Book contents
- Frontmatter
- Dedication
- Contents
- List of figures and tables
- Notes on contributors
- Foreword
- 1 The NHS at 75: an unfolding story
- 2 NHS governance: the centre claims authority
- 3 Health and care funding at 75
- 4 The devolved nations
- 5 NHS at 75: general practice through the lens of access
- 6 NHS hospitals and the bedpan doctrine: the first 75 years
- 7 Quality and the NHS: fair-weather friends or a longstanding relationship?
- 8 Improving health and tackling health inequalities: what role for the NHS?
- 9 NHS managers at a crossroads: part of the problem or the solution?
- 10 Forgotten, neglected and a poor relation? Reflecting on the 75th anniversary of adult social care
- 11 The NHS at 75 in comparative perspective
- 12 Our NHS? The changing involvement of patients and the public in England’s health and care system
- 13 After 75 years, whither the NHS? Some conclusions
- Index
4 - The devolved nations
Published online by Cambridge University Press: 03 April 2024
- Frontmatter
- Dedication
- Contents
- List of figures and tables
- Notes on contributors
- Foreword
- 1 The NHS at 75: an unfolding story
- 2 NHS governance: the centre claims authority
- 3 Health and care funding at 75
- 4 The devolved nations
- 5 NHS at 75: general practice through the lens of access
- 6 NHS hospitals and the bedpan doctrine: the first 75 years
- 7 Quality and the NHS: fair-weather friends or a longstanding relationship?
- 8 Improving health and tackling health inequalities: what role for the NHS?
- 9 NHS managers at a crossroads: part of the problem or the solution?
- 10 Forgotten, neglected and a poor relation? Reflecting on the 75th anniversary of adult social care
- 11 The NHS at 75 in comparative perspective
- 12 Our NHS? The changing involvement of patients and the public in England’s health and care system
- 13 After 75 years, whither the NHS? Some conclusions
- Index
Summary
When … established 70 years ago, inspired by Aneurin Bevan and the model of the Tredegar Medical Aid Society, the NHS was visionary, bold and radical. … But we no longer live in the world the NHS was originally designed for. … We acknowledge the level of challenge to meet the aspirations of this plan, but … this can be met if we can rediscover the confidence and bold ambition that made Wales the birthplace of the greatest National Health Service in the world. (Welsh Government, 2021)
The government decides the policy for the NHS, it decides the funding for the NHS, we fund the NHS to a higher level proportionately than other governments across the UK and we’ll continue to do that. We’ll continue to have the difficult discussions with those who run the NHS … about how we ensure the sustainability of the service. But the founding principles on which that service is based are not up for discussion by government and will not change. (Scottish First Minister, 2022)
The World Health Organization defines health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’. That is the health outcome I want to deliver for our people. … We are facing a time of change for our health system but it is change that must happen. This document sets out a direction of travel that I hope all of our society can embrace and support in the challenging but exciting time ahead. (Northern Ireland Executive, 2016)
Introduction
The first of these revealing statements, by the Welsh Labour Secretary for Health and Social Care, gives a partial account of the origins of the National Health Service (NHS). The second, by the then Scottish National Party (SNP) first minister, emphasises her government’s commitment to NHS ‘founding principles’. The third ignores NHS history, with the Sinn Féin minister citing a post-war World Health Organization aspiration. None mentions the UK or NHS England. We are thus alerted to healthcare’s highly politicised nature, the relevance of its history, the significance of devolution, and that its treatment in many social policy and historical texts notwithstanding, the ‘NHS’ is not monolithic.
- Type
- Chapter
- Information
- The NHS at 75The State of UK Health Policy, pp. 71 - 89Publisher: Bristol University PressPrint publication year: 2023