NHS

What is the NHS?

The NHS was founded in 1948 by the post-war Labour government as part of the welfare state, offering free healthcare. Charges for prescriptions, glasses, and dental care were introduced in 1951. Funding worsened by an ageing population and costly medical advances.

How is the NHS funded?

The NHS is primarily funded through general taxation (80%) and National Insurance contributions, land sales, and patient charges (20%).

How did Thatcher reform the NHS in 1990?

Community Care Act introduced the concept of the ‘internal market’ within the NHS. This divided the system into ‘purchasers’ or ‘commissioners’ who buy services for patients and ‘providers,’ such as NHS hospital trusts, that supply the services. The aim was to create market-like competition to drive efficiency and service improvements, though this remains a controversial aspect of the NHS.

How did Blair reform the NHS?

NHS funding increased from 6.7% to 9.7% of GDP (1997–2010), while the internal market remained. In 2002, Primary Care Trusts (PCTs) were created to commission healthcare, and some NHS Trusts became self-governing Foundation Trusts. The controversial 2003 Health and Social Care Act allowed PCTs to buy care from private providers or abroad to reduce waiting lists.

How did Cameron reform the UK in 2012?

Health and Social Care Act replaced PCTs with Clinical Commissioning Groups (CCGs), made up of GPs and the public. NHS Trusts became Foundation Trusts, allowed to generate income from private treatments. Hospitals gained semi-autonomy, and NHS Trusts now compete with private providers for funding from CCGs.

What were the 2022 NHS reforms?

The 2022 Health and Care Act abolished Clinical Commissioning Groups and focused on collaboration through Integrated Care Systems (ICS). ICS includes Integrated Care Boards (ICBs) for NHS planning and Integrated Care Partnerships (ICPs) to address broader health and social care needs.

How is the NHS currently run?

The Secretary of State for Health (Wes Streeting) oversees England's health system. NHS England provides leadership and supports 42 Integrated Care Systems (ICSs), each with an Integrated Care Board (ICB) for NHS services. ICBs are currently accountable to NHS England but will report to the Health Secretary after NHS England's abolition. Integrated Care Partnerships (ICPs) address broader health and social care needs, working with local authorities. Scotland, Wales, and Northern Ireland have different systems.

What are some key issues for the NHS?

• Ageing population

• Health care inflation

• Lack of adult social care meaning that elderly people who could be discharged are kept in hospital

• Waiting times for treatment

• Ambulance waiting times

• Nurses and doctors pay

• Funding

• Access to your GP, sometimes difficult

• Crisis in A and E departments

• Impact of private, profit-making healthcare companies

• Access to mental health services

What is the care quality commission?

a regulator that inspects hospitals, care homes, dental and GP surgeries, and issues reports

What is health watch?

represents the views of patients

What is the Parliamentary and Health Service Ombudsman?

deals with complaints

What is The National Institute for Health and Care Excellence?

provides national guidance and advice to improve health and social care including approving new drugs.