The 60th anniversary of Britain's National Health Service finds it undergoing the most radical, rapid and continuous programme of reorganisation and `reform' in its history. While most services remain free at point of use, and the NHS is still funded publicly, a growing share of the NHS budget is now being spent on buying services from a private sector that has grown rapidly in the last ten years.
Aneurin Bevan's bold stroke in 1948, of nationalising a collection of mostly tiny private, voluntary and municipal hospitals, swept away a failed market system, and created the most popular of all the public services. By contrast, New Labour reforms are reversing this historic modernisation, and spending more money to create a new, artificial `market' in health care which could never exist without government subsidy.
The NHS After 60 takes a fresh look at the origins and evolution of the NHS, with the greatest emphasis on the `reforms' which, in its sixth decade, have begun to transform it into a European-style social health insurance fund, for the purchase of services from a variety of private and public sector providers.
The NHS After 60 also examines the NHS in an international context, and discusses recent tendencies of Scottish, Welsh and Northern Irish governments to follow alternative lines of policy. The conclusion looks at the alternatives for the future development of the NHS. Will ministers roll the wheel of history further back towards a more radical market system, or move forward to a public service based on greater accountability and responsiveness to the needs and wishes of local people and those with greatest health needs?