The National Health Service: It should have been saved in 1948…

Posted: January 9, 2012 in Discussion, National Health Service, Opinions, Political, Politics, Society, Uncategorized
Tags: , , , ,

I apologise now for any referencing errors contained within this article.

On July 5th, 1948, the National Health Service (NHS) was established by the Labour Party. The central principle, a health service available to all: provided free at the point of delivery; financed entirely from taxation. However, it did not take very long before flaws were identified in Labours grand plan, in fact only seven months.

In an article published in the British Medical Journal (BMJ), February 19, 1949, titled, “The cost of the National Health Service”: Ffrangcon Roberts, M.D., [Roberts] clearly identified why the NHS was flawed; the areas identified, being as relevant today, some sixty three years later.

. Ageing population
. Expansion of hospital practice
. Misconceptions about the nature of disease

Other areas of relevance identified by Roberts include:

. Social and economic conditions
. Disease and working capacity
. Standard of living
. Moral implications
. Medicine considered as a commodity

Perhaps the NHS would be far different today if his points had been taken seriously in 1949.

The central principle of a health service available to all, provided free at the point of delivery, is how we would wish to see the NHS maintained. Having worked with many international staff involved in the provision of healthcare, the principle of the NHS is envied the world over.

The question of how this ideology can be financially maintained is one that divides the political spectrum. Roberts made reference to “The Beveridge report”: that full prevention and curative treatment must be available “without economic barrier at any point”; (P.162). How can this be possible with a system based on taxation? “Without economic barrier at any point”, suggests taxation would provide infinite funding for the NHS; yet in 1948, as now, there was and never would be sufficient numbers contributing to the health care coffer.

Roberts concludes,

“I believe that through ignorance and miscalculation in its preparation the cost of the Health Service has been grossly underestimated, that when in full operation it will be not less than £500 million, and that in future years it will rise to an even higher figure. Whatever the exact figure, I am firmly convinced that at the present rate of expenditure it will involve us in national ruin.” BMJ (1949).

“The alternative is hardly less comforting. It is that a limit will beset by shortage of personnel and materials. This means (mark it well!) that medicine will be rationed and controlled, and there is no reason for supposing that nationalized medicine possesses any moral superiority rendering it immune from the vices which rationing and control invariably bring in their train.” BMJ (1949).

Sixty-five years on and Ffrangcon Roberts words ring true; and the implications to the resolution of the health care crisis remain obvious…

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Comments
  1. dieta says:

    The National Health Service (NHS) is the shared name of three of the four publicly funded healthcare systems in the United Kingdom . They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom. Only the English NHS is officially called the National Health Service , the others being NHS Scotland and NHS Wales . Health and Social Care in Northern Ireland is called the HSC rather than the NHS. Each system operates independently, and is politically accountable to the relevant government: the Scottish Government , Welsh Government , the Northern Ireland Executive , or the UK government .

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