chapter  1
12 Pages

Mixed modes of finance

It is impossible to understand why health care is financed the way it is in the United Kingdom without looking briefly at its historical origins. By the early part of last century two kinds of hospital had emerged that set the pattern for finance and provision for the next 150 years. The voluntary hospitals were private charities. The finance of primary care has had a very different history. Medical practitioners began as individual private entrepreneurs selling their skills and medical knowledge, such as it was. But it was never a free market. Total spending on the National Health Service represented about 4 per cent of the gross domestic product in 1948, and rose to 6.5 per cent by 1995. The Road Traffic Act of 1933 obliges motorists or their insurance company to make some contribution to the expenses of treating the victims of an accident if the driver is liable.