History of the National Health Service (England)
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The
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
in England was created by the National Health Service Act 1946. Responsibility for the NHS in Wales was passed to the
Secretary of State for Wales The secretary of state for Wales ( cy, ysgrifennydd gwladol Cymru), also referred to as the Welsh secretary, is a secretary of state in the Government of the United Kingdom, with responsibility for the Wales Office. The incumbent is a member ...
in 1969, leaving the
Secretary of State for Social Services The Secretary of State for Health and Social Services was a position in the UK cabinet, created on 1 November 1968 with responsibility for the Department of Health and Social Security. It continued until 25 July 1988 when Department of Health and ...
responsible for the NHS in England by itself.


Development of the NHS in England and Wales, 1948–1969

The original structure of the NHS in England and Wales had three aspects, known as the ''tripartite system'': * Hospital services: Fourteen regional hospital boards were created in England and Wales to administer the majority of hospital services. Beneath these were 400 hospital management committees which administered hospitals. Teaching hospitals had different arrangements and were organised under boards of governors. * Primary care: GPs were independent contractors (that is, they were not salaried employees) and would be paid for each person on their list. Dentists, opticians and pharmacists also generally provided services as independent contractors. Executive councils were formed and administered contracts and payments to the contractor professions as well as maintaining lists of local practitioners and dealing with patients. * Community services:
Maternity ] A mother is the female parent of a child. A woman may be considered a mother by virtue of having given birth, by raising a child who may or may not be her biological offspring, or by supplying her ovum for fertilisation in the case of gestati ...
and child welfare clinics, health visitors,
midwives A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their lifespan; co ...
, health education,
vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...
&
immunisation Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an infectious agent (known as the immunogen). When this system is exposed to molecules that are foreign to the body, called ''non-sel ...
and ambulance services together with environmental health services were the responsibility of local authorities. This was a continuation of the role local government had held under the Poor Laws. In 1948 across England and Wales there were 377 hospital management committees, and 36 teaching hospitals, each with its own board of governors. There were also 146 local health authorities, running health centres, ambulances services and other community services, and 140 executive councils, managing general practices,
NHS dentistry Dentistry provided by the National Health Service in the United Kingdom is supposed to ensure that dental treatment is available to the whole population. Most dentistry is provided by private practitioners, most of whom also provide, on a commerci ...
, pharmacists and opticians. The new service instantly became Britain's third largest employer with around 364,000 staff across England and Wales. These included 9,000 full-time doctors, 19,000 professional and technical staff (including 2,800 physiotherapists, 1,600 laboratory technicians and 2,000 radiographers), 25,000 administrative and clerical staff, 149,000 nurses and midwives (23,000 of whom were part-time), and 128,000 ancillary staff (catering, laundry, cleaning and maintenance). By the beginning of the 1950s, spending on the NHS was exceeding expectations, leading in 1952 to the introduction of a one-
shilling The shilling is a historical coin, and the name of a unit of modern currencies formerly used in the United Kingdom, Australia, New Zealand, other British Commonwealth countries and Ireland, where they were generally equivalent to 12 pence o ...
charge for prescriptions and a £1 charge for dental treatment; these were exceptions to the NHS being free at the point of use. Political concerns about spiralling NHS costs later receded in the wake of the 1956 Guillebaud Report, which praised the "responsible attitude among hospital authorities" towards the "efficient and economical" use of public funds. The 1950s saw the planning of hospital services, dealing in part with some of the gaps and duplications that existed across England and Wales. The period also saw growth in the number of medical staff and a more even distribution of them with the development of hospital outpatient services. By 1956, the NHS was stretched financially and doctors were disaffected, resulting in a Royal Commission on doctors' pay being set up in February 1957. The investigation and trial of alleged
serial killer A serial killer is typically a person who murders three or more persons,A * * * * with the murders taking place over more than a month and including a significant period of time between them. While most authorities set a threshold of three ...
Dr John Bodkin Adams exposed some of the tensions in the system. Indeed, if he had been found guilty (for, in the eyes of doctors, accidentally killing a patient while providing treatment) and hanged, the whole NHS might have collapsed. The
Mental Health Act 1959 The Mental Health Act 1959 was an act of the Parliament of the United Kingdom concerning England and Wales which had, as its main objectives, to abolish the distinction between psychiatric hospitals and other types of hospitals and to deinstitui ...
also significantly altered legislation in respect of
mental illness A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
and reduced the grounds on which someone could be detained in a mental hospital. The 1960s have been characterised as a period of growth. Prescription charges were abolished in 1965 and reintroduced in 1968. New drugs came to the market improving healthcare, including polio vaccine, dialysis for chronic
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
and chemotherapy for certain cancers were developed, all adding to upfront costs. Health Secretary
Enoch Powell John Enoch Powell, (16 June 1912 – 8 February 1998) was a British politician, classical scholar, author, linguist, soldier, philologist, and poet. He served as a Conservative Member of Parliament (1950–1974) and was Minister of Health (1 ...
undertook three initiatives: * The Hospital Plan published in 1962 proposed the development of
district general hospital A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency ...
s for population areas of about 125,000 and laid out a pattern for the future district by district; * The Church House speech predicted that many of the large mental health institutions would close within ten years. Concern continued to grow about the structure of the NHS and weaknesses of the tripartite system. Powell agreed to the creation of a Royal Commission on doctors’ pay, which resulted in a statutory review body. Further development came in the form of the Charter of General Practice, negotiated between new Health Minister Kenneth Robinson and the BMA, that provided financial incentives for practice development. This resulted in the concept of the
primary health care Primary health care, or PHC, refers to "essential health care" that is based on scientifically sound and socially acceptable methods and technology. This makes universal health care accessible to all individuals and families in a community. PHC in ...
in better-housed and better-staffed practices, stimulating doctors to join together and the development of the modern group practice. In 1969, responsibility for the NHS in Wales was passed to the
Secretary of State for Wales The secretary of state for Wales ( cy, ysgrifennydd gwladol Cymru), also referred to as the Welsh secretary, is a secretary of state in the Government of the United Kingdom, with responsibility for the Wales Office. The incumbent is a member ...
from the Secretary of State for Health who was thereafter just responsible for the NHS in England. After the publication by the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'' on 24 December 1949 of
University of Cambridge , mottoeng = Literal: From here, light and sacred draughts. Non literal: From this place, we gain enlightenment and precious knowledge. , established = , other_name = The Chancellor, Masters and Schola ...
consultant paediatrician
Douglas Gairdner Douglas Montagu Temple Gairdner FRCP (19 November 1910 – 10 May 1992) was a Scottish paediatrician, research scientist, academic and author. Gairdner was principally known for a number of research studies in neonatology at a time when that su ...
's landmark paper detailing the lack of medical benefit and the risks attached to non-therapeutic (routine) circumcision, the National Health Service took a decision that circumcision would not be performed unless there was a clear and present medical indication. Both the cost and the non-therapeutic, unnecessary, harmful nature of the surgical operation were taken into account.


1970s and early 1980s

The NHS in England was reorganised in 1974 to bring together services provided by hospitals and services provided by local authorities under the umbrella of regional health authorities, with a further restructuring in 1982. The 1970s also saw the end of the economic optimism which had characterised the 1960s and increasing pressures coming to bear to reduce the amount of money spent on public services and to ensure increased
efficiency Efficiency is the often measurable ability to avoid wasting materials, energy, efforts, money, and time in doing something or in producing a desired result. In a more general sense, it is the ability to do things well, successfully, and without ...
for the money spent. The 1970s and 1980s saw issues with contaminated blood and blood products which was referred to later as the "worst treatment disaster in the history of the NHS".


Thatcher government reforms

In the 1980s,
Thatcherism Thatcherism is a form of British conservative ideology named after Conservative Party leader Margaret Thatcher that relates to not just her political platform and particular policies but also her personal character and general style of manag ...
represented a systematic, decisive rejection and reversal of the
Post-war consensus The post-war consensus, sometimes called the post-war compromise, was the economic order and social model of which the major political parties in post-war Britain shared a consensus supporting view, from the end of World War II in 1945 to the ...
, whereby the major political parties largely agreed on the central themes of Keynesianism, the welfare state, nationalised industry, public housing and close regulation of the economy. There was one major exception: the National Health Service, which was widely popular and had wide support inside the Conservative Party. Prime Minister Margaret Thatcher promised Britons in 1982, the NHS is "safe in our hands." In the 1980s modern management processes (''General Management'') were introduced in the NHS to replace the previous system of consensus management. This was outlined in the Griffiths Report of 1983. This recommended the appointment of general managers in the NHS with whom responsibility should lie. The report also recommended that clinicians be better involved in management. Financial pressures continued to place strain on the NHS. In 1987, an additional £101 million was provided by the government to the NHS. In 1988 the then Prime Minister,
Margaret Thatcher Margaret Hilda Thatcher, Baroness Thatcher (; 13 October 19258 April 2013) was Prime Minister of the United Kingdom from 1979 to 1990 and Leader of the Conservative Party (UK), Leader of the Conservative Party from 1975 to 1990. S ...
, announced a review of the NHS. From this review and in 1989, two
white paper A white paper is a report or guide that informs readers concisely about a complex issue and presents the issuing body's philosophy on the matter. It is meant to help readers understand an issue, solve a problem, or make a decision. A white paper ...
s, ''Working for Patients'' and ''Caring for People'', were produced. These outlined the introduction of what was termed the "internal market", which was to shape the structure and organisation of health services for most of the next decade. In spite of intensive opposition from the BMA, who wanted a pilot study or the reforms in one region, the internal market was introduced. In 1990, the National Health Service & Community Care Act (in England) defined this "internal market", whereby Health Authorities ceased to run hospitals but "purchased" care from their own or other authorities' hospitals. Certain GPs became "fund holders" and were able to purchase care for their patients. The "providers" became
NHS trust An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
s, which encouraged competition but also increased local differences. Studies suggest that while the competition introduced in the "internal market" system resulted in shorter waiting times it also caused a reduction in the quality of care for patients.


Blair government reforms

These innovations, especially the "fund holder" option, were condemned at the time by the Labour Party. Opposition to what was claimed to be a
Conservative Conservatism is a cultural, social, and political philosophy that seeks to promote and to preserve traditional institutions, practices, and values. The central tenets of conservatism may vary in relation to the culture and civilization i ...
intention to
privatise Privatization (also privatisation in British English) can mean several different things, most commonly referring to moving something from the public sector into the private sector. It is also sometimes used as a synonym for deregulation when ...
the NHS became a major feature of Labour's election campaigns. Labour came to power in 1997 with the promise to remove the "internal market" and abolish fundholding. In a speech given by the new Prime Minister,
Tony Blair Sir Anthony Charles Lynton Blair (born 6 May 1953) is a British former politician who served as Prime Minister of the United Kingdom from 1997 to 2007 and Leader of the Labour Party from 1994 to 2007. He previously served as Leader of th ...
, at the Lonsdale Medical Centre on 9 December 1997, he stated that: However, in his second term Blair pursued measures to strengthen the internal market as part of his plan to "modernise" the NHS. Driving these reforms were a number of factors including the rising costs of medical technology and medicines, the desire to increase standards and "patient choice", an ageing population, and a desire to contain government expenditure. Since the national health services in Wales, Scotland and Northern Ireland are not controlled by the UK government, these reforms have increased the differences between the national health services in different parts of the United Kingdom. (See
NHS Wales NHS Wales ( cy, GIG (Gwasanaeth Iechyd Gwladol) Cymru) is the publicly-funded healthcare system in Wales, and one of the four systems which make up the National Health Service in the United Kingdom. NHS Wales was formed as part of the public ...
and
NHS Scotland NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, ...
for descriptions of their developments). Reforms included (amongst other actions) the laying down of detailed service standards, strict financial budgeting, revised job specifications, reintroduction of a modified form of fundholding – "practice-based commissioning", closure of surplus facilities and emphasis on rigorous clinical and
corporate governance Corporate governance is defined, described or delineated in diverse ways, depending on the writer's purpose. Writers focused on a disciplinary interest or context (such as accounting, finance, law, or management) often adopt narrow definitions th ...
. In addition
Modernising Medical Careers Modernising Medical Careers (MMC) is a programme for postgraduate medical training introduced in the United Kingdom in 2005. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the ...
medical training had an unsuccessful restructuring which was so badly managed that the Secretary of State for Health was forced to apologise publicly. It was then revised but its flawed implementation left the NHS with significant medical staffing problems. Some new services were developed to help manage demand, including
NHS Direct NHS Direct was the health advice and information service provided by the National Health Service (NHS), established in March 1998. The nurse-led telephone information service provided residents and visitors in England with healthcare advice 24 ho ...
. A new emphasis was given to staff reforms, with the
Agenda for Change Agenda for Change (AfC) is the current National Health Service (NHS) grading and pay system for NHS staff, with the exception of doctors, dentists, apprentices and some senior managers. It covers more than 1 million people and harmonises their pay ...
agreement providing harmonised pay and career progression. These changes gave rise to controversy within the medical professions, the media and the public. The Blair Government, whilst leaving services free at point of use, encouraged outsourcing of medical services and support to the private sector. Under the
Private Finance Initiative The private finance initiative (PFI) was a United Kingdom government procurement policy aimed at creating "public–private partnerships" (PPPs) where private firms are contracted to complete and manage public projects. Initially launched in 199 ...
, an increasing number of hospitals were built (or rebuilt) by private sector consortia; hospitals may have both medical services (such as
independent sector treatment centre Independent sector treatment centres (ISTCs) are private-sector owned treatment centres contracted within the English National Health Service to treat NHS patients free at the point of use. They are sometimes referred to as 'surgicentres' or ‘sp ...
(ISTC or "surgicentres"), and non-medical services (such as catering) provided under long-term contracts by the private sector. A study by a consultancy company which worked for the Department of Health showed that every £200 million spent on privately financed hospitals resulted in the loss of 1000 doctors and nurses. The first PFI hospitals contained some 28 per cent fewer beds than the ones they replaced. In 2005, surgicentres treated around three per cent of NHS patients (in England) having routine surgery. By 2008 this was expected to be around 10 per cent.
NHS primary care trust Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May ...
s have been given the target of sourcing at least 15 per cent of primary care from the private or voluntary sectors over the medium term. As a corollary to these initiatives, the NHS was required to take on pro-active socially "directive" policies, for example, in respect of
smoking Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have bee ...
and
obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...
. The NHS encountered significant problems with the information technology (IT) innovations accompanying the Blair reforms. The NHS's
National Programme for IT The NHS Connecting for Health (CFH) agency was part of the UK Department of Health and was formed on 1 April 2005, having replaced the former NHS Information Authority. It was part of the Department of Health Informatics Directorate, with the role ...
(NPfIT), believed to be the largest IT project in the world, is running significantly behind schedule and above budget, with friction between the government and the programme contractors. Originally budgeted at £2.3 billion, present estimates are £20–30 billion and rising. There has also been criticism of a lack of patient information security. The ability to deliver integrated high quality services will require care professionals to use sensitive medical data. This must be controlled and in the NPfIT model it is, sometimes too tightly to allow the best care to be delivered. One concern is that GPs and hospital doctors have given the project a lukewarm reception, citing a lack of consultation and complexity. Key "front-end" parts of the programme include
Choose and Book Choose and Book was an E-Booking software application for the National Health Service (NHS) in England which enabled patients needing an outpatient appointment to choose which hospital they were referred to by their general practitioner (GP), an ...
, intended to assist patient choice of location for treatment, which has missed numerous deadlines for going "live", substantially overrun its original budget, and is still (May 2006) available in only a few locations. The programme to computerise all NHS patient records is also experiencing great difficulties. Furthermore, there are unresolved financial and managerial issues on training NHS staff to introduce and maintain these systems once they are operative. Between 2004/5 and 2013/4 NHS output increased considerably. Hospital admissions increased by 32%, outpatient attendances by 17%, primary care consultations by 25% and community care activity by 14%. Hospital death rates reduced, especially in stroke. At the same time there was an increase in wages of 24% and an increase of 10% in the number of staff and increases in the use of equipment and supplies. As a whole NHS output increased by 47% and inputs by 31%, an increase in productivity of 12.86% during the period, or 1.37% per year.


Coalition and Cameron government reforms

The return of a
Conservative Conservatism is a cultural, social, and political philosophy that seeks to promote and to preserve traditional institutions, practices, and values. The central tenets of conservatism may vary in relation to the culture and civilization i ...
-led government in 2010 coincided with another deterioration in industrial relations. The introduction of further private sector involvement in the
Health and Social Care Act 2012 The Health and Social Care Act 2012c 7 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date.''BMJ'', 2011; 342:d408Dr Lansley's Mon ...
provoked mass demonstrations led by health workers, and some NHS workers also participated in a national
strike Strike may refer to: People * Strike (surname) Physical confrontation or removal *Strike (attack), attack with an inanimate object or a part of the human body intended to cause harm *Airstrike, military strike by air forces on either a suspected ...
over pay restraint in 2014. 2016 also saw major industrial action by junior doctors, protesting at the imposition of a new contract aiming to extend weekend working. The
Health and Social Care Act 2012 The Health and Social Care Act 2012c 7 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date.''BMJ'', 2011; 342:d408Dr Lansley's Mon ...
did not extend patient choice as envisaged (as this policy subsequently took a backseat) but did lead to an increasing amount of the NHS budget being diverted to private providers. In 2019, doctors and MPs warned that the ongoing privatisation of certain NHS England cancer screening services would lead to patient harm. In July 2019, it was announced that the NHS would be partnering with the virtual assistant
Amazon Alexa Amazon Alexa, also known simply as Alexa, is a virtual assistant technology largely based on a Polish speech synthesiser named Ivona, bought by Amazon in 2013. It was first used in the Amazon Echo smart speaker and the Echo Dot, Echo Studio and ...
to offer health advice directly from the NHS website.


See also

*
History of the National Health Service The name National Health Service (NHS) is used to refer to the free public health services of England, Scotland and Wales, individually or collectively. Northern Ireland’s services are known as 'Health and Social Care' to promote its dual integ ...
*
History of NHS Scotland NHS Scotland is the publicly funded healthcare systems in Scotland. It was founded by the National Health Service (Scotland) Act 1947 (since repealed by the National Health Service (Scotland) Act 1978) and was launched on 5 July 1948, under the c ...
* History of NHS Wales *
History of Health and Social Care in Northern Ireland Health and Social Care (HSC) ( ga, Sláinte agus Cúram Sóisialta, ) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a ...
*
Keep Our NHS Public Keep Our NHS Public is a campaigning organisation, with local groups across England, committed to reversing what it describes as the ongoing privatisation of the NHS and its services. History The group was founded in 2005 by the NHS Consul ...
*
List of hospitals in England The following is a list of hospitals in England. For NHS trusts, see the list of NHS Trusts. East Midlands * Arnold Lodge, Leicestershire *Babington Hospital – Belper, Derbyshire *Bassetlaw District General Hospital – Worksop, Nottinghams ...
*
List of NHS trusts This list of NHS trusts in England provides details of current and former English NHS trusts, NHS foundation trusts, acute hospital trusts, ambulance trusts, mental health trusts, and the unique Isle of Wight NHS Trust. , 217 extant trusts empl ...


References


Further reading

{{columns-list, colwidth=30em, * Abel-Smith, B. ''The Hospitals 1800–1948: A Study in Social Administration in England and Wales'' (Harvard U.P., 1964). * Campbell, J. ''Aneurin Bevan and the Mirage of British Socialism'' (W.W. Norton, 1987) * Eckstein, H. ''Pressure Group Politics; The Case of the British Medical Association. ''(Stanford, CA: Stanford U.P., 1960). * Eversley, J. ''The History of NHS Charges', ''Contemporary British History'', 15, 2 (2001), pp. ''53–75. * Forsyth, G. ''Doctors and State Medicine: A Study of the British Health Service'' (London: Pitman Medical Publishing, 1966). * Foot, Michael. ''Aneurin Bevan: 1945–1960'' (vol 2, 1973) PP 100–216 * Fox, D. ''Health Policies, Health Politics: The British and American Experience 1911–1965'' (Princeton U.P., 1986). * Fraser, D. ''The Evolution of the British Welfare State: A History of Social Policy Since the Industrial Revolution'' (London: Macmillan, 1973). * Gemmill, P. '' Britain's Search for Health: The First Decade of the National Health Service'' (U. ''of Pennsylvania Press, 1960). * Godber, G. ''The Health Service: Past, Present and Future'' (Athlone, 1975). * {{cite journal , author = Godber G , year = 1988 , title = Forty Years of the NHS: Origins and Early Development , journal = British Medical Journal , volume = 297 , issue = 6640, pages = 37–43 , doi=10.1136/bmj.297.6640.37, pmid = 3044487 , pmc = 1834188 * Goodman, G. ed. ''The State of the Nation: The Political Legacy of Aneurin Bevan'' (Victor Gollancz, 1997). * Goodman, N. ''Wilson Jameson: Architect of National Health (London: George Allen & Unwin, 1970). * Gorsky, Martin. "The British National Health Service 1948–2008: A Review of the Historiography," ''Social History of Medicine,'' Dec 2008, Vol. 21 Issue 3, pp 437–460 * Grimes, S. ''The British National Health Service: State Intervention in the Medical Marketplace, 1911–1948'' (New York: Garland, 1991). * Hacker, Jacob S. "The Historical Logic of National Health Insurance: Structure and Sequence in the Development of British, Canadian, and U.S. Medical Policy," ''Studies in American Political Development,'' April 1998, Vol. 12 Issue 1, pp 57–130. * Ham, C. ''Health Policy in Britain: The Politics and Organisation of the National Health Service'' (2nd edn (Macmillan, 1985). * Hollingsworth, J. ''A Political Economy of Medicine: Great Britain and the United States'' (Johns Hopkins U.P., 1986) * Honigsbaum, F. ''Health, Happiness, and Security: The Creation of the National Health Service'' (Routledge, 1989). * Jewkes, J. and S. Jewkes. ''The Genesis of the British National Health Service'' (2nd edn (Basil Blackwell, 1962). * Klein, R. ''The New Politics of the National Health Service'' (3rd ed. 1995). * Lindsey, A. ''Socialized Medicine in England and Wales: The National Health Service, 1948–1961'' (U. of North Carolina Press, 1962). * Loudon, Irvine, John Horder and Charles Webster. ''General Practice under the National Health Service 1948–1997'' (1998
online
* Powell, M. "Hospital Provision before the National Health Service: A Geographical Study of the 1945 Hospital Surveys', ''Social History of Medicine'' (1992), 5#3 pp. 483–504. * Powell, M. "An Expanding Service: Municipal Acute Medicine in the 1930s", ''Twentieth Century History'' (1997), 8#3 pp. 334–57.
Rintala, Marvin. ''Creating the National Health Service: Aneurin Bevan and the Medical Lords'' (2003)
* Rivett, G. C. The Development of the London Hospital System, 1823–1982 (first edition Kings Fund 1986) and second edition 1823–2013 via website www.nhshistory.net * Rivett, G. C. From Cradle to Grave, the history of the NHS 1948–1998. First Edition King's Fund 1998, and second edition 1948–2014 in two parts from website www.nhshistory.net. *{{cite web , url=https://www.nuffieldtrust.org.uk/health-and-social-care-explained/nhs-reform-timeline/ , title=NHS reform timeline , website=Nuffield Trust, date=2019, author=Geoffrey Rivett , access-date= 31 July 2020 * Stewart, John. "The Political Economy of the British National Health Service, 1945–1975: Opportunities and Constraints," ''Medical History,'' Oct 2008, Vol. 52 Issue 4, pp 453–470 * Valier, Helen K. "The Manchester Royal Infirmary, 1945–97: a microcosm of the National Health Service," ''Bulletin of the John Rylands University Library of Manchester,'' 2005, Vol. 87 Issue 1, pp 167–192 * Watkin, B. ''The National Health Service: The First Phase 1948–1974 and After'' (George Allen & Unwin, 1978). * Webster, C. 'Conflict and Consensus: Explaining the British Health Service', ''Twentieth Century British History'', (1990) 1#2 pp. 115–51 * Webster, Charles. '' The National Health Service: A Political History'' (Oxford UP, 1998
online


External links


Interactive timeline of the history of the NHS
by the Nuffield Trust

* ttp://www.60yearsofnhsscotland.co.uk/ Celebrating 60 years of the NHS in Scotland
Chronology of NHS reform

The "Matchbox on a Muffin": The Design of Hospitals in the Early NHS (pdf)

Celebrating 60 years of the NHS
National Health Service (England)
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
National Health Service (England) The National Health Service (NHS) is the Publicly funded health care, publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare s ...
National Health Service (England) The National Health Service (NHS) is the Publicly funded health care, publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare s ...
National Health Service (England) The National Health Service (NHS) is the Publicly funded health care, publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare s ...