THE REFORM OF THE NATIONAL HEALTH SERVICE

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Abstract
After a long period of growth and relative organizational stability, the last 10 years have been a period of reappraisal. One driving force has been the desire of governments simply to contain health care costs. Another has been the search to find ways of obtaining better value for money. Thus, the reforms of the British National Health Service should be seen in an international context. Britain is by no means alone in introducing changes which would have been thought inconceivable only 10 years ago. Sweden has, of course, also been introducing changes. And it may be that there will be more to follow. The changes in Britain should be seen as a process, starting essentially from 1984. The Thatcher White Paper in 1989 was the culmination of it. Essentially the changes consist of an attempt to bring private business methods into the running of the health services while still retaining the essential principles of medical services being largely free at the point of use and intended to offer equal access to all citizens. It has been, in part, a change of control from bodies representing different interests to control by bodies established on similar lines to the Board of Directors of a public company and acting as such.

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