There has been some change since the war, but not much. Britons of all
classes were surprised, and some of them a little disgusted, by the
clinical descriptions of President Eisenhower's illness in American
newspapers. But the National Health Service has done much to reduce
the old reluctance to visit the doctor or the dentist because of the
expense.
Three subsequent acts in 1949, 1951, and 1952 have modified the scheme
slightly and have provided for charges for some services. But the
National Health Service is otherwise free and available according to
medical need. Its availability is not dependent on contribution to
National Insurance.
What does the service do? The Ministry of Health is directly
responsible for all hospital and specialist services on a national
basis, the mental-health functions of the old Board of Control,
research work on the prevention, diagnosis, or treatment of illness,
the public-health laboratory service, a blood-transfusion service.
These broad general headings cover an enormous organization, the basis
of which is the General Practitioner Services, which covers the medical
attention given to individuals by doctors and dentists of their own
choice from among those enrolled in the service. About 24,000 or nearly
all of the general practitioners in Britain are part of the service. Of
approximately 10,000 dentists in England and Wales, about 9,500 are in
the service.
Again, costs are high. For six years Labor and Conservative
administrations have sought to keep the net total annual cost of the
National Health Service to just over £400,000,000 or $1,120,000,000. To
limit the drain on the Exchequer it was found necessary to charge for
prescription forms, dentures, and spectacles. Like any welfare scheme,
the National Health Service invited malingerers and imaginary invalids
who cost the doctors--and the state--time and money.
I asked a young doctor in the West Country what he thought of the
scheme. "Well, I don't know if it has contributed much to the health
of my bank statement," he said, "but it has contributed to the health
of the folk around here. People are healthier because they don't wait
until they're desperately ill to see a doctor. And the care of children
has improved tremendously. Perhaps this might have come naturally under
the old system. I don't know. But it's here now, and we're a healthier
lot."
The opposition view was put by an elderly doctor in London who opined
that so great was the pressure on the ordinary general practitioner
from "humbugs" that he never got a chance to do a thorough job on the
seriously ill. The hospitals, he added, were crowded with people who
"don't belong there" and who occupied beds needed by the really sick.
This controversy, like those over the nationalization of industry, will
continue. Again there seems little prospect that any government will
modify in any important way the basic provisions of the National Health
Service Act.
Public-domain text, read in full here on John Shaqi.
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