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The National Health Service (NHS) at 70: Bevan’s double-edged legacy

Published online by Cambridge University Press:  08 January 2018

Rudolf Klein*
Affiliation:
Honorary Professor, London School of Hygiene and Tropical Medicine, London, UK
*
*Correspondence to: Professor Rudolf Klein, 12A Laurier Road, London NW5 1SG, UK. Email: rudolfklein30@gmail.com

Abstract

The paper analyses the achievements and problems stemming from Nye Bevan’s model of a tax funded national health care system, on the assumption that only so could equity be achieved. The evidence shows that indeed the National Health Service (NHS) scores highly on equity, so vindicating Bevan’s vision. The price paid is that fiscal crises are the norm for the NHS, with ever more centralisation, intensive regulation and performance management. Successive reorganisations represent attempts to square the circle – to combine the strengths of Bevan’s model and those of a less hierarchic system – but have so far failed to deliver and can be expected to continue.

Type
Perspective
Copyright
© Cambridge University Press 2018 

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