The National Health Service is much more than a healthcare system: it is one of Britons' best-loved institutions, celebrated even in the opening ceremony of the 2012 London Olympics. Created on 5 July 1948 at the initiative of Labour minister Aneurin Bevan, it was the first health system in the world to offer free care to the whole population, funded by taxes rather than insurance.
How it works
The founding principle is that care is free at the point of use for people living in the country: GP visits, hospital stays, operations, A&E, maternity. The service is funded largely from general taxation and employs about 1.5 million people in England alone, one of the largest employers in the world. In reality there are four separate systems: the NHS in England, NHS Scotland, NHS Wales and, in Northern Ireland, HSC, which combines health and social care. Rules on charges and prescriptions vary: in Scotland, Wales and Northern Ireland prescriptions are free, while in England there is a flat charge of about £10 per item, with many exemptions (children, older people, pregnant women, people on low incomes).
The family doctor
The way in is the GP (general practitioner), with whom you register in the area where you live. The GP refers patients to specialists and hospitals. Getting an appointment can take days or weeks, and many practices now offer phone or online consultations. For urgent but non-life-threatening problems you call 111, available day and night; for emergencies 999 (or 112). There are also walk-in centres and urgent treatment centres for minor cases. Dentistry is partly charged even on the NHS, and finding an NHS dentist accepting new patients has become difficult in many areas.
The difficulties
In recent years the NHS has entered a deep crisis. After a decade of smaller spending increases than in the past, the pandemic made backlogs explode: waiting lists for planned treatment in England have passed 7 million, A&E waits are often long and staff, amid strikes by resident doctors and nursing shortages, are under pressure. The service depends more and more on doctors and nurses trained abroad. The government has launched a reform that abolishes NHS England, absorbed by the Department of Health, and a ten-year plan to shift care from hospitals to the community and prevention.
For visitors and foreign residents
- European visitors: the European Health Insurance Card (EHIC) covers necessary treatment during a temporary stay in public facilities. Travel insurance is still advisable, including for repatriation.
- People moving on a visa: pay the Immigration Health Surcharge in advance, £1,035 a year for workers and £776 for students and children, and then use the NHS like residents.
- Europeans with resident status: have full access to the NHS, like British citizens.
A&E and treatment for certain infectious diseases are always free for everyone. See also quality of life, travelling after Brexit and living in the UK.