It began with one straightforward aim – to give everyone in our society access to high quality healthcare, no matter where you live and regardless of your ability to pay. For many people the NHS removed the uncertainty around being able to access healthcare during sickness.

The start of the NHS in 1948 coincided with the wider use of antibiotics making them accessible to the whole population. It had a huge impact on the management of many infectious diseases, like bronchitis and pneumonia, and in the treatment of childhood disease where before antibiotics 90% of children with bacterial meningitis died. Making medical advancements available to all remains a key strength of the NHS. 

What are the four basic models of healthcare?

Key Fact

On an average day in the NHS around 1 million people attend a GP appointment

There has been a 16% rise in the number of patients per full time equivalent (FTE) GP in the past seven years.

Many GPs work beyond the safe limit of 25 patients per day

Equity and efficiency

We share the cost of the NHS fairly through the tax system, pooling the risk of ill health. Centralised funding allows for economies of scale in purchasing and ensures funding is distributed fairly. The public want to see NHS funding used wisely and waste minimised. Overall there is evidence that the NHS is already cost efficient, with less spent on administration compared with other healthcare systems that are based around charges and insurance.

Does the NHS have too many managers?

Key Fact

Since 2009, the NHS has averaged 1.4% efficiency gains each year, outperforming the wider economy of 0.2%. However, recent rises in productivity gains have occurred mainly due to restrictions in staffing


Public service

The NHS has always relied upon a vast pool of committed staff, who are trained to high professional standards and are motivated by a culture of public service which prioritises the needs of patients.

Over the last decade NHS staffing levels have not kept pace with the demand. A lack of planning and investment in workforce has coincided with a long-term rise in waiting times, which started before the pandemic. The government has published a new workforce plan but history shows that public pressure will be needed to ensure it is backed by consistent funding.

Comprehensive services 

Anyone living in the UK can access a huge range of healthcare provided through the NHS, including the care of family doctors, community health services, diagnostic services, hospitals and emergency facilities. Inconsistency in funding has affected capacity and increased waiting lists, but the clinical urgency of care is an important principle in deciding priority. 

Why is charging to see a GP or attend A&E a bad idea

Key Fact

A good indication of the trust and coverage offered by the NHS is The number of people who opt for private health insurance in the UK is around 10%, whereas the average in EU countries is three times higher. 


A cooperative network

In 1948 the NHS replaced a patchwork of charities and local authority services with a national network that cooperates to deliver high quality services to every corner of the UK. Despite recent attempts to allow commercial approaches to be more dominant, it does not work for profit and remains largely publicly delivered.

There is some accountability to local people, but this has been reduced over recent years. However, the popularity of the NHS remains, boosted by its immense response to the pandemic, and it has a pivotal place in British society.

Active NHS supporters have regularly applied campaigning pressure on local and national politicians in order to protect and improve its services.- a cooperative network, publicly supported, that is not for profit.

Would European style social health insurance be the answer to the problems of the NHS?

Key Fact

The public overwhelmingly support the NHS, but is deeply negative about the state of the NHS. Only a third (33%) agree that the NHS is providing a good service nationally, while nearly half (47%) disagree.

Adaptive and resilient

The NHS is hugely adaptable and resilient. Over the last 75 years it has adapted to advances in technology and medicine and been hugely popular for the service it has provided. It has also had to survive through many periods of damaging reform, and cope with years of under-resourcing, proving its ability to adapt and cope under immense pressure.

Does it help the NHS if richer people ‘go private’

Key Fact

The public is deeply negative about the state of the NHS. Only a third (33%) agree that the NHS is providing a good service nationally, while nearly half (47%) disagree.

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