Medicine and healthcare in the UK have since at least 1948 been distinguished from some other countries by a generally available and free at the point of delivery health service funded from general taxation (the so called national insurance scheme established then is administered and controlled as part of centralised taxation and does not cover all health and social care expenditure ) . This was called the National Health Service (NHS) when it was composed of essentially independent organisations throughout the provinces above working with similar aims and methods under a national umbrella.
More recently the umbrella has reversed the order of things by showering more and more policies upon what are now essentially independent organisations throughout the provinces above working with similar aims and methods under national umbrellas called respectively the English NHS, Welsh NHS, Scottish NHS and Northern Ireland NHS. The planning and delivery system is still very hierarchical with for example more centralised control over primary care than in some other systems.
Another feature more pronounced in the UK than in much of the world is the gatekeeper role of general practice, which has been declared responsible for the efficiency and cheapness of the service in its initial half century, and in recent years vitiated or abandoned by adding a variety of alternative routes to secondary care. This has formed part of a programme of substantially increased central spending which has resulted in a smaller increase in effectiveness and nearly improved morale.
The NHS has been described within the UK as "the envy of the world". There is controversy on this claim.
Government of the UK
The United Kingdom joined the European Economic Community (as it then was) on 1 January 1973. It is scheduled to leave the European Union (EU) on 29 March 2019 (Brexit). Health is devolved to individual nations of the EU, but effectively was consistent as of 2018 with EU governance, in which the highest court was the European Court of Justice, EU law had been enacted as UK law, and such law in multiple areas impacted upon healthcare. These include the rights of EU citizens to treatment in any EU state, employment rights of EU citizens who are healthcare workers, and regulation of medical devices and medicines.
There are various tiers of government within the United Kingdom. They include:
- A UK-wide goverment, comprising two "houses of parliament" - the House of Commons, and the House of Lords. Parliament produces laws - "Acts of Parliament".
- Devolved government applies to certain aspects of law and policy-making in Wales, Scotland, and Northern Ireland. (Parliament, including members of parliament (MPs) from the devolved administration, makes laws for England. The fact that Scottish (and Welsh and Northern Ireland) MPs make laws for England, while (for matters devolved to the local administration) English MPs have no say in the devolved administration, is an oddity of the situation, sometimes referred to as the West Lothian Question.
UK administrations since the foundation of the NHS
UK government health departments
- Department of Health (England)
- National Assembly for Wales
- NHS Scotland
- Department of Health for Northern Ireland
- They work for you website which lists all MPs, Lords, facilitates identification of the MP for any UK postcode, and has links to parliamentary questions, debates, ministerial statements, and so on.
- Office of Public Sector Information website, where you can download Acts of Parliament, Bills (which may subsequently become Acts of Parliament), and so forth.