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CRC - Who Cares?: The Great British Health Debate

Organization: CRC
Publication Date: 1 January 1998
Page Count: 247


As a nation there are few institutions we care more about than our health service. We are born into it, it is there throughout our lives and we die in its care. It is a peculiarly British creation, created by our own breed of socialists to make sure no one who could not afford health care went without. Unlike other systems around the world, it is still funded mostly by tax and still derives its justification from providing care free at the point of use, according to need. British people still believe the NHS is a defining pillar of their civility.

However, as the service passes through its fiftieth birthday, there is a growing fear that the foundations on which it was established are crumbling. Can a nation which only elects governments that pledge to cut taxes expect to have a fully funded national health service free to everyone who needs it? Or would it be better to abandon what many argue is already the pretence of universalism for a more clear cut system which clearly defines a limit as to what the state will provide? In short, has Britain changed so much in the 50 years since the creation of the NHS that it no longer recognizes the values that underpinned its creation? Until now there have been no radical solutions to these growing problems. Indeed, the attempts to reform the NHS have at worse threatened it and at best, as in the latest series of attempts, prolonged an inevitable national agony. Meanwhile, the public debate is constrained by the idealism and affection we still hold for the NHS. Arguments focus on short-term issues - closure of hospitals, cuts in local services, tragic though these may be to people involved. Against this background, risk-averse politicians shy away from taking decisive steps to save the system. This book looks behind the headlines and explains in a simple, straightforward way what has happened to our NHS and what future waits in store. It is intended to be read by anyone who reads a newspaper of whatever shape or size. There are several things however it does not set out to do. It does not tackle detailed medical or technical questions and does not, unfortunately, deal with the problems of mental illness and care in the community. It focuses on the relationship between the primary and hospital sectors of the NHS, the private sector, the managers and politicians that run them and the public that use them. I hope that, despite any omissions, it provides a readable and stimulating account for health professionals and laymen alike.

Author: Gareth Mallon