The History of NHS Charges

Transformational Moments in Social Welfare

“…As defence spending was cut back, overall public expenditure fell by over 20 per cent in Labour's first five years in office to 1950, while spending on social services increased only moderately from approximately 10 per cent of GDP to 14 per cent (Tomlinson, 1995: 209). Financial constraints led Labour to introduce the new family allowances at a lower rate than desired and even to consider charges for prescriptions and some NHS treatments (Eversley, 2001;Glennerster, 2007). Expenditure on education, for example, did not exceed pre-war levels until 1950 (Thane, 2018: 195).…”

Middle-class medicine

“…Despite the principle of medical services free at the point of use, patient payment has always had some role within the NHS. 97 Indeed, those limited 'pay beds' present in the pre-NHS hospitals as the only means of securing treatment for middle-class patients were continued and became a means for those with cash to opt out of the public health service. Although private practice was entrenched and even encouraged within the NHS, it remained contentious, leading to private surgery fees being capped in 1953 at seventy-five guineas, although allowed to rise to 125 guineas in exceptional circumstances.…”

Obtenir un meilleur rapport qualité-prix dans les soins de santé

“…Lorsqu'on examine les implications économiques de la facturation aux usagers des soins de santé, il est important de garder à l'esprit les controverses politiques intenses qui y sont souvent associées. Eversley (2001) rapporte par exemple l'histoire navrante déclenchée en 1951 par l'imposition d'une prise en charge par les patients dans le système britannique de santé ; l'affaire a conduit le ministre de la Santé à démissionner et précipité la chute du gouvernement travailliste. Même lorsque des prises en charge ont été imposées, les exemptions se sont généralisées.…”