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Making and breaking a health service

Published online by Cambridge University Press:  16 March 2018

Tim Doran
Tim Doran*
Affiliation:
Professor of Health Policy, Department of Health Sciences, University of York, Heslington, York, UK
*
*Correspondence to: Tim Doran, Professor of Health Policy, Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK. Email: tim.doran@york.ac.uk
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Abstract

The creation of the National Health Service (NHS) marked a radical break with the past, making health care universally available on the basis of need rather than means. The NHS was conceived during wartime emergency and has had to survive further regular crises to reach its 70th year, but it now faces challenges that are unprecedented in scale and there are doubts about its ability to continue in its present form. Resources have not increased with need, and the NHS can no longer function as a comprehensive service during periods of peak demand. Policymakers look for solutions in service rearrangements, new technologies, quality improvement initiatives and alternative funding arrangements; meanwhile, chronic lack of capacity is taking a predictable toll on patient care and staff morale. The NHS has become a formidably resilient institution, but securing its future may take as great a collective effort as the one that created it.

Type
Perspective
Information
Health Economics, Policy and Law , Volume 14 , Issue 1 , January 2019 , pp. 19 - 24
Copyright
© Cambridge University Press 2018 

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References

Asaria, M., Griffin, S. and Cookson, R. (2016), ‘Distributional cost-effectiveness analysis: a tutorial’, Medical Decision Making, 36: 8–19.Google Scholar
BBC News Online (2018), ‘Boris Johnson to push for more cash for NHS’, BBC News Online, 23 January, http://www.bbc.co.uk/news/uk-politics-42783247 [23 January 2018].Google Scholar
Brook, R., Keeler, E., Lohr, K., Newhouse, J., Ware, J., Rogers, W., A. Ross Davies, C. Sherbourne, G. Goldberg, P. Camp, C. Kamberg, A. Leibowitz, J. Keesey and D. Reboussin (2006), ‘The health insurance experiment’. RAND Research Brief, https://www.rand.org/pubs/research_briefs/RB9174.html [14 November 2017].Google Scholar
Comptroller and Auditor General (2017), Health and Social Care Integration, London: National Audit Office.Google Scholar
Conway, L. and Mor, F. (2018), ‘The Collapse of Carillion’, House of Commons Briefing Paper No. 08206, 18 January, http://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-8206#fullreport [20 January 2018].Google Scholar
Ewbank, L., Thompson, J. and McKenna, H. (2017), NHS Hospital Bed Numbers: Past, Present, Future, London: The King’s Fund, https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers [12 January 2018].Google Scholar
Francis, R. (2014), ‘Culture, compassion and clinical neglect – probity in the NHS after Mid Staffordshire’, Journal of Medical Ethics, 2013: 101462.Google Scholar
Kershaw, M. (2018), Black Alerts: For Emergencies Only?, London: The King’s Fund. https://www.kingsfund.org.uk/blog/2018/01/black-alerts-emergencies-only [12 January 2018].Google Scholar
Mani, A., Mullainathan, S., Shafir, E. and Zhao, J. (2013), ‘Poverty impedes cognitive function’, Science, 341: 976–980.Google Scholar
Maynard, A. and Sheldon, T. (2002), ‘Funding for the National Health Service’, The Lancet, 360: 576.Google Scholar
Maynard, A. and Street, A. (2006), ‘Seven years of feast, seven years of famine: boom to bust in the NHS’, British Medical Journal, 332: 906–908.Google Scholar
Nuffield Trust, Health Foundation and The King’s Fund (2017), ‘The Autumn Budget: Joint Statement on Health and Social Care’, https://www.kingsfund.org.uk/publications/autumn-budget-2017 [2 January 2018].Google Scholar
O’Neill, C., McGregor, P. and Merkur, S. (2012), ‘United Kingdom (Northern Ireland): health system review’, Health Systems in Transition, 14(10): 1–91.Google Scholar
Public Accounts (2015), ‘Public Accounts – Forty Sixth Report. An Update on Hinchingbrooke Health Care NHS Trust’, https://publications.parliament.uk/pa/cm201415/cmselect/cmpubacc/971/97102.htm [20 January 2018].Google Scholar
Reinhardt, U. (2011), ‘The many different prices paid to providers and the flawed theory of cost shifting: is it time for a more rational all-payer system?’, Health Affairs, 30: 2125–2133.Google Scholar
Royal College of General Practitioners (RCGP) (2017), ‘“3 before GP”: New RCGP Mantra to Help Combat Winter Pressures in general Practice’, http://www.rcgp.org.uk/news/2017/december/3-before-gp-new-rcgp-mantra-to-help-combat-winter-pressures-in-general-practice.aspx [12 January 2018].Google Scholar
Siddique, H. (2017), ‘“Haemorrhaging nurses”: one in 10 quit NHS England each year’, The Guardian, 17 January 2018, https://www.theguardian.com/society/2018/jan/17/nhs-england-hospital-staffing-one-in-10-nurses-quit-each-year [20 January 2018].Google Scholar
Wanless, D. (2002), Securing Our Future Health: Taking a Long Term View. A Final Report, London: HM Treasury.Google Scholar