Granny's footsteps, fractures and the principles of the NHS

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Abstract
In spite of the great amount of work on the health reforms since 1979, the question of whether they break the principles of the National Health Service has tended to be neglected. This paper examines the conceptual problems involved in specifying the principles of the NHS, and the em pirical problems associated with detecting breaks in these principles. First, the principles of the NHS are explored. Second, the period between 1948 and 1979 is reviewed to see if any principles were compromised before the term of office of the current government and, third, the period since 1979 is examined to see how the principles have fared. It concludes that the principles of the service have come under greater strain since 1979, and fractures have become more obvious.