GENERAL HEALTH SERVICES IN GREAT BRITAIN
I. In Great Britain the authorities concerned in the administration of public health are central and local. In England and Wales the chief central authority is the Ministry of Health.
The National Health Service was established in 1948. The Minister of Health has assumed direct responsibility for the provision on a national basis of all hospital and specialist services, the conduct of research work into any matters relating to the prevention, diagnosis or treatment of illness or mental defect,a public health laboratory service and a blood transfusion service.He has indirect responsibility for the establishment and maintenance of general practitioner services and all other services.
The local authorities charged with the administration of public health services are the Rural and Urban District councils. These bodies are assisted in the discharge of their duties by a technical staff consisting of the Medical Officer and the Chief Sanitary Inspector.
Among others, upon the Local Health Authority rests an obligation to make arrangements withthe medical practitioners for the vaccination of those who live within its area against smallpoxand also for immunization against diphtheria.
II. At the very core of the schemeremains the family doctor. The duty generally falls on him to advise on the need for the various forms of treatment. Each Local Executive Council prepares and publishes a list, which is kept up to a day, of doctors providing general medical services in the area.
In theory everyone is permitted to choose his own general practitioner. A full choice is not always possible, because if the doctor's list has reached the permitted maximum (3.500 patients) he cannot accept the would-be patient. If a doctor has an assistant, he is allowed to add an additional 2.000 patients to his list.
The family doctor service is free to everyone who chooses to make use of it. If someone decides not to use the service, he may choose to be a paying and private patient. In this case, the provision of drugs under the service cannot be claimed. The patient must pay for any drugs prescribed fora private patient.
It is a doctor's responsibility to provide his own accommodationin the area of his practice. This must include proper and sufficient surgery and waiting roomsfor his patients.
III. Where the family doctor considers that his patient requires the services of a consultant or needs hospital treatment the doctor is empowered toarrange this on his own initiative.
Hospital services are available to everyone and no insurance qualification is required but most hospitals have long waiting lists for in-patient treatment.At the same time, some have closed wards owing to lack of staff.
In many parts of the country there is an urgent needfor new hospital buildings to replace the present often-antiquated ones. The provision of ambulancesand other means of transport is another duty of every Local Health Authority. But as the Ambulance Service and the Hospital Service are not under the same authority there is room for possible friction and misunderstanding between them. Delay and frustration to patientssometimes result.
IV. An expectant mother is entitled tothe services of a doctor who undertakes maternity work (whether he is her doctor or not) and of a midwife, as well as general care before and after of the confinement.
The doctor will advise whether there is need for the confinement to take place in hospital. If this is unnecessary on medical grounds, the expectant mother can make her own choice as to whether or not she has her baby at home.
However, hospital accommodation for other than priority cases is in short supply.
V. The National Health Service Act, 1946, makes provision for health centres at which facilities shall be available for the provision of general medical, dental and pharmaceutical services as well as specialist and any other services, which a Local Health Authority is empowered to provide.
As yet, however only a very few such health centres are in existence, on the official plea that scarcity of resourcesprevents the building of new centres.
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