Before 1948, a sick person in Britain usually paid for help. Then the government decided that everyone should be able to see a doctor whatever they had in the bank, and the National Health Service was born. Its 75th anniversary fell on 5 July.
The idea is simple. Treatment is “free at the point of use”. Taxes pay for it, collected from UK adults, and a small amount comes from other places, such as the prescription charges patients pay in England and the fees from people who pay for NHS services.
Four governments, one name
The UK government runs the NHS in England only. Scotland, Northern Ireland and Wales each look after their own. Prescriptions show the split: in England people start paying at 16, while in the other three countries they are always free.
Anyone living in the UK can use the service. Visitors can walk into a hospital and get help too, though they may be billed. The staff list runs well past doctors and nurses to surgeons, ambulance drivers, opticians, paramedics, midwives and psychologists.
Money is the constant worry. The NHS has a fixed budget for the whole population and has to choose carefully how to spend it. Many services say they are struggling and need more. People are living longer, so there are more elderly patients, and older people are more likely to need care. Anyone who wants to be seen faster than the NHS can manage can pay for private healthcare instead.
A record of firsts
British surgeons carried out the country’s first heart transplant at an NHS hospital in 1958. Europe’s first liver transplant followed in 1968. In 1971 the world’s first CT scan on a patient used x-rays to build 3D images of organs. Seven years later the NHS helped bring about the world’s first test-tube baby through IVF.
Vaccination programmes protected children from whooping cough, measles and tuberculosis. In 1999 the meningitis C vaccine was offered nationally, a world first. The service also lists the world’s first liver, heart and lung transplant in 1987, bionic eyes, and a rapid whole genome sequencing service for seriously ill babies and children.
For its 70th anniversary in 2018, the Queen awarded the NHS the George Cross, which recognises “acts of the greatest heroism or of the most courage in circumstances of extreme danger”. It came in the midst of the coronavirus pandemic.
