The national health service in gb ответы егэ

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ЗаданиеОтвет

The National Health Service in GB

The NHS (the National Health Service) in GB __ORGANIZE__ centrally and medical insurance is compulsory.

There are a number of private medical insurance schemes in the country. These days such schemes __BECOME__ increasingly popular as being more convenient.

The modern __DIFFICULTY__ of the NHS are the same as those faced by equivalent systems in other countries.

The number of old people needing medical care __GROW__ dramatically since 1998.

But the country spends __LITTLE__ money per person on health care than any other country in the western world.

One possible reason for this is the way that GPs __PAY__ .

The money which they get from the government __NOT DEPEND__ on the number of consultations they perform, it depends on the number of registered patients.

The National Health Service in GB

The NHS (the National Health Service) in GB IS ORGANIZED centrally and medical insurance is compulsory.

There are a number of private medical insurance schemes in the country. These days such schemes ARE BECOMING increasingly popular as being more convenient.

The modern DIFFICULTIES of the NHS are the same as those faced by equivalent systems in other countries.

The number of old people needing medical care HAS GROWN dramatically since 1998.

But the country spends LESS money per person on health care than any other country in the western world.

One possible reason for this is the way that GPs ARE PAID .

The money which they get from the government DOES NOT DEPEND on the number of consultations they perform, it depends on the number of registered patients.

Задание №6593.
Чтение. ЕГЭ по английскому

Прочитайте текст и заполните пропуски A — F частями предложений, обозначенными цифрами 1 — 7. Одна из частей в списке 1—7 лишняя.

The health and fitness of the UK population is a regular topic on national news and many of us are strongly aware of the need to adopt a healthy lifestyle. From eating the right things including our five pieces of fruit or vegetables a day to getting enough exercise, ___ (A).

Those in the health professions make continuous pleas to us to ‘exercise more’ and ‘cook healthy, nutritious meals’ yet the public replies that ___ (B). Work and family commitments take priority and if there’s any time ‘spare’ then going to a gym is often the last thing on people’s minds.

‘Health spa’ is a term that surely appeals greatly and with the rising popularity of spa amongst men and women it would seem that the industry has come up with a winning combination. Statistics reveal that the spa industry is growing faster ___ (C). It offers so much opportunity that many are diving in with both feet to make the most of this market.

But why is spa so popular? With today’s hectic lifestyles, the idea of retreating to a haven of peace and relaxation sounds like total luxury. Professional, friendly therapists are ready to greet you and listen to your needs ___ (D). Add to this our desire to hold back the years and look forever young, it’s no doubt we’re booking and staying at more spa resorts ___ (E).

Choosing what treatments to have during your spa visit can be a tricky choice. Like reading a menu in a 5-star restaurant you’ll find the choices staggering as words such as relaxing, revitalising, refreshing and moisturising jump out from all over the pages with promises of soothing away all aches, pains and wrinkles. Location is also an important consideration and many independent hotels have excellent spa facilities ___ (F).

1. that you can’t miss this opportunity
2. while also benefiting from superb positions
3. than ever before
4. there is no time within their already overloaded schedules
5. as you discuss the very tempting treatment menu
6. there are whole host of things to do to keep us healthy
7. than the fitness industry

A	B	C	D	E	F

Решение:
Пропуску A соответствует часть текста под номером 6.
Пропуску B соответствует часть текста под номером 4.
Пропуску C соответствует часть текста под номером 7.
Пропуску D соответствует часть текста под номером 5.
Пропуску E соответствует часть текста под номером 3.
Пропуску F соответствует часть текста под номером 2.

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Источник: ЕГЭ-2018, английский язык: 30 тренировочных вариантов для подготовки к ЕГЭ. Е. С. Музланова

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ЕГЭ Грамматика и лексика (Задания В4-В10)

Прочитайте приведенный ниже текст. Преобразуйте, если необходимо, слова, напечатанные заглавными буквами в конце строк, обозначенных номерами В4-В10 так, чтобы они грамматически соответствовали содержанию текста. Заполните пропуски полученными словами. Каждый пропуск соответствует отдельному заданию из группы В4-В10.

Задание 1.1 A Practical Joke

Mr and Mrs Parker were having a quiet day at home. Their 18-year-old daughter was away in Wales

B4 STAY with a friend. Suddenly the phone B5 RING . A hoarse voice told Mr Parker that his daughter

B6 KIDNAP and that he had to pay a ransom of $ 2,000. He was also warned that if he B7 NOT PAY , he would never see his daughter again. The voice then gave him instructions about where and when to hand over the money. Mr Parker took the B8 ONE train to Wales. He went to the hotel and gave the briefcase with the money to a woman in a scarf and a raincoat. At 11 p.m. the same evening, to his great relief, his daughter came back home. She looked B9 HAPPY than ever and could hardly stop herself from laughing when she handed him his briefcase with $ 2,000. It turned out that she and her friend B10 DECIDE to play a practical joke.

Задание 1.2 Tricks on April Fool’s Day

In 1698, a number of Londoners received invitations to see the lions washed in the Thames. It happened on April Fool’s Day. However, the same trick B4 REPEAT in 1860, and again a lot of curious Londoners came to enjoy the lions washed. In 1957 BBC Television played an even B5 HILARIOUS joke on its viewers. It showed a film about a spaghetti crop B6 GROW in Southern Switzerland. While agricultural workers B7 PICK

long strands of spaghetti from bushes, the presenter of the film commented on the uniform length of the spaghetti and on the successful cultivation of “these vegetables”. After the programme had finished, there B8 BE a lot of calls from curious TV viewers. Obviously, those people B9 NOT UNDERSTAND the joke. They wanted to know where they B10 CAN buy spaghetti bushes.

Задание 1.3 Street Styles

Many people, especially young people, wear things which express their ideas and feelings about life. If a boy B4 HAVE very short, almost shaven hair, people expect him to have right wing politics. But boys with very long hair B5 THINK to have left wing politics. A boy who wears a leather jacket B6 COVER in bits of metal will probably ride a motorbike. The rules of fashion are not as rigid as they once were and today’s teenagers B7 NOT FOLLOW any particular trend at all. But teens are very influenced by B8 CELEBRITY and they have a desire to buy more luxurious items. Street styles B9 NOT CREATE by the big fashion designers. In fact, the fashion designers often use ideas from street fashion. But some leaders of British fashion have enough ideas of their own. One of them is Jean Muir, whose designs let her be one of the B10 GOOD designers.

Задание 1.4 The National Health Service in GB

The NHS (the national health service) in GB B4 ORGANIZE centrally and medical insurance is compulsory. There are a number of private medical insurance schemes in the country. These days such schemes B5 BECOME increasingly popular as being more convenient. The modern B6 DIFFICULTY of the NHS are the same as those faced by equivalent systems in other countries. The number of old people needing medical care B7 GROW dramatically since 1998. But the country spends B8 LITTLE money per person on health care than any other country in the western world. One possible reason for this is the way that GPs B9 PAY . The money which they get from the government B10 NOT DEPEND on the number of consultations they perform, it depends on the number of registered patients.

Задание 1.5 What Can Computers Do?

Computers and microchips B4 BECOME part of our everyday lives. We read magazines which B5 PRODUCE on computer, we buy things with the help of computers, we pay bills prepared by computers. Just B6 DIAL a phone number involves the use of a sophisticated computer system. In the past, life without computers was much B7 DIFFICULT than it is today. The first computers were able to multiply long numbers, but they B8 NOT CAN do anything else. Nobody B9 BELIEVE stories about robots and space travel, but now computers are able to do almost all difficult jobs. What makes your computer such a miraculous device? It is a personal communicator that B10 ENABLE you to interact with other computers and with people around the world. And you can even use your PC to relax with computer games.

Задание 1.6 A Strange Visitor

Министерство
образования Российской Федерации

Дальневосточный
государственный университет

для студентов IV
курса Восточного института

Владивосток

Издательство
Дальневосточного университета

1999

ББК81.2Англ

УДК 802.0:910 (076.5)

Данная лабораторная
работа предназначена для студентов IV
курса. Цель — овладеть лексикой по
данной теме. Комплекс упражнений,
представленных в работе, способствует
активному усвоению лексики, расширяет
словарный запас, способствует закреплению
навыков устной речи и обеспечивает их
дальней­шее развитие.

Подготовлена на
кафедре английского языка Восточного
института ДВГУ.

Составители: Н. Г.
Зверева. З.М. Пантюх, Н.В. Юрчик.

Печатается по
решению учебно-методического совета
ДВГУ.

© Издательство
Дальневосточного университета, 1999

The National Health Service

The Acts
setting up the National Health Service in Britain came
into force in 1948. Before that time the state was mostly concerned
with the development of the environmental health ser­vices,
such as provision of pure water, sewerage, disposal of refuse and
cleaning of streets.

The
object of the National Health Service Act was the estab­lishment
of a comprehensive health service designed to secure im­provement
in the physical and mental health of the people and the prevention,
diagnosis and treatment of illness.

The
introduction of the new health service did not mean a complete break
with the past. On the contrary, all that was good in the
existing services was absorbed into a new scheme. The National Health
Service made it possible that the benefits once available only to
insured persons or those who could afford to pay for them, or as a
form
of charity, became available to everyone.

Originally
it was free but certain charges were introduced later and
show a definite tendency to grow.

The
services provided by the National Health Service fall into three
main groups:

1. The
   general practitioners services. This includes the family doctor
   service,
   the dental service, the eye service and some other services.

2. The hospital and specialists
   services.

3. The
   local health and welfare authority services (comprising a range
   of home and clinical services for prevention, treatment or care).

The
cost of health and welfare services in Britain is met from general
taxation, local rates and from charges paid by the patients.

There
are charges for prescriptions, for dental treatment, for some
other health services. The cost of prescriptions has risen so sharply
of late that people who need them most (old-age pensioners, people
with large families) often cannot afford to buy medicines.

The
public is free to use the Service, or any independent part of it,
as it pleases.

About
97 per cent of the whole population of Great Britain is using the
Service. The great majority of specialists and general practitioners
are taking part in the Service.

Practitioner services

The
practitioner services consist of the Family Doctor Service, the
Dental Service, and the Pharmaceutical Service. All these services
provide
the patient with the individual medical attention that he needs.

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ЕГЭ Грамматика и лексика (Задания В4-В10)

Прочитайте приведенный ниже текст. Преобразуйте, если необходимо, слова, напечатанные заглавными буквами в конце строк, обозначенных номерами В4-В10 так, чтобы они грамматически соответствовали содержанию текста. Заполните пропуски полученными словами. Каждый пропуск соответствует отдельному заданию из группы В4-В10.

Задание 1.1 A Practical Joke

Mr and Mrs Parker were having a quiet day at home. Their 18-year-old daughter was away in Wales

B4 STAY with a friend. Suddenly the phone B5 RING . A hoarse voice told Mr Parker that his daughter

B6 KIDNAP and that he had to pay a ransom of $ 2,000. He was also warned that if he B7 NOT PAY , he would never see his daughter again. The voice then gave him instructions about where and when to hand over the money. Mr Parker took the B8 ONE train to Wales. He went to the hotel and gave the briefcase with the money to a woman in a scarf and a raincoat. At 11 p.m. the same evening, to his great relief, his daughter came back home. She looked B9 HAPPY than ever and could hardly stop herself from laughing when she handed him his briefcase with $ 2,000. It turned out that she and her friend B10 DECIDE to play a practical joke.

Задание 1.2 Tricks on April Fool’s Day

In 1698, a number of Londoners received invitations to see the lions washed in the Thames. It happened on April Fool’s Day. However, the same trick B4 REPEAT in 1860, and again a lot of curious Londoners came to enjoy the lions washed. In 1957 BBC Television played an even B5 HILARIOUS joke on its viewers. It showed a film about a spaghetti crop B6 GROW in Southern Switzerland. While agricultural workers B7 PICK

long strands of spaghetti from bushes, the presenter of the film commented on the uniform length of the spaghetti and on the successful cultivation of «these vegetables». After the programme had finished, there B8 BE a lot of calls from curious TV viewers. Obviously, those people B9 NOT UNDERSTAND the joke. They wanted to know where they B10 CAN buy spaghetti bushes.

Задание 1.3 Street Styles

Many people, especially young people, wear things which express their ideas and feelings about life. If a boy B4 HAVE very short, almost shaven hair, people expect him to have right wing politics. But boys with very long hair B5 THINK to have left wing politics. A boy who wears a leather jacket B6 COVER in bits of metal will probably ride a motorbike. The rules of fashion are not as rigid as they once were and today’s teenagers B7 NOT FOLLOW any particular trend at all. But teens are very influenced by B8 CELEBRITY and they have a desire to buy more luxurious items. Street styles B9 NOT CREATE by the big fashion designers. In fact, the fashion designers often use ideas from street fashion. But some leaders of British fashion have enough ideas of their own. One of them is Jean Muir, whose designs let her be one of the B10 GOOD designers.

Задание 1.4 The National Health Service in GB

The NHS (the national health service) in GB B4 ORGANIZE centrally and medical insurance is compulsory. There are a number of private medical insurance schemes in the country. These days such schemes B5 BECOME increasingly popular as being more convenient. The modern B6 DIFFICULTY of the NHS are the same as those faced by equivalent systems in other countries. The number of old people needing medical care B7 GROW dramatically since 1998. But the country spends B8 LITTLE money per person on health care than any other country in the western world. One possible reason for this is the way that GPs B9 PAY . The money which they get from the government B10 NOT DEPEND on the number of consultations they perform, it depends on the number of registered patients.

Задание 1.5 What Can Computers Do?

Computers and microchips B4 BECOME part of our everyday lives. We read magazines which B5 PRODUCE on computer, we buy things with the help of computers, we pay bills prepared by computers. Just B6 DIAL a phone number involves the use of a sophisticated computer system. In the past, life without computers was much B7 DIFFICULT than it is today. The first computers were able to multiply long numbers, but they B8 NOT CAN do anything else. Nobody B9 BELIEVE stories about robots and space travel, but now computers are able to do almost all difficult jobs. What makes your computer such a miraculous device? It is a personal communicator that B10 ENABLE you to interact with other computers and with people around the world. And you can even use your PC to relax with computer games.

Задание 1.6 A Strange Visitor

The main organ of Health Service in Great Britain is the National Health Service. The National Health Service Act was passed through parliament in 1946 and in 1948 this Act received the Royal Assent and was brought into operation. The N.H.S. consists of three parts: the Local Health Authorities, the General Practitioners and Hospitals or Specialist Services.

The Local Health Authority has an obligation to make arrangements with the General Practitioners for the vaccination of those who live within its area. The Hospitals and Specialist Services have definite interrelations too. The role of the family doctor is very important in the Health Service. Not all patients need highly specialized attention and the GP does invaluable work by filtering off 90 per cent of the total medical work

Most medical treatment in Great Britain is free but charges are made for drugs, spectacles and dental care. Free emergency medical treatment is given to any visitor from abroad who becomes ill while staying in the country. But those who come to England specially for treatment must pay for it.

The National Health Service provides free medical treatment both in hospital and outside. People may use the N.H.S. and they may go to doctors as private patients. Many people who have enough money prefer to be private patients because they think that they can in that way establish more personal relations with the doctor or because they do not want to be put in a large room with other patients. The patient in England can choose between the N.H.S. and private treatment at any time. Moreover he can take one part with the service, the other privately. If a patient is dissatisfied with his N.H.S. familydoctor or dentist, he may change to another one. In fact, 97% of the population use the N.H.S.

This freedom of choice applies to doctors and dentists too. All doctors may take part in the Family Doctor System and most of them do so. This service is free to everyone. They can choose whether they want to join the N.H.S. or not and if they can have N.H.S. and private patients. Physicians may have private practice receiving the pay directly from the patients for their medical advice. N.H.S. doctors are paid by the Government, the pay depending on the number of the patients they have served every month.

The hospital service includes general and special hospitals, tuberculosis sanatoria, infectious disease units, and all forms of specialized treatment together with the provision of most surgical and medical needs. Besides the hospitals there are infirmatories and nursing homes. An infirmatory is a room in an institution used for sick people. A nursing home is usually a «private small hospital for the patients and aged people. In fact, half of the hospitals are over 100 years old. They were built in the nineteenth century, they are small with about 200 beds. Such hospitals are uneconomic and cannot provide a full range of services, which require a district hospital of 800 beds or more. Now they have more than 150 health centres in the U.K. Health centres provide opportunities for hospital specialists and GPs. Health centres contain all the special diagnostic and therapeutic services which family doctors need, such as electrocardiography, X-ray, physiotherapy, etc. Family doctors have access to hospital resources and can be brought into close relationship with hospital doctors. Health centres are the bases of primary care.

There are centres, which provide consultant services in general medicine and surgery, ear-nose-throat diseases, obstetrics and gynaecology, ophthalmology, psychiatry and orthopaedics. All consultations in the centres are by appointment only. The patient is given a definite time at which to attend. Each doctor decides for himself how many patients he can examine for an hour. It must be born in mind that the patient is the most important person in the health centre and all the energies of the medical personnel are directed to helping him as much as possible.

1 Answer the following questions:

1 When was the N.H.S. brought into operation?

2 What parts does the National Health Service consist of?

3 Are there any interrelations between these parts?

4 Are there private patients in Great Britain?

2 Arrange the following expressions according to the contents (keep to a logical consistency)

a) Types of hospitals in the U.K.

b) The interrelations between the three parts of the N.H.S.

c) Freedom of choice applied to doctors and dentists.

d) The N.H.S. and its structure.

e) Problems of British health care system.

f) Freedom of choice of medical treatment.

g) Health centres in the U.K.

The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the «NHS» name (the NHS in England, NHS Scotland and NHS Wales). Health and Social Care in Northern Ireland was created separately^[2] and is often locally referred to as «the NHS». The four systems were established in 1948 as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay.^[3] Each service provides a comprehensive range of health services, free at the point of use for people ordinarily resident in the United Kingdom apart from dental treatment and optical care.^[4] In England, NHS patients have to pay prescription charges; some, such as those aged over 60 and certain state benefit recipients, are exempt.^[5]

Taken together, the four National Health Services in 2015–2016 employed around 1.6 million people with a combined budget of £136.7 billion.^[6] In 2014, the total health sector workforce across the United Kingdom was 2,165,043. This broke down into 1,789,586 in England, 198,368 in Scotland, 110,292 in Wales and 66,797 in Northern Ireland.^[7] In 2017, there were 691,000 nurses registered in the United Kingdom, down 1,783 from the previous year. However, this is the first time nursing numbers have fallen since 2008. Every 24 hours it sees one million patients, and with 1.7 million staff it is the fifth biggest employer in the world,^[8] as well as the largest non-military public organisation in the world.^[9]

When purchasing drugs, the four healthcare services have significant market power that, based on their own assessment of the fair value of the drugs, influences the global price, typically keeping prices lower.^[10] A small number of products are procured jointly by two or more UK healthcare services.^[11] Several other countries either copy the United Kingdom’s model or directly rely on Britain’s assessments for their own decisions on state-financed drug reimbursements.^[12]

History[edit]

Calls for a «unified medical service» can be dated back to the Minority Report of the Royal Commission on the Poor Law in 1909.^[14]

Somerville Hastings, President of the Socialist Medical Association, successfully proposed a resolution at the 1934 Labour Party Conference that the party should be committed to the establishment of a State Health Service.^[15]

Following the 1942 Beveridge Report’s recommendation to create «comprehensive health and rehabilitation services for prevention and cure of disease», cross-party consensus emerged on introducing a National Health Service of some description.^[16] Conservative MP and Health Minister, Henry Willink later advanced this notion of a National Health Service in 1944 with his consultative White Paper «A National Health Service» which was circulated in full and short versions to colleagues, as well as in newsreel.^[17]

When Clement Attlee’s Labour Party won the 1945 election he appointed Aneurin Bevan as Health Minister. Bevan then embarked upon what the official historian of the NHS, Charles Webster, called an «audacious campaign» to take charge of the form the NHS finally took.^[18] Bevan’s National Health Service was proposed in Westminster legislation for England and Wales from 1946 and Scotland from 1947, and the Northern Ireland Parliament’s Public Health Services Act 1947.^[19]
NHS Wales was split from NHS (England) in 1969 when control was passed to the Secretary of State for Wales.^[20] According to one history of the NHS, «In some respects the war had made things easier. In anticipation of massive air raid casualties, the Emergency Medical Service had brought the country’s municipal and voluntary hospitals into one umbrella organisation, showing that a national hospital service was possible.»^[21] Webster wrote in 2002 that «the Luftwaffe achieved in months what had defeated politicians and planners for at least two decades.»^[22]

The NHS was born out of the ideal that healthcare should be available to all, regardless of wealth. Although being freely accessible regardless of wealth maintained Henry Willink’s principle of free healthcare for all, Conservative MPs were in favour of maintaining local administration of the NHS through existing arrangements with local authorities fearing that an NHS which owned hospitals on a national scale would lose the personal relationship between doctor and patient.^[23]

Conservative MPs voted in favour of their amendment to Bevan’s Bill to maintain local control and ownership of hospitals and against Bevan’s plan for national ownership of all hospitals. The Labour government defeated Conservative amendments and went ahead with the NHS as it remains today; a single large national organisation (with devolved equivalents) which forced the transfer of ownership of hospitals from local authorities and charities to the new NHS. Bevan’s principle of ownership with no private sector involvement has since been diluted, with later Labour governments implementing large scale financing arrangements with private builders in private finance initiatives and joint ventures.^[24]

At its launch by Bevan on 5 July 1948 it had at its heart three core principles: That it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay.^[25]

Three years after the founding of the NHS, Bevan resigned from the Labour government in opposition to the introduction of charges for the provision of dentures, dentists,^[26] and glasses; resigning in support was fellow minister and future Prime Minister Harold Wilson.^[27] The following year, Winston Churchill’s Conservative government introduced prescription fees. However, Wilson’s government abolished them in 1965; they were later re-introduced but with exemptions for those on low income.^[28] These charges were the first of many controversies over changes to the NHS throughout its history.^[29]

From its earliest days, the cultural history of the NHS has shown its place in British society reflected and debated in film, TV, cartoons and literature. The NHS had a prominent slot during the 2012 London Summer Olympics opening ceremony directed by Danny Boyle, being described as «the institution which more than any other unites our nation».^[30]

Eligibility for treatment[edit]

Everyone living in the UK can use the NHS without being asked to pay the full cost of the service, though NHS dentistry and optometry do have standard charges in each of the four national health services in the UK.^[31] In addition, most patients in England have to pay charges for prescriptions though some patients are exempted.^[5]

Aneurin Bevan, in considering the provision of NHS services to overseas visitors wrote, in 1952, that it would be «unwise as well as mean to withhold the free service from the visitor to Britain. How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors? For if the sheep are to be separated from the goats both must be classified. What began as an attempt to keep the Health Service for ourselves would end by being a nuisance to everybody.»^[32]

The provision of free treatment to non-UK-residents, formerly interpreted liberally, has been increasingly restricted, with new overseas visitor hospital charging regulations introduced in 2015.^[33]

Citizens of the EU holding a valid European Health Insurance Card and persons from certain other countries with which the UK has reciprocal arrangements concerning health care can get emergency treatment without charge.^[34]

The NHS is free at the point of use, for general practitioner (GP) and emergency treatment not including admission to hospital, to non-residents.^[35] People with the right to medical care in European Economic Area (EEA) nations are also entitled to free treatment by using the European Health Insurance Card. Those from other countries with which the UK has reciprocal arrangements also qualify for free treatment.^[36][37] Since 6 April 2015, non-EEA nationals who are subject to immigration control must have the immigration status of indefinite leave to remain at the time of treatment and be properly settled, to be considered ordinarily resident. People not ordinarily resident in the UK are in general not entitled to free hospital treatment, with some exceptions such as refugees.^[4][38]

People not ordinarily resident may be subject to an interview to establish their eligibility, which must be resolved before non-emergency treatment can commence. Patients who do not qualify for free treatment are asked to pay in advance or to sign a written undertaking to pay, except for emergency treatment.

People from outside the EEA coming to the UK for a temporary stay of more than six months are required to pay an immigration health surcharge at the time of visa application, and will then be entitled to NHS treatment on the same basis as a resident. This includes overseas students with a visa to study at a recognised institution for 6 months or more, but not visitors on a tourist visa.^[39] In 2016 the surcharge was £200 per year, with exemptions and reductions in some cases.^[40] This was increased to £400 in 2018. The discounted rate for students and those on the Youth Mobility Scheme will increase from £150 to £300.^[41]

From 15 January 2007, anyone who is working outside the UK as a missionary for an organisation with its principal place of business in the UK is fully exempt from NHS charges for services that would normally be provided free of charge to those resident in the UK. This is regardless of whether they derive a salary or wage from the organisation, or receive any type of funding or assistance from the organisation for the purposes of working overseas.^[42] This is in recognition of the fact that most missionaries would be unable to afford private health care and those working in developing countries should not effectively be penalised for their contribution to development and other work.

Those who are not ordinarily resident (including British citizens who may have paid National Insurance contributions in the past) are liable to charges for services.

There are some other categories of people who are exempt from the residence requirements such as specific government workers and those in the armed forces stationed overseas.

Historic issues[edit]

The trade union, Unite, said back in early 2019 that the NHS had been under pressure as a result of economic austerity.^[43] A 2018 public survey reported that public satisfaction with the NHS has fallen from 70% in 2010 to 53% in 2018.^[44] The NHS is consistently ranked as the institution that makes people proudest to be British, beating the Royal family, Armed Forces and the BBC.^[45] One 2019 survey ranked nurses and doctors — not necessarily NHS staff — amongst the most trustworthy professions in the UK.^[46]

Funding[edit]

This section needs to be updated. The reason given is: The figures seem to largely date back to the middle of the 2010s. Please help update this article to reflect recent events or newly available information. (July 2021)

The systems are 98.8% funded from general taxation and National Insurance contributions, plus small amounts from patient charges for some services.^[48][49] About 10% of GDP is spent on health and most is spent in the public sector.^[50] The money to pay for the NHS comes directly from taxation. The 2008/09 budget roughly equates to a contribution of £1,980 per person in the UK.^[51]

When the NHS was launched in 1948 it had a budget of £437 million^[52] (equivalent to £16.25 billion in 2020). In 2016–2017, the budget was £122.5 billion.^[53] In 1955/56 health spending was 11.2% of the public services budget. In 2015/16 it was 29.7%.^[54] This equates to an average rise in spending over the full 60-year period of about 4% a year once inflation has been taken into account. Under the Blair government spending levels increased by around 6% a year on average. Since 2010 spending growth has been constrained to just over 1% a year.^[54]

Some 60% of the NHS budget is used to pay staff. A further 20% pays for drugs and other supplies, with the remaining 20% split between buildings, equipment, training costs, medical equipment, catering and cleaning. Nearly 80% of the total budget is distributed by local trusts in line with the particular health priorities in their areas.^[55] Since 2010, there has been a cap of 1% on pay rises for staff continuing in the same role. Unions representing doctors, dentists, nurses and other health professionals have called on the government to end the cap on health service pay, claiming the cap is damaging the health service and damaging patient care.^[56] The pay rise is likely to be below the level of inflation and to mean a real-terms pay cut.^[57] The House of Commons Library did research showing that real-terms NHS funding per head will fall in 2018–19, and stay the same for two years afterwards.^[58]

There appears to be support for higher taxation to pay for extra spending on the NHS as an opinion poll in 2016 showed that 70% of people were willing to pay an extra penny in the pound in income tax if the money were ringfenced and guaranteed for the NHS.^[59] Two thirds of respondents to a King’s Fund poll favour increased taxation to help finance the NHS.^[60]

The Guardian has said that GPs face excessive workloads throughout Britain and that this puts the GP’s health and that of their patients at risk.^[61] The Royal College of Physicians surveyed doctors across the UK, with two-thirds maintaining patient safety had deteriorated during the year to 2018: 80% feared they would be unable to provide safe patient care in the coming year while 84% felt increased pressure on the NHS was demoralising the workforce. Jane Dacre said, «We simply cannot go through this [a winter when the NHS is badly overstretched] again. It is not as if the situation was either new or unexpected. As the NHS reaches 70, our patients deserve better. Somehow, we need to move faster towards a better resourced, adequately staffed NHS during 2018 or it will happen again.»^[62] At a time when the NHS is short of doctors foreign doctors are forced to leave the UK due to visa restrictions.^[63] A study found that a fifth of doctors had faced bullying from seniors in the previous year due to pressure at work.^[64]

The NHS is under-resourced compared to health provisions in other developed nations. A King’s Fund study of OECD data from 21 nations, revealed that the NHS has among the lowest numbers of doctors, nurses and hospital beds per capita in the western world.^[65] Nurses within the NHS maintain that patient care is compromised by the shortage of nurses and the lack of experienced nurses with the necessary qualifications.^[66] According to a YouGov poll, 74% of the UK public believes there are too few nurses.^[67] The NHS performs below average in preventing deaths from cancer, strokes and heart disease.^[68] Staff shortages at histology departments are delaying diagnosis and start of treatment for cancer patients.^[69] In England and Scotland cancer wards and children’s wards have to close because the hospital cannot attract sufficient qualified doctors and nurses to run the wards safely. Cancer patients and child patients are having to travel very long distances to get treatment and their relatives must travel far to visit the patients. In wards which have not closed staff sometimes work under stress due to staff shortages. Brexit is likely to aggravate these problems.^[70] Due to the shortage of nurses the NHS is relying on less qualified staff like healthcare assistants and nursing associates.^[71]

Cancer survival rates in the UK have been rising fast but probably still lag behind the best results internationally, mainly because of late diagnosis.^[72] However death rates from breast cancer are falling faster in Britain than in any other of the six largest countries in Europe, and are estimated now to have improved beyond the European average.^[73][74] According to Breast Cancer Care 72% of NHS trusts across the UK do not provide dedicated specialist nurses for patients with incurable breast cancer.»^[75][72] Cancer Research UK maintains more NHS cancer personnel are needed to enable the UK to catch up The NHS in England is expanding early diagnosis services with the goal of increasing the proportion of cancers diagnosed early (at stages 1 and 2) from 53% to 75% in the decade to 2028.^[76] The NHS was the first health service in Europe to negotiate coverage for novel CAR-T cancer therapy, with agreement reached within 10 days of its European marketing authorisation.^[77]

In 2018, British Prime Minister Theresa May announced that NHS in England would receive a 3.4% increase in funding every year to 2024, which would allow it to receive an extra £20bn a year in real terms funding.^[78] There is concern that a high proportion of this money will go to service NHS debts rather than for improved patient care. There are calls for the government to write off the NHS debt. Saffron Cordery of NHS Providers said that hospitals needed help to do their work without being up in deficit, as two-thirds were in the year to 2018.^[79] Some expressed doubt over whether May could carry out this proposed increase in funding.^[80] The next day, Health Secretary Jeremy Hunt backed the extra £20bn annual increase in NHS funding and responded to criticism by stating that taxation would be used to carry out the funding and that details would be revealed when the next budget is unveiled in November.^[78][81]

The Institute for Fiscal Studies has stated a 5% real-terms increase was needed for real change. Paul Johnson of the IFS said the 3.4% was greater than recent increases, but less than the long-term average.^[82] Health experts maintain the money will «help stem further decline in the health service, but it’s simply not enough to address the fundamental challenges facing the NHS, or fund essential improvements to services that are flagging.»^[83] Inflation may erode the real value of this funding increase.^[84]

As part of the 2018 funding increase the UK Government asked the NHS in England to produce a 10-year plan as to how this funding would be used. On 7 January 2019, the NHS England published the NHS Long Term Plan.

Staffing[edit]

The United Kingdom’s exit from the European Union will affect physicians from EU countries, about 11% of the physician workforce.^[86] A survey suggested 60% of these physicians were considering leaving.^[87] Record numbers of EU nationals (17,197 EU staff working in the NHS which include nurses and doctors) left in 2016. The figures, put together by NHS Digital, led to calls to reassure European workers over their future in the UK.^[88]

In June 2018, the Royal College of Physicians calculated that medical training places need to be increased from 7,500 to 15,000 by 2030 to take account of part-time working among other factors. At that time there were 47,800 consultants working in the UK of which 15,700 were physicians. About 20% of consultants work less than full-time.^[89]

A study by the Centre for Progressive Policy called for NHS trusts to become “exemplar employers” by improving social mobility and pay especially for those «trusts in poorer places where they can play a particularly large role in determining the economic wellbeing of the local population.” They found the NHS to be » a middle ranking employer in comparison to other large organisations and falls short on social mobility and the real Living Wage», and ranked trusts using a ‘good employer index’. Ambulance trusts were ranked worst.^[90]

In September 2021 the Daily Telegraph carried a story saying that «nearly half of all NHS staff have no medical qualifications», being managers, administrators or unqualified assistants.^[91]

Performance[edit]

A 2018 study by the King’s Fund, Health Foundation, Nuffield Trust, and the Institute for Fiscal Studies to mark the NHS 70th anniversary concluded that the main weakness of the NHS was healthcare outcomes. Mortality for cancer, heart attacks and stroke, was higher than average among comparable countries. The NHS was doing well at protecting people from heavy financial costs when ill. Waiting times were about the same, and the management of longterm illness was better than in other comparable countries. Efficiency was good, with low administrative costs and high use of cheaper generic medicines.^[92] Twenty-nine hospital trusts and boards out of 157 had not met any waiting-time target in the year 2017–2018.^[93] The Office for National Statistics reported in January 2019 that productivity in the English NHS had been growing at 3%, considerably faster than across the rest of the UK economy.^[94]

Over 130,000 deaths since 2012 in the UK could have been prevented if progress in public health policy had not stopped due to austerity, analysis by the Institute for Public Policy Research found. Dean Hochlaf of the IPPR said: «We have seen progress in reducing preventable disease flatline since 2012.»»^[95]. The key NHS performance indicators (18 weeks (RTT), 4 hours (A&E) and cancer (2 week wait) have not been achieved since February 2016, July 2015 and December 2015 respectively. ^[96]

British exit from the European Union[edit]

There is concern that a disorderly Brexit may compromise patients’ access to vital medicines. In February 2018 many medical organisations were planning for a worst-case Brexit scenario because «time is running out» for a transition deal to follow the UK’s formal exit, scheduled for March 2019.^[97] Pharmaceutical organisations working with the Civil Service to keep medicine supplies available in the case of a no-deal Brexit had to sign 26 Non-Disclosure Agreements (NDAs) to prevent them from giving the public information. The figures were given on 21 December 2018 after Rushanara Ali asked a parliamentary question. Ali said, «It is utterly unacceptable for the government to use non-disclosure agreements with pharmaceutical businesses and trade associations. By effectively ‘gagging’ these organisations, these secretive agreements are preventing essential information from being shared, are undermining transparency and are hampering businesses’ ability to speak out.»^[98] As negotiations continue between the UK and the EU as of 1 January 2021, vulnerable people needing treatment when working, living or travelling to the UK may lose out by not having access to NHS Care.^[99]

[edit]

Social care will cost more in future according to research by Liverpool University, University College London, and others and higher investment are needed. Professor Helen Stokes-Lampard of the Royal College of GPs said, “It’s a great testament to medical research, and the NHS, that we are living longer – but we need to ensure that our patients are living longer with a good quality of life. For this to happen we need a properly funded, properly staffed health and social care sector with general practice, hospitals and social care all working together – and all communicating well with each other, in the best interests of delivering safe care to all our patients.”^[100]

Mental health[edit]

Some patients have to wait excessively long for mental health care. The Royal College of Psychiatrists found some must wait up to thirteen months for the right care. Wendy Burn of the Royal College of Psychiatrists said, “It is a scandal that patients are waiting so long for treatment. The failure to give people with mental illnesses the prompt help they need is ruining their lives.” Even patients who are suicidal or who have attempted suicide are sometimes denied treatment; patients are told they are not ill enough or waiting lists are too long. During very long waits for treatment, one in three patients deteriorate, and they may become unemployed or get divorced. One in four patients throughout the UK wait over three months to see an NHS mental health professional, with 6% waiting at least a year.^[101]

The National Audit Office found mental health provisions for children and young people will not meet growing demand, despite promises of increased funding. Even if promises to provide £1.4bn more for the sector are kept, there will be “significant unmet need” due to staff shortages, inadequate data and failure to control spending by NHS clinical commissioning groups. Currently one-quarter of young people needing mental health services can get NHS help. The Department of Health and Social Care hopes to raise the ratio to 35%. Efforts to improve mental health provisions could reveal previously unmet demand.^[102]

Meg Hillier of the select committee on public accounts said: «The government currently estimates that less than a third of children and young people with a diagnosable mental health condition are receiving treatment. But the government doesn’t understand how many children and young people are in need of treatment or how funding is being spent locally. The government urgently needs to set out how departments, and national and local bodies, are going to work together to achieve its long-term ambition.” Amyas Morse said, “Current targets to improve care are modest and even if met would still mean two-thirds of those who need help are not seen. Rising estimates of demand may indicate that the government is even further away than it thought.»^[102]

In response, NHS England has embarked on a major programme to expand mental health services, whose budgets are now growing faster than the NHS overall.^[103] MIND the mental health charity responded saying: «We are pleased that the plan includes a commitment of £2.3bn a year towards mental health, to help redress the balance. The plan promises that this money will see around two million more people with anxiety, depression and other mental health problems receive help, including new parents, and 24 hour access to crisis care. The plan also includes a guarantee that investment in primary, community and mental health care will grow faster than the growing overall NHS budget so that different parts of the NHS come together to provide better, joined-up care in partnership with local government. Since the funding announcement in the summer, Mind has been working with the NHS, Government and voluntary sector to help shape the long term plan. This longer-term strategy was developed in consultation with people with mental health problems to ensure their views are reflected.»^[103]

Surgery[edit]

Waiting times for routine surgery have fallen substantially since 2000. As of July 2019, the median wait for planned care in England is under 8 weeks. The number of people waiting over 12 months has fallen from over 200,000 in the 1980s to under 2000 in 2019.^[104] However the number of patients on the waiting list has risen recently as constrained funding, hospital beds and staffing growth has not kept up with increasing patient need.^[105]

Electronic systems[edit]

Twenty-one different electronic systems are used in the NHS in England to record data on patients. These systems do not communicate well with each other so there is a risk doctors treating a patient will not know everything they need to know to treat the patient effectively. There were 11 million patient interactions out of 121 million where information from a previous visit could not be accessed. Half the Trusts using Electronic Medical Records used one of three systems and at least those three should be able to share information. A tenth of Trusts used multiple systems in the same hospital. Leigh Warren who participated in the research said, «Hospitals and GPs often don’t have the right information about the right patient in the right place at the right time. This can lead to errors and accidents that can threaten patients’ lives.»^[106]

Sale of data[edit]

Information on millions of NHS patients in England was sold to international pharmaceutical companies, in the US and other nations for research, adding to concerns over USA ambitions to access remunerative parts of the NHS after Brexit. There is concern over lack of transparency and clarity over the data and how it is used. Phil Booth of medConfidential , campaigning for privacy of health data, said: «Patients should know how their data is used. There should be no surprises. While legitimate research for public health benefit is to be encouraged, it must always be consensual, safe and properly transparent. Do patients know – have they even been told by the one in seven GP practices across England that pass on their clinical details – that their medical histories are being sold to multinational pharma companies in the US and around the world?»^[107]

Medicines[edit]

In November 2019 unprecedented shortages of medicines patients need developed. Drugs to treat cancer, heart disease, Parkinson’s disease, mental health conditions, some eye conditions, antibiotics for tuberculosis and drugs to control epilepsy are among those in short supply. Life saving drugs will have to be rationed and not all patients who need them will get them. Some patients can be switched onto other drugs, though this may increase the workload of hard-pressed medical staff; other patients cannot be switched to alternative drugs. Many problems can impact the supply chain, like IT failure, speculators stockpiling drugs, alterations in regulation and sudden disease outbreaks. Tony O’Sullivan of Keep Our NHS Public said: «The Health Department’s guidance includes an unprecedented list of drugs unavailable or in short supply. Patients and clinicians alike should be on high alert when the advice includes how to ‘share stocks’ to make them last, to ‘prioritise’ patients already on specific treatments including cancer rather than a new patient and effectively how to ration so many vital drugs. Drug companies’ behaviour must be controlled. We must urgently protect the NHS from further risks of loss of control of drug prices and supplies from trade deals with the US and that requires returning it to a wholly public service.»^[108][109]

Whistleblowing[edit]

In an independent review in 2016 by Robert Francis, it was concluded that some staff in England felt unable or unwilling to raise concerns about standards of care due to fear or low expectations, and that some staff who raised concerns had bad experiences and suffered unjustifiable consequences which the report described as «shocking».^[110]: 86 There is a culture of bullying towards those who raise concerns.^[110]: 87 This response may consist of placing the whistleblower on performance review, providing no assistance to them, starting a review process that can take months or years, possibly leading to mental health problems, and bullying and victimisation by other staff.^[110]: 56 This process rarely ended with being redeployed in an organisation, instead resulting in retirement, dismissal, or alternative employment.^[110]: 63

An issue identified by the report was the use of «gagging clauses» involved in settlements surrounding the termination of employment of those who whistleblow. While the report found that all the contracts were legal, it noted that the language used was often complicated and legalistic, a culture of fear deterred public interest disclosures even when they were not in breach of contract, and that the terms were often unnecessarily restrictive, for example by making the existence of the agreement confidential.^[110]: 187

Surgeon Peter Duffy wrote about his experiences of whistleblowing following an avoidable death in an independently published book, Whistle In the Wind.^[111]

Role in combating coronavirus pandemic[edit]

In 2020, the NHS issued medical advice in combating COVID-19 and partnered with tech companies to create computer dashboards to help combat the nation’s coronavirus pandemic.^[112][113] During the pandemic, the NHS also established integrated COVID into its 1-1-1 service line as well.^[114] Following his discharge from the St. Thomas’ Hospital in London on 13 April 2020 after being diagnosed with COVID-19, British Prime Minister Boris Johnson described NHS medical care as «astonishing» and said that the «NHS saved my life. No question.»^[115][116] In this time, the NHS underwent major re-organisation to prepare for the COVID-19 pandemic.^[117]

On the 5 July 2021, Queen Elizabeth II awarded the NHS the George Cross.^[118] The George Cross, the highest award for gallantry available to civilians and equivalent in stature to the Victoria Cross, is bestowed for acts of the greatest heroism or most conspicuous courage. In a handwritten note the Queen said the award was being made to all NHS staff past and present for their “courage, compassion and dedication” throughout the pandemic.^[119]

Hospital beds[edit]

In 2015, the UK had 2.6 hospital beds per 1,000 people.^[120] In September 2017, the King’s Fund documented the number of NHS hospital beds in England as 142,000, describing this as less than 50% of the number 30 years previously.^[121] In 2019 one tenth of the beds in the UK were occupied by a patient who was alcohol-dependent.^[122]

NHS music releases[edit]

NHS charity songs under various choir names have become a tradition (usually at Christmas time but not necessarily) and various formation carrying the name of NHS have released singles including:

• 2015: National Health Singers — «Yours»
• 2015: NHS Choir — «A Bridge Over You» (being a mashup of «Bridge Over Troubled Water» and «Fix You»)
• 2018: NHS Voices — «With a Little Help from My Friends»
• 2018: National Health Singers — «NHS 70: Won’t Let Go»
• 2020: NHS and keyworkers — «You’ll Never Walk Alone»

See also[edit]

• History of the NHS England
• History of NHS Scotland
• History of NHS Wales
• Private providers of NHS services

General

• Health care in the United Kingdom
• Health in the United Kingdom

Notes[edit]

References[edit]

Further reading[edit]

External links[edit]

• Official website of the NHS in England
• Official website of NHS Scotland
• Official website of NHS Wales
• Official website of Health and Social Care in Northern Ireland