ABSTRACT
Mental health service delivery systems in the United Kingdom are, as with all medical services, embedded within the National Health Service. This means that both capital and revenue is obtained via a block grant through a centrally administered government system, the National Health Service. The funds themselves are raised from direct taxation of the population of the United Kingdom. As a result of recent reorganization of this service, we have a model where central planning shapes healthcare policy for the nation, but government passes the responsibility for detailed decision making down to local levels, where significant differences in population demographics (e.g., in cities, rural areas, industrialized vs. agricultural populations, elderly vs. children) need to be taken into account. The aim is to ensure an equitable distribution of finance to all areas of the country and to monitor the performance of health authorities charged with planning responsibilities. The government has certain health-of-the-nation targets that it expects to be incorporated into local healthcare planning. In practice, this public health model aims to help in the making of difficult local decisions by providing national data and policy advice on how to prioritize within a healthcare budget. As part of the previous government reorganizations, the local services were split into purchasing authorities, who have responsibilities for the organization, planning, and funding of healthcare for a given location, and providing organizations, who have specific responsibilities for healthcare delivery and for ensuring that, as much as current funds allow, services are “needs-led” rather than “demand-led.”
