Since its launch in 1948, the NHS has grown to become the world’s largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive.
The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth. That principle remains at its core. With the exception of charges for some prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK. That is currently more than 62m people. It covers everything from antenatal screening and routine treatments for coughs and colds to open heart surgery, accident and emergency treatment and end-of-life care.
Although funded centrally from national taxation, NHS services in England, Northern Ireland, Scotland and Wales are managed separately. While some differences have emerged between these systems in recent years, they remain similar in most respects and continue to be talked about as belonging to a single, unified system.
Scale
The NHS employs more than 1.7m people. Of those, just under half are clinically qualified, including, 39,409 general practitioners (GPs), 410,615 nurses, 18,450 ambulance staff and 103,912 hospital and community health service (HCHS) medical and dental staff.
Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people.
The NHS in England is the biggest part of the system by far, catering to a population of 52m and employing more than 1.4m people. The NHS in Scotland, Wales and Northern Ireland employ 155,312; 85,252 and 65,016 people respectively.
Around 3 million people are treated in the NHS in England every week.
Funding
When the NHS was launched in 1948 it had a budget of £437 million (roughly £9 billion at today’s value). For 2011/12 it is around £106 billion. For more information about the spending review visit the Department of Health (DH) website.
Structure
The Department of Health is responsible for the NHS. The secretary of state for health is the head of the Department of Health and reports to the prime minister. The Department of Health controls England’s 10 Strategic Health Authorities (SHAs), which oversee all NHS activities in England. In turn, each SHA supervises all the NHS trusts in its area. The devolved administrations of Scotland, Wales and Northern Ireland run their local NHS services separately.
Performance
It is difficult to measure the efficiency of healthcare systems. The NHS, like other healthcare systems, has never consistently and systematically measured changes in its patients’ health. As a result, it’s impossible to say exactly how much the nation's health improves for each pound spent by the NHS.
In the UK life expectancy has been rising and infant mortality has been falling since the NHS was established. Both figures compare favourably with other nations. Surveys also show that patients are generally satisfied with the care they receive from the NHS. Importantly, people who have had recent direct experience of the NHS tend to report being more satisfied than people who have not.
