Advancing Universal Health Coverage : What Developing Countries Can Learn from the English Experience?
The United Kingdom has in many respects the archetypal centrally planned, publicly financed health care system in the form of National Health Service (NHS), established in 1948 in a time of great austerity after Second World War. It is largely fund...
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| Format: | Working Paper |
| Language: | English |
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World Bank, Washington, DC
2018
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| Online Access: | http://documents.worldbank.org/curated/en/184761516173371689/Advancing-universal-health-coverage-what-developing-countries-can-learn-from-the-English-experience http://hdl.handle.net/10986/29183 |
| Summary: | The United Kingdom has in many respects
the archetypal centrally planned, publicly financed health
care system in the form of National Health Service (NHS),
established in 1948 in a time of great austerity after
Second World War. It is largely funded from general
taxation, and provides wide coverage of most mainstream
health services, with little recourse to user charges. It
offers strong financial protection against the costs of
health care and enjoys high public approval ratings. Its
principal shortcomings have been weaknesses in service
quality, often in the form of long waiting times, and
sometimes relating to clinical quality. This paper
concentrates on the experience in England, which accounts
for 84 percent of the UK population of 64.6 million. The
system of health service coverage adopted in the NHS is very
simple. There is no explicit requirement to enroll in an
insurance plan. Instead, citizens must register with a
general practitioner (GP) of their choice. GPs act as a
gatekeeper to nonemergency secondary care and prescription
medicines and devices. Apart from small fees for some
prescription medicines (from which many citizens are
exempt), patients are not directly charged for access to NHS
care. Throughout most of its history, the NHS model of
governance has entailed strong central control by the
national ministry, with local administration responsible for
detailed local planning and purchasing. The forms of local
administration have varied. In the early years of the NHS
they were primarily local NHS hospitals, with separate
committees for oversight of primary care. Since 1974, local
health authorities have assumed the role of oversight of
local services, currently covering, on average, populations
of 250,000. |
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