An Analysis Of The1991Reforms Of Britian’s National Health Service

The19thcentury was an important era for Britain’s Welfare system. In1948Britainestablished itself as the first welfare state in the world, which has been the "greatestachievement of the Labor Government". It is of great significance to learn lessons from theNHS reforms of western welfare states. This thesis provides an analysis of Britain’s1991NHS reforms in respects of causes and effects.In the first chapter, this article first looks back upon the establishment of Britain’sNational Health Service, exploring the historical background of Beveridge Report andWelfare State. It gives a general introduction on the ’big bang’ reforms by the ConservativeParty in1990s. Based upon the1944White Paper of then Coalition Government and theNational Health Service Act of May1946, the government launched a highly centralizedNational Health Service managed and financed by the State.The second chapter narrates the health policies initiated by the Thatcheradministration. During the decades after the NHS was successfully established, thegovernment took the most responsibility and became the provider of health care service.Increasingly, the fatal flaws of the NHS turned obvious: rising expenditure of health care;confusing and low-efficiency management; the falling down of people’s satisfaction. AfterThatcher’s accession in1979, the Conservative Government started series of health carereforms, guided by the principles of neo-liberalism. Eventually, the internal marketmechanism was introduced into Britain’s National Health Service.The third chapter offers an objective assessment of the1991internal market reform inrespects of quality of care, patients’ choice and providers’ responsiveness for patients,employing plenty of official statistics and indirect research articles. In the1989government White Paper Working for Patients, the Conservative Party put forwardaggressive reform proposals upon the NHS. The NHS and Community Care Act of1990introduced NHS trusts and GP fundholding, which were designed to improve efficiencywith the separation of purchaser and provider. These policy measures had long-standingimpact on the future development of health care system. Although the Labor Party whichtook office in1997advocated "the third way" in welfare arena, it had some similarity to Thatcherite reforms. In the end the author provides an analysis of central effects andconcerns of the1991reforms. Although the1991reforms greatly dismantled thedecades-long development model of the NHS, the expected outcome was still far fromreach. However, the analysis of Britain’s1991NHS reforms not only provide a betterunderstanding of Britain’s health care system, but also inspires us of China’s ongoinghealth care reform.