{"title":"Dismantling the National Health Service in England.","authors":"Peter Roderick, Allyson M Pollock","doi":"10.1177/00207314221114540","DOIUrl":null,"url":null,"abstract":"<p><p>The National Health Service was established in the United Kingdom in 1948 as a universal, comprehensive service free at the point of delivery, which is publicly provided, funded, and accountable. Market incrementalism in England has eroded this system over three decades. The recently enacted Health and Care Act will erode it further. This article first explains briefly how legislation and policy initiatives in 1990, 2003, and 2012 furthered development of the market and private provision of health services, and then describes the main structural changes in the new Act and their implications. England is now moving decisively toward a marketized, two-tier, mixed-funding system with several similarities to the United States.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/e4/10.1177_00207314221114540.PMC9449439.pdf","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Health Services","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00207314221114540","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 3
Abstract
The National Health Service was established in the United Kingdom in 1948 as a universal, comprehensive service free at the point of delivery, which is publicly provided, funded, and accountable. Market incrementalism in England has eroded this system over three decades. The recently enacted Health and Care Act will erode it further. This article first explains briefly how legislation and policy initiatives in 1990, 2003, and 2012 furthered development of the market and private provision of health services, and then describes the main structural changes in the new Act and their implications. England is now moving decisively toward a marketized, two-tier, mixed-funding system with several similarities to the United States.
联合王国于1948年建立了国家卫生服务体系，作为一项普及的综合服务，在提供服务时免费，由政府提供、资助和负责。30年来，英国的市场渐进主义侵蚀了这一体系。最近颁布的《医疗保健法案》(Health and Care Act)将进一步削弱它。本文首先简要解释了1990年、2003年和2012年的立法和政策举措如何进一步发展了市场和私人提供的保健服务，然后描述了新法案的主要结构变化及其影响。英国现在正果断地朝着市场化、双层、混合的资助体系迈进，这与美国有几个相似之处。
期刊介绍：
The International Journal of Health Services is a peer-reviewed journal that contains articles on health and social policy, political economy and sociology, history and philosophy, ethics and law in the areas of health and well-being. This journal is a member of the Committee on Publication Ethics (COPE).
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