Is the NHS a business?

Abstract

If you go onto the NHS England website you will quickly come across, Putting Patients First: The NHS England Business Plan for 2013/14–2015/16. 1 Attend any hospital board meeting and the most popular buzzword is always ‘business.’ Trust board papers proliferate with ‘business plans’ for every conceivable hospital service. Even the newly-created boards of clinical commissioning groups (CCGs) constantly talk of the NHS as a ‘business’. The purpose of this article is twofold, first to refute the above claim and secondly, to argue that the NHS, despite ideological pressure, and legislation to the contrary, still remains a service. It is not a business in either the literal, or the popular sense of the word. The dictionary definition of a business is, ‘commercial activity, or a commercial organisation’. Commerce is described as, ‘the activity of buying or selling, especially on a large scale’ and commercial activity as, ‘making, or intending to make a profit’. This set of definitions hardly describes the NHS. The main purpose of the NHS is not to buy or sell. It certainly doesn’t seek to make a profit from its activities, that is not its intention Indeed, the NHS is none of the above, so it is not a business in the actual sense of the word. In 1948 when the NHS was established its founders had no problem with the title, it was to be what the name implied — a health service that would cover the nation. No one ever suggested calling it a business. A service is described as a, ‘department of royal or public employ or of work done to meet some general need.’ The army, navy, and air force are quoted as examples of services. The NHS is indeed very similar in certain respects to the armed forces, they are both paid …