About the NHS

Since its launch in 1948, the NHS has grown to become the world’s largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive.
The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth. That principle remains at its core. With the exception of charges for some prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK. That is currently more than 60m people. It covers everything from antenatal screening and routine treatments for coughs and colds to open heart surgery, accident and emergency treatment and end-of-life care.
Although funded centrally from national taxation, NHS services in England, Northern Ireland, Scotland and Wales are managed separately. While some differences have emerged between these systems in recent years, they remain similar in most respects and continue to be talked about as belonging to a single, unified system.

Scale

The NHS employs more than 1.7m people. Of those, just under half are clinically qualified, including 120,000 hospital doctors, 40,000 general practitioners (GPs), 400,000 nurses and 25,000 ambulance staff.
Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people.
The NHS in England is the biggest part of the system by far, catering to a population of 51m and employing more than 1.3m people. The NHS in Scotland, Wales and Northern Ireland employ 165,000, 90,000 and 67,000 people respectively.
The number of patients using the NHS is equally huge. On average, it deals with 1m patients every 36 hours. That’s 463 people a minute or almost eight a second. Each week, 700,000 people will visit an NHS dentist, while a further 3,000 will have a heart operation. Each GP in the nation’s 10,000-plus practices sees an average of 140 patients a week.

Funding 

 When the NHS was launched in 1948 it had a budget of £437million (roughly £9billion at today’s value). In 2008/9 it received over 10 times that amount (more than £100billion).

This equates to an average rise in spending over the full 60-year period of about 4% a year once inflation has been taken into account. However, in recent years investment levels have been double that to fund a major modernisation programme.
Some 60% of the NHS budget is used to pay staff. A further 20% pays for drugs and other supplies, with the remaining 20% split between buildings, equipment and training costs on the one hand and medical equipment, catering and cleaning on the other. Nearly 80% of the total budget is distributed by local trusts in line with the particular health priorities in their areas.
The money to pay for the NHS comes directly from taxation. According to independent bodies such as the King’s Fund, this remains the “cheapest and fairest” way of funding health care when compared with other systems. The 2008/9 budget roughly equates to a contribution of £1,980 for every man, woman and child in the UK.

Structure
The Department of Health controls the NHS. The secretary of state for health is the head of the Department of Health and reports to the prime minister. The Department of Health controls England’s 10 Strategic Health Authorities (SHAs), which oversee all NHS activities in England. In turn, each SHA supervises all the NHS trusts in its area. The devolved administrations of Scotland, Wales and Northern Ireland run their local NHS services separately. 

Performance
It is difficult to measure the efficiency of healthcare systems. The NHS, like other healthcare systems, has never consistently and systematically measured changes in its patients’ health. As a result, it’s impossible to say exactly how much the nation's health improves for each pound spent by the NHS.
In the UK life expectancy has been rising and infant mortality has been falling since the NHS was established. Both figures compare favourably with other nations. Surveys also show that patients are generally satisfied with the care they receive from the NHS. Importantly, people who have had recent direct experience of the NHS tend to report being more satisfied than people who have not.