The UK Medical System
The majority of healthcare in the UK is provided by the National Health Service (NHS) – one of the world’s largest publically funded health services, employing over 1.7 million people and dealing with over 1 million patients every 36 hours.
Established in 1948 under a Labour government, the NHS was introduced to make good healthcare available to all, irrespective of their financial circumstances. It offers free medical care to all UK residents at the point of delivery. Taxation and a portion of National Insurance contributions (which are commensurate with earnings) are primarily used to fund the NHS.
The NHS acts as an umbrella body for NHS England, NHS Scotland, NHS Northern Ireland and NHS Wales. Responsibility for healthcare in Scotland and Northern Ireland is devolved to their governments; the Northern Ireland Assembly, the Scottish Government and the Welsh Assembly Government.
Since it was established, the NHS has undergone many structural changes. The latest significant changes were in April 2013 when the Health and Social Care Act 2012 came into force in England.
As a result, NHS England oversees new local organisations – Clinical Commissioning Groups (CCGs) – that decide how local hospital and community health services should be provided. The UK government’s health secretary, currently Jeremy Hunt, sets out a mandate every three years, which then outlines what NHS England is expected to achieve and prioritise.
The services offered by the NHS fall into two categories; primary care and secondary care.
- Primary care services are the first point of contact for patients, and include; general practice, general dentistry, pharmacy, walk-in centres and NHS Direct (a telephone service run by nurses).
- Secondary care services cover specialist hospital care provided from referrals by primary care services and emergency care.
Doctors who work within primary care are usually general practitioners (GPs), and are part of a local CCG. Under the recent reforms, they also have responsibility for purchasing healthcare from secondary healthcare providers.
Within secondary care, doctors are employed by hospitals providing acute, specialist, mental or community services. There are a wide range of roles and training opportunities within these services.
Whilst the NHS provides most of the healthcare in the UK, a private health care sector runs in parallel. Employers occasionally fund private healthcare as part of a benefits scheme by providing medical insurance. Private medical companies also market their services directly to the general public. However, if private health care is chosen, most patients still retain their NHS GP as a first point of contact.