Our health is determined by the conditions in which we are born, we grow, we live and we work. The right to health thus includes not only the right to health services, but also to the wide range of things that help us live in good health such as proper housing, education, employment, social support, family income and access to health services.
The National Health Service (NHS), launched on 5 July 1948 in the UK, was the first instance of completely free healthcare that was made available to all on the basis of citizenship rather than the payment of fees or insurance.
It brought hospitals, doctors, opticians, dentists and nurses together under one service. It had huge public support, though the British Medical Association until as late as February 1948 threatened to boycott it. The newly created health boards took control of 2,751 of Britain’s 3,000 hospitals, which were run by charities or local authorities. By the day of the launch 94% of people enrolled with the NHS. The NHS made health a fundamental right of the people.
The last 70 years have seen the NHS grow and subsequently face a relentless attack since the 1980s.
- There are now 1.7m people employed by the NHS across the UK, making it the fifth largest employer in the world. There are now 10 times as many doctors working for the NHS as there were when it was created.
- The amount spent on health is now 12 times higher than in 1948, taking inflation into account. Today government spends 30p out of every £1 collected as taxes on services for health, which was 11.2% in 1951-52.
On 1 April 1991 the NHS came under severe attack. Health authorities stopped running the hospitals and instead began buying healthcare from these hospitals for the patients in their area. This created a divide between the health authorities as “purchasers” and hospitals as “providers”.
In 2012, the British parliament passed the Health and Social Care Act, 2012 that institutionalised the most extensive reorganisation of the structure of the NHS. It removed responsibility for the health of citizens from the Secretary of State for Health, abolished the NHS primary care trusts and Strategic Health Authorities and allowed for increased private players. The growing involvement of private companies is threatening the core function of the NHS: to provide healthcare based on need.
In a world of increasing inequality, the NHS as it was conceived and run for several decades, has been a great leveller and an example to be followed.
