The national health Service

The British National Health Service (NHS) was set up in 1948 and was designed to provide equal basis health care, free of charge, for everybody in the country. Before this time health care had to be paid for by individuals.

Nowadays central government is directly responsible for the NHS although it is administered by local health authorities.

About 83 per cent of the cost of the health service is paid for by general taxation and the rest is met from the National Insurance Contributions paid by those in work.

There are charges for prescriptions and dental care but many people, such as children, pregnant women, pensioners, and those on Income Support, are exempt from the payment.

Most people are registered with a local doctor (a GP, or General Practitioner) who is increasingly likely to be a part of a health centre which serves the community.

As the population of Britain gets older the hospital service now treats more patients than ever before, although patients spend less time in hospital. NHS hospitals – many of which were built in the nineteenth century – provide nearly half a million beds and have 480, 000 medical staff. The NHS is the biggest employer in Europe.

During the 1980s there was considerable restructuring of the Health Service with the increased emphasis on managerial efficiency and the privatization of some services (for example, cleaning).

At the end of the 1980s the Government introduced proposals for further reform of the NHS, including allowing some hospitals to be self-governing, and encouraging GPs to complete for patients.

Patients would be able to choose and change their family doctor more easily and GPs would have more financial responsibility. The political questions continue of how much money should be provided to support the NHS where it should come from.

4. Learn the following:

1. National Health Service (NHS) – the system in Britain which supplies free or cheap medical care for everybody. It is paid by taxes.

2. Administer v. – manage affairs, act as administrator.

3. Provide v. – supply something for someone.

4. National Insurance – the system in which the government collects money regularly from employees so that it can pay money to people who are ill, unemployed or retired.

5. Contribution n. – a part of your wages that you pay to the government or the company you work for and that you receive back as social security payments.

6. General Practitioner (GP) – a doctor who does not specialize in any particular area of medicine but who has a medical practice in which he or she treats all types of illnesses.

7. Health centre – a building in which the doctors of a particular district have offices where patients can visit them.

5. Explain the meaning of the following words or word combinations:

to provide equal basis health care

to administer the NHS

to meet the cost of the health service from the National Insurance contributions

to be exempt from the payment

to be part of a health centre

medical staff

an emphasis on managerial efficiency

self-governing

6. Give a definition for each of these words or expressions:

GP, NHS, doctor, hospital, prescription, insurance, health care, patient, disease.

7. Find a word in the text with a meaning similar to each of the following:

To establish, to develop for a certain purpose or use, medical care, to cover the expenses, the price for a service, to direct or control something, to run a hospital without an outside control.

8. Answer the questions:

1. What was the original aim of the NHS in Britain?

2. What used to happen before the NHS was set up?

3. How is the NHS paid for?

4. Do all people have to pay for prescription and dental care?

5. Who is exempt from the payment?

6. What reforms have been proposed for the NHS?

9. Summarize the text “National Health Service”.