ABSTRACT
The creators of the National Health Service (NHS) made what has turned out to be a number of remarkably resilient decisions. The NHS was to be comprehensive, so that it covers all the people of the UK, it was to be free, and it would be funded in the main from general taxation. The NHS is a complex organization that delivers a heterogeneous mix of outcomes. This immediately makes any measurement of the input/output relationship a complex task. Despite the attempts by health economists, and others, to convert all of these outputs into a single ‘currency’, this complexity remains. The chapter discusses the intellectual and conceptual resources for a public health critique of the NHS. Perhaps the most interesting finding regarding the post-reform NHS is the way that explicit regulation became a central part of the way services were provided.
