Abstract

Britain's National Health Service (NHS), as constituted in 1948, had two defining characteristics. First, it was a universal system, funded predominantly by taxation, that made health care available to the whole population and removed financial barriers to access. Second, it was essentially a paternalistic system designed to meet the needs of patients as defined by the professionals delivering the services rather than to respond to the demands articulated by patients. These have continued to be the defining characteristics of the NHS over the decades. Now, however, the government is proposing a transformation of the system. The financial and organizational framework . . .

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