Introduction

Over the half century of its existence, the NHS has found itself subject to the effects of different ideological forces and political agendas. On the threshold of the twenty-first century its commitment to ideals of social justice is being scrutinised and its principle of ‘universalism’ redefined. As welfare restructuring continues, the NHS now operates in an arena in which the relationships between various service providers is changing. A ‘mixed economy’ of welfare is now well established and the incorporation of the independent sector into the new ‘welfare regime’ that is emerging to replace the ‘welfare state’ continues to develop. Perhaps the most significant challenge facing the NHS in 2001 is the same as it faced in 1948, namely the existence of major inequalities in health within the British population. In this section of the reader the focus is on this major area of enquiry and debate in the sociology and politics of health.