Was the National Health Service (NHS) doomed from its introduction?

Anyone living in Great Britain will be more than familiar with the National Health Service (NHS); a publicly-funded, national healthcare service, free to the point of consumption. The NHS was introduced by the Labour Government shortly after World War Two and in this article, I want to establish why I feel it was doomed right from its introduction.

The NHS was established with the National Health Service Act, 1946 and came into operation on July 5, 1948, 68 years ago; the NHS is administered in England, Wales and Scotland, however, today I will be mainly referring to the English NHS. Initially set-up to provide citizens with comprehensive service, treatment and care, it is now currently used by over 98% of the English population. Private healthcare is used by 8% of citizens, but usually only as an ‘add-on feature’ to the treatment provided by the NHS.

The main point that I will focus on is how the actual cost has nearly always superseded the estimated cost right from its introduction in 1948 and that the deficit is growing faster than can be contained.

Whether it be in reference to 1948, or 2016, the cost of running the NHS seems to draw a lot of attention. In the first year that the NHS was introduced, it had an estimated running cost of £198.4 million: the actual cost ended up being £275.9 million. The undervaluation of how much the National Health Service would cost has carried on for many years and wretchedly, even into the 21st Century – the National Health Service Trust Development Authority (TDA) reported a net deficit for NHS Trusts of around £241 million in 2013/14 with 25 Trusts ending the Fiscal Year (FY) in a deficit.

Harrowingly, the NHS seems to cost too much and quite frankly, more-and-more, year-on-year. Whilst Junior Doctors are currently striking against longer working hours that Jeremy Hunt MP, Secretary of State for Health is trying to implement, this draws very similar parallels to the British Medical Association’s (BMA) strikes which took place between January and May 1948. Whilst 25,842 BMA doctors were against reforms made by Government in-regards to pay and private-practice, only 14,620 were in favour of joining the NHS 68 years ago, yet were still advised to co-operate.

Currently, the Labour Party is campaigning long-and-hard to try and get more money invested into the NHS – but where is this money going to go? Money keeps on flowing into the NHS, but seemingly gets lost in trying to resolve the cesspit of problems that have been created since the 1940s. No-matter how much money gets thrown that way, it will never be enough. According to gov.uk, £125 billion is set to be invested into the NHS this year, with £2.51 billion being used to pay off last year’s deficits.

Clearly the NHS cannot cope with the strain of the increasing population, amongst other things. Demand for healthcare has superseded all initial predictions – in the late 1940s, the Government budgeted £1 million for opticians, but within a year, prescriptions and optical exams created a bill worth £31 million more. This inability to create an efficient system has unfortunately foreshadowed what we see today. The NHS didn’t meet targets of a four-hour waiting time in many months in 2016; the proportion of patients seen in four hours (target being 95%) has only been met once in the past 18 months and there has been a major fall in the number of ambulances which reach life-threatening casualties in the target of eight minutes.

Whilst tabloid newspapers in 1948 such as The Daily Sketch compared Aneurin Bevan and the Labour Party to a bunch of Socialists, “the state medical service is part of the Socialist plot to convert Great Britain into a National Socialist economy”, we have to admire and appreciate the attempt at creating a universal service which provides for the poor and the rich alike and ensures that we have a national system to protect every legal resident’s well-being. Nonetheless, I cannot help-but-notice the murky parallels between the undervaluation of the cost today and the cost in the 1940s. Regardless of medical supplies being much more expensive when the NHS was first introduced, with the ever-increasing demand, the NHS has never been able to cope – this was established when the actual cost per FY was well-over the estimated cost; when the cost of each department was well over the predicted amount and when the number of users were also far-more than expected. The complications seen in the last Century are a warning of what will carry on happening and how the service is doomed unless there is serious reform.

Indeed, the answer to solving this longstanding and prominent problem is not as easy as saying ‘start again’. When created in 1948, part of the 1946 Act read, “it shall be the duty of the Minister of Health… to promote the establishment… of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness and for that purpose to provide or secure the effective provision of services…” We cannot abandon one of the greatest welfare feats that this country has established, but the doom-and-gloom we see today stems from the problems created in the 20th Century. In-order to move forward and promote the well-being of legal British citizens, the NHS needs to be seriously transformed to distance itself from the difficulties it has been associated with for so long.

by Milan Shah

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