in the United Kingdom. The minister of health at the time, Aneurin Bevan, was one of the greatest advocates of the service. The National Health Insurance system was able to provide health services to 21 million citizens but left the rest of the population to pay for their medical services. The Labour and the Beveridge party came to the realization that people are being deprived off health services mainly because they are not able to afford it. Many doctors did not like the introduction of the National Health Service. The logical reason underlying the doctors’ reactions was that they felt that they would lose money as a result. They believed that the freedom of their profession was going to be jeopardized. Their projections indicated that the number of private patients available to them was going to reduce drastically and, as a result, they will lose out on their finances. The doctors also had the worry that the National Health Service will subject their patients to certain doctors hence they will not be able to choose their own. However, they later realized that their worry was unfounded. Many people appreciated the introduction of the National Health Services. Almost the entire medical profession joined the National Health Service after its inception. Its popularity was however unplanned for. Its resources were being used up much more quickly than it had been anticipated. Funds set aside for glasses, and dental surgery got quickly depleted. The program had set aside £2 million for free spectacles to be used in nine months. This amount had been already used up within the first six weeks. By 1950, the British government had estimated that the National Health Service would require funding of £140 million per year. However, the National Health Service ended up costing £358 million per year. Therefore, since the introduction of the service in 1948, the National Health Service has always appeared to be coming short on money. The Conservatives had promised to maintain the National Health Service during the 1950 election campaigns, but its popularity proved to be irrelevant since the Labour Party eventually won the elections. After taking over the government, the Labour party tried to make adjustments to the service by introducing a charge on medicine prescriptions and dental treatment. Aneurin Bevan resigned to protest against this because he insisted on free health services.

[2]Before the introduction of the National Health Service, the health care organization and general access to it was coupled with a number of drawbacks. The National Health Service was introduced by Lloyd George, who was the chancellor in 1911. There were benefits that were accrued out of this for a low-income earner. It however did not include dependents. The contributions were not scaled according to the income one earned, but it was at a flat rate. The employer and the employee shared the contribution on a fifty-fifty basis. Their contributions earned cash benefits for accident, sickness and disability. The contributors were also entitled to free care from a local doctor. This was, however, limited. The only entitlement they received to hospital treatment was when the suffered from tuberculosis. The doctors got a “capitation fee” which was a standard payment for each patient they treated in the panel. Before 1948, the insurance service introduced by Chancellor Lloyd George was one of the largest healthcare systems in Britain. There were other systems providing medical assistance. The Poor Law, for instance, focused on providing healthcare to the poorest citizens. It also provided other services such as health education and meals in schools. Voluntary hospitals were another major hospital system that provided care to the Britons before the introduction of the National Health Services. The voluntary hospitals were mainly supported by donations from subscribers. In 1930, this system experienced a financial crisis. Briefly put, the British health care system before 1948 was riddled with a lot of problems. It was made up of a shady combination of several institutions which did not exactly meet the people’s need as far as health care was concerned. There was no access to health care for one’s dependents, and there was also no access to hospital care. Most of the citizens used to get over the counter medicine in local pharmacies. Therefore, medical attention caused major financial problems for families in Britain.

[3]The National Health Care system stepped in to offer health care to the entire population in Britain at their exact point of need. The service was funded through taxation. It did not follow the principle of insurance and entitlement was based on contributions. During the war, it had been anticipated that the local government’s public health service would provide a solution to the national health care system. The role of local government was however limited. After charges had been introduced in 1951 by the labor government, it was realized that the National Health System’s structure had a problem. The structure had a measure of compromise in itself aiming to cap the support of the medical profession. The government aimed it to be an entity that was administered locally, but its inception received criticism from a very hostile medical profession. Aneurin Bevan, the minister of health, accepted the fact that the National Health Service could not be successful without the support of the doctors. He tried to save the situation by nationalizing the hospitals. It was immediately disputed by local councilors as they felt that it was a system that lacked democracy. The major reason it was viewed as such was because the local councilors felt that they had been deprived of the control of the country’s health system. The National Health Service was also criticized because of it lacked integration. The service was divided into local, hospitals, and government services. The three parts were intended to operate independently from each other.

[4]The National Health System had components that made it different from other health care systems formed in Britain. Given the fact that it was funded through taxation, it meant that it was going to have some political influence. It was readily accepted by the population because it removed the fear of illness, and it appeared to be very ideal. The only political interference that the National Health Service experienced was through the insurance platform in 1980. Health care matters have, therefore, proven to be more sensitive in the United Kingdom than in other countries since it is based on taxes and not on insurance. The politicians have tried to solve the problems that are being experienced by the National Health Service through making some amendments. One such reorganization includes the introduction of the general practice appointment booking. Despite the National Health Service acquiring a reputation of financial decadence, it has proven to be quite cost effective. The funding projections had been made to come from the local government and not on the national taxation. Hence, its true funding had been grossly underestimated. The funding proportion has since been gradually increased by the government to cater for the deficiencies. This, however, has proven not to be enough since there are increasing numbers of people that are depending on the services. As the government puts in efforts to fund the service, they tend to make poor projections as to the number of people the healthcare service is intended to serve.

[5]Instead, the structure that the National Health Service has taken is the one that has led to its continuing problems. Despite the fact that the previous health systems had been fragmented, dividing the National Health Service into three parts left quite much to be desired. The “polyclinic” has recently been adopted in order to bring together general practitioners, specialists and other services. During the inception of the system, health centers were built as a unification factor. However, very few were built. Another problem that the system faced was that, during its introduction, it was a service that was majorly dominated by doctors and experienced conflict over surgery opening hours.

[6]The Wanless Report provided efforts to give solutions to the problems that health service showed. The report developed what is popularly known as Primary Health Care (PHC). This has enabled a wider range of practitioners to deliver health to the citizens of the United Kingdom. Midwives and dentists have also been given priority through the introduction of Primary Health Care. The practice of ‘counter prescribing is, therefore, being built upon by the community pharmacists. However, lack of democracy has continued to elude the National Health Service since the nationalization of hospitals. Participation of patients and the public had been greatly limited in the structure of the NHS. The government has therefore been prompted to once more reassess the input of patients.

[7]Well, we learn a number of things from problems that riddled the formation of the National Health Service in 1948. The NHS was introduced with the ideology of universal access and giving health care at the point of need and has, therefore, maintained a level of popularity. Since the system is funded through taxation, the government is expected to have a direct influence on the health services being delivered to the citizens of the United Kingdom. Despite maintaining its popularity, the system has been unable to deliver the ideal health care to its citizens. It is, therefore, factual to say that the structures put in place by the National Health Service in 1948 were greatly flawed, and it gave doctors too much influence. There was less focus on positive health, and much more focus was put on sickness. There was also a lack of democratic input in the system. Attempts to deal with such structural problems were often seen as new initiatives. Some of the suggested solutions either partly achieved its intended objective or simply brought new problems altogether. Most decisions that have been made regarding healthcare since the inception of the service in 1948 has proven to be a ripple effect that echoes negatively into the future of the National Health Service.

[8]Recently, there are many reasons that have been attributed for making the service reach a crisis point. One of the reasons is the increasing number of the ageing population. The diseases that could have killed people during the inception of the National Health Services have been cured. Therefore, the mortality rate has greatly reduced. This means that people can able to live for a relatively longer period of time and would, therefore, need continued health services. The projections made might have not factored in the fact that the ageing population would eventually increase as a result. The old people living with long-term, complex conditions such as kidney diseases and diabetes require specialist care, and this is probably draining the National Health Service. Lifestyle factors continued to change since the introduction of the NHS. The lifestyle people are adapting to seem to be creating a negative impact to their health. There has been an increasing trend in people’s alcohol consumption and cigarette smoking. The citizens are also accustomed to poor dieting which does not have enough or any fruit and vegetables. Not doing enough exercises is another reason. There has been a recorded increase in the number of overweight children which signifies that the problem is set to continue. The citizens’ reliance on the health care services is therefore being strained with time. Thirdly, the expectations of the public slowly changed as time went by. The National Health Service mainly focused on tackling diseases. The public, however, continued expecting more and more with time. The NHS is expected by the people to manage health care, social care, issues to do with mental health, vaccination programmes, contraception and maternity services. It is also held accountable for efficient processing of medication and medical appointments. Coupled with the aforementioned facts of a growing ageing population and depreciation of health due to poor lifestyle factors, the NHS is subjected to experience the problems that it has been experiencing. The accident and emergency department is also being strained beyond its capacity. More and more people are visiting these departments due to minor injuries. Though these visits can be argued to be unavoidable, most people are visiting these units as a result of poor management of their long-term health conditions. There is also poor appointment management as insufficient information is given while booking appointments. The visitor numbers continue to grow by the year, and the medical profession is finding it difficult to deal with. There has also been a rising cost as far as health care in Britain is concerned. Since the introduction of the NHS, there have been a lot of technological advancements and innovations in the medical field that would require more in terms of investment. Keeping in mind that there are more and more people that are meant to be catered for, the NHS is bound to experience an economic disaster. It has been projected, based on how the system has been working, without the necessary radical changes the NHS is eventually going to be unsustainable due to major pressures on its finances and debts.

In conclusion, the problems that the National Health Service experienced during its inception in 1948 could have been well avoided. The formulators of the program could have made far much better projections before they introduced the health care system to the public. It appeared that the health care system was introduced on the premise of trial and error. The acceptance and popularity that it eventually received caught it flat-footed because, after only two years since its introduction, it has started experiencing financial problems. Other factors such as an increasing ageing population, deteriorating way of living and increase in costs due to innovations and technological advancements could have been considered. With these issues in mind, the government could have set aside a good amount to fund the system and also factor in room for contingencies. The idea of funding the health care system through taxation was also a major flaw. This meant that the National Health Service will always be affected by politics. This can prove to be disastrous because people can manipulate it in order to serve their own needs.  Such flaws have led to continued problems to the NHS, and if something substantial is not done, the system will eventually be abolished.

REFERENCES

WEARDEN, G.  “NHS IT project costs soar”: ZDNet, 2004

COLLINS, T. “Is it too late for NHS national programme to win support of doctors for new systems?”: Computer Weekly, 2005

RINTALA, M. Creating the National Health Service: Aneurin Bevan and the Medical Lords:Sage Publications, 2003

KLEIN, R. The New Politics of the National Health Service: Wiley publishers, 1995

EVERSLEY, J. “The History of NHS Charges”, Contemporary British History, Vol.15, pp. 53-75, 2002.

POLLOCK, A. NHS plc: the privatisation of our healthcare: Verso, 2004

MANDELSTA, M. Betraying the NHS: Health Abandoned. Jessica: Kingsley Publishing, 2005

GORSKY, M. “The British National Health Service 1948-2008: A Review of the Historiography,” Social History of Medicine, Vol. 21 Issue 3, pp 437–460, 2008

[1]EVERSLEY, J. “The History of NHS Charges”, Contemporary British History, Vol.15, pp. 53-75, 2002

[2]KLEIN, R. The New Politics of the National Health Service: Wiley publishers, 1995

[3]RINTALA, M. Creating the National Health Service: Aneurin Bevan and the Medical Lords:Sage Publications, 2003

[4]COLLINS, T. “Is it too late for NHS national programme to win support of doctors for new systems?”: Computer Weekly, 2005

[5]GORSKY, M. “The British National Health Service 1948-2008: A Review of the Historiography,” Social History of Medicine, Vol. 21 Issue 3, pp 437–460, 2008

[6]MANDELSTA, M. Betraying the NHS: Health Abandoned. Jessica: Kingsley Publishing, 2005

[7]WEARDEN, G.  “NHS IT project costs soar”: ZDNet, 2004

[8]POLLOCK, A. NHS plc: the privatisation of our healthcare: Verso, 2004

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