Système de santé

The National Health System in United Kingdom provides effective, appropriate and cheaper drugs, treatments, medical consultations with both general practitioners and specialist doctors. Therefore everyone, whatever their means, can be treated. It is considered as one of the best health system in the world. It applies to the four parts of the country : in England, in Scotland, in Wales and in Northern Ireland the HSC.It has been initiated during the twentieth century following the Second World War with the Coalition. It has been established in 1948 by the Labour Party in the context of the « Welfare State ».After its creation, the NHS was an immediate success with the public and has remained popular ever since. Two major reforms account for this change : the first one with the conservative government lead by Thatcher and Major in 1991, and the second one with Tony Blair in 1997.

However despite all these changes the NHS system has nowadays serious difficulties : Indeed the hospitals are stretched to capacity, the number of nurses and general practitioners is too low. Moreover the country has taken recently the decision to leave the European Union, which might destabilize even more the economy.

Consequently we are entitled to ask what conditions have led the politics to create the NHS at the end of the war, then how it has evolved over the years and lastly how it takes place in the current context.

I. First I am going to introduce you the NHS's establishment

Before the NHS, the only national system of Health in Great Britain was the « National Insurance » which had been established in 1911.  However it was restricted to working people. Despite this system, it lacked a real social aid system for everybody.

Many reasons have led the government to establish the NHS : World War II which for instance brought new advanced drugs that people could not afford. Moreover people expected a change of their social rights. Indeed over the years the society evolved in a system with more equity, fairness between all citizens of a same country. At this period, from 1940 since 1945, the government in power was a coalition composed by Conservatives and Labours led by Winston Churchill. William Beveridge published in 1942 the “ Beveridge Report”. This report recommended that every citizen who was old enough to work to pay social cotisations weekly as compensation for sickness, unemployment, retirement, … He was convinced that  the restoration of a sick person to health is a duty of the state prior to any other. It has been defended by Aneurin Bevan, a politician who worked in coal mines and came from a poor family. He said it was morally right to look after people and to treat them because poor health could happen to everyone and gave many speeches. Therefore the Labour party newly elected in 1945 created a range of reforms in a situation called the Welfare State : One of the major ones was the NHS established in 1948. It provided free health care in many domains for everyone thanks to the taxes.

However spending on the NHS was exceeding expectations, leading in 1952 to the introduction by the Conservative party, newly elected, of the first low prescriptions’ charges. 

II. In a second part I am going to present you the NHS's tranformation

As all public health systems, the NHS has seen  its costs rocketting over the years. Labour or Conservatives, had tried to control the costs of the system while maintaining the quality of the service.

- The real first major reform came with the arrival of Margaret Thatcher in power. She represented the Conservative party. She  created the "internal market" in 1991. The idea was to separate the functions of purchasers and healthcare providers, which are subject to competition rules in order to make them economically responsible. The hospitals became autonomous and financially responsible called the "NHS trusts". The results were predictable; on the one hand, the drama of the "hospital Waiting lists", the increased of waiting lists for treatment in hospital, on the other hand the reduction of some treatments, and finally the development of private health insurance systems.

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