The National Health Service was founded by the Labour government in 1948 as part of its welfare state programmes. According to Kesselman, Krieger, and Joseph (2009), the intentions of the government when establishing NHS were very noble. In fact, the scholars note that the concept dates back to the Victorian era when the royal ruler envisaged a system where government would help the poor to access basic needs such as cheap housing and affordable healthcare. This vision was achieved when the government established NHS to make healthcare services affordable to all the residents of the United Kingdom. Under various governments, this programme has faced a number of challenges, especially with the issue of founding, which has affected the quality of services it offers. The inability of this system to deliver quality services has earned it massive criticism from a section of the society that feels it is no longer serving its original purpose. These critics argue that members of the public are currently forced to take private insurance cover besides NHS to ensure that they can get quality medical care from private institutions. However, another section of the society still believes that NHS is the best thing that ever happened in the United Kingdom’s healthcare sector. In this paper, the researcher seeks to confirm that National Health Service is still the jewel in the crown of the welfare state.
The United Kingdom’s Welfare State
The welfare state in the United Kingdom was an attempt by the government to bridge the gap between the rich and the poor when it came to accessing basic needs. The idea was first developed during the Victorian era when the royal ruler realized that the poor had no access to some of the basic needs in their lives. However, the idea was never implanted because there was no clear blueprint that could be used to make it a success. However, the concept emerged again in the early 1940s during the Second World War. Prominent people such as William Beveridge were concerned about the suffering of the poor during this time. After consultation with the national government, it was announced that all the people living in the United Kingdom will be given free treatment at all public hospitals for the entire period of the war. The intention was to ensure that the country retained a population that was healthy and strong to support the military at the battlefields. The program was a success.
In 1942, William Beveridge published a blueprint of an ideal welfare state that could be used by the government to ensure that the poor and the rich could have access to basic human needs. The report included a publicly funded health insurance cover and cheap housing for the people in the lower social class. After the defeat of Winston Churchill’s Conservative Party, the Labour Party formed the government in 1945 led by Clement Attlee. Clement Attlee’s new government announced that it would implement the welfare state as envisaged in Beveridge Report of 1942. After a series of consultations and preparations, National Health Service was finally introduced in the United Kingdom in 1948 as part of the welfare state. Moore (2013) recalls that there was an attempt to oppose the welfare society because it was seen to be leaning more towards communism. Some politicians argued that this was a socialist agenda that should not be allowed in a society that had embraced capitalism. However, these issues were addressed and the government went ahead with its implementation programme.
Critics of National Health Service
The National Health Service has earned criticism from a section of the society that believes that it is no longer serving the purpose for which it was meant. According to Kesselman, Krieger, and Joseph (2015), NHS is may be a jewel in the crown of the welfare state only in name but not in practice. Over the years, the successive governments in the United Kingdom have reduced its funding to this programme, making its implementation very challenging. It is through the tax that the government gets money to fund this project. However, lack of strict and very clear regulatory policies that determines the minimum amount of money that the government should be spending in NHS has given it a leeway to manipulate this fund, a problem that has starved the institution for a very long time. NHS has remained a tool used by politicians to win the electorates’ votes. Once elected to the office, they forget their promises to the public and focus on issues that matters most to them.
The rise of private insurance funds within the United Kingdom is a clear indication of an eminent collapse of National Health Service. The citizens of the United Kingdom are taxed every year, and part of this tax is meant to fund NHS for the benefit of the public. However, recent statistics shows that it has failed to meet the expectations of the people of this country. Part of the contributions to this institution is meant for construction of new buildings and buying better equipment as a way of improving services offered at public hospitals. This has not been the case for the past several years. The rate at which population is increasing in this country, especially in major cities such as London, is lower than the rate at which the capacity of public health facilities is increasing. This has led to massive congestion at these facilities, something that has lowered quality of services they offer. Patients are forced to wait for longer hours at the emergency unit as there is limited space to attend to them. Some of the equipments would often break down when patients are receiving critical care at these facilities (Naylor 2015). This is a clear indication that NHS has failed, forcing many people to get private health insurance cover. This way, they can go to private hospitals where services are better than what is offered at the public healthcare institutions. It becomes illogical for the public to pay for private insurance cover when the state collects tax that should be funding free medical services at public hospitals.
The national government has failed to come up with policies that would regulate people who get medical services at public hospitals. The United Kingdom is one of the countries that have been receiving high number of illegal immigrants from various parts of the world. These illegal immigrants do not pay tax and neither do they contribute to any social security funds in the country (Kjellstrand & Dossetor 2013). However, they get free medical services at public institutions at the expense of the tax payers. This explains why the emergency department, where identity of the patient is always considered unnecessary, has always been flooded making it impossible for the citizens to get services they have paid for through their taxes.
Supporters of National Health Service
National Health Service is the only solution to the poor who seek medical services in the country. According to a report by Boyle (2011), the cost of healthcare services has been on the rise over the past two decades following the emergence or increased prevalence of diseases such as diabetes, cancer, cardiovascular diseases, and renal problem, among others. These problems may cost a fortune to manage for the peasants who do not have well-paying jobs. For instance, the cost of weekly dialysis for a diabetic patient may run into thousands of dollars per month. These are people who are struggling to earn a living in this country. Cancer treatment may be out of reach for many patients in the United Kingdom. Treating this disease at advanced stages require highly specialized procedures that involved removing the cancerous cells through surgery. This is a process that a person earning less than $ 2000 may not afford in this country. Going by the recent statistics, this would mean that over 30% of the citizens may not afford such a medication due to its high cost of management. The little money they get is meant to cover for their rental services, food, and clothing. They cannot afford the expensive costs of managing these lifestyle diseases on a monthly basis. The only hope that they have in staying alive is to be covered by the NHS. Fitzpatrick (2002) says that the poor can now be assured that despite the rising cost of healthcare services, they can still access medical services at public hospitals.
National Health Service has helped in reducing the gap that exists between the poor and the rich within the United Kingdom. According to Davies, Wetherell, and Barnett (2006), for a long time policy makers have been struggling to address the issue of the gap between the poor and the rich that has been seen to be on the rise for the past decades. The government has come up with policies such as progressive tax system where the rich are taxed more than the poor. To an extent, this has been of help, but NHS has offered one of the best solutions to this problem. As Hallam (2012) says, the main problem posed by the big gap between the poor and the rich is that the poor may fail to access basic needs that can help them survive while the rich have more than they need in their lifetime. This programme does not stop the rich from having wealth enough for several of their generations to come. Under the capitalistic system that we have in our country, we cannot stop them from achieving such a massive success as long as they use legal processes. However, it does stop a situation where the poor cannot get basic needs in the society. Healthcare is a basic need that one cannot survive without. It means that both the rich and the poor can get healthcare products, as one of the fundamental needs, despite the difference in their social status. The massive wealth of the rich can buy them luxuries, which one can afford to live without, but when it comes to primary needs, NHS ensures that they are equal.
According to French and Swain (2011), most of the critics of NHS have not offered an alternative that can be used to address the needs of the poor, a sign that it is still the best policy. Majority of those who have been critical of this programme are rich members of the society who have private health insurance covers to cater for their medical needs. These people are used to services they receive at private medical facilities in the country. As Brown (2013) notes, the only way through which private healthcare institutions can attract clients is to ensure that quality of their services exceeds that offered at public hospitals. At public hospitals, these services are offered for free, and the only rationale for their existence must be that they offer superior services. They charge highly for these additional services, some of which are superficial and only meant to please the clients. It is, therefore, unfair to compare services offered at private facilities to that offered in public hospitals. Private institutions know that they are handling the rich in the society who love lavishness in every product they purchase. The government cannot afford these luxuries as it tries to make medical products universally available.
The government, through NHS, has ensured that public can now get comprehensive medical services, something that is not common in some of the neighbouring countries (Taylor 2013). At first, there were specific ailments that were taken care of for free under this programme. However, the government has expanded its scope to include other specialized medical services. For instance, it is a requirement that patients with eye problem should make additional payments if they need eye treatment. However, there is a provision which states that this requirement only applies to those who have the financial capacity to pay. For those who are financially crippled and lack the capacity to make such payments, the provision states that they should get such services for free. This still emphasizes on the need to make healthcare services comprehensive and universally accessible to everyone.
The National Health Service is the jewel in the crown of the welfare state. It is actually the symbol of a successful welfare state where government is directly involved in providing basic needs to all the citizens. It is true that this programme has had a number of challenges over the recent past. Most of the woes of this programme have been linked to political leaders who may not be sharing the same idea as the founders of NHS. Cases of underfunding have led to reduced capacity of public hospitals to expand and improve their capacity in response to the increasing population in the country. However, it is unfair to claim that the programme has failed because of these weaknesses. The cost of health in the United Kingdom and the entire Europe has been on the rise over the past decades. Managing diseases such as cancer, diabetes and cardiovascular problems can only be affordable to the rich. However, NHS has made it possible for the poor to access medical services to address these problems without having to pay the high costs. It has successfully bridged the gap between the poor and the rich in healthcare sector. It is indeed the jewel in the crown of the welfare state.
List of References
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Brown, C 2013, Glory and blocks: The truth behind ten defining events in British history, Oneworld, London.
Davies, C, Wetherell, M & Barnett, E 2006, Citizens at the centre: Deliberative participation in healthcare decisions, Policy Press, Bristol.
Fitzpatrick, M 2002, The Tyranny of Health: Doctors and the Regulation of Lifestyle, Routledge, New York.
French, S, & Swain, J 2011, Working with Disabled People in Policy and Practice: A Social Model, McMillan, London.
Hallam, J 2012, Nursing the Image: Media, Culture and Professional Identity, Routledge, New York.
Kesselman, M, Krieger, J & Joseph, W 2009, Introduction to comparative politics, Houghton Mifflin Harcourt, Boston.
Kesselman, M, Krieger, J & Joseph, W 2015, Introduction to Comparative Politics: Political Challenges and Changing Agendas, Houghton Mifflin Harcourt, Boston.
Kjellstrand, C & Dossetor, J 2013, Ethical problems in dialysis and transplantation, Springer Netherlands, Dordrecht.
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