The British National Health Service: Professional Determinants of Administrative Structure

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Abstract
It is contended that divisions within the medical profession and conflict between the various branches of the profession and the government have had a stronger influence on modifying the pattern of medical care in Great Britain today than the adoption and extension of the principle of social insurance. A fully integrated and free system of medical care was envisaged but the strength and power of two branches of the profession forced the government to accept certain modifications. Primary and secondary medical care and public health activities were all organized separately at the operational level, giving rise to a “tripartite” structure, and a limited amount of private practice persists.

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