Health Charges in Britain: a necessary evil or a spent force?
| Author | Allan Bruce |
| Published date | 01 March 2000 |
| Date | 01 March 2000 |
| DOI | http://doi.org/10.1177/014473940002000105 |
Teaching Public Administration, Spring 2000, Vol.
XX,
No.1, pp.39-53
HEALTH
CHARGES
IN
BRITAIN:
A
NECESSARY
EVIL
OR
A
SPENT
FORCE?l
Allan Bruce
Glasgow Caledonian University
Introduction
Since their introduction into the National Health Service (NHS) in the early
1950s, health charges have been a consistent source
of
controversy. Imposed
upon an NHS that the post-war Labour government believed could deliver
services free at the point
of
consumption, charges have provoked debates that
have tended to centre around their scope and level rather than the question
of
whether to charge at all. Indeed, with the exception
of
a brief period in the
mid 1960s when prescription charges were abolished by the Labour
government, charges have been an inveterate feature
of
NHS finance. This
analysis, whilst not advocating that charges should be abolished, questions the
extent
to
which the imposition
of
charges can continue to represent an
uncritical means
of
raising revenue and
of
influencing demand.
An analysis
of
recent statistical evidence indicates that, since 1990,
governments have placed less emphasis upon charges than was the case
during the Thatcher governments
of
the 1980s and, since the election
of
Labour in 1997, this moderating trend has,
if
anything, become more evident.
However, in spite,
of
the bullish approach to health charges that characterised
the 1980s, the often substantial increases in the level
of
charges were never
accompanied by a comensurate growth in revenue. The widespread use
of
exemptions from health charges -prescription charges in particular -has
resulted in a large proportion
of
the health care population being sheltered
from the influence
of
charges.
To begin with, this analysis is developed within the context
of
a chronology
of
health charges. This approach seeks to contextualise the various debates
surrounding the imposition
of
health charges.
In
the process, it seeks to
identify the key components
of
health charges. The analysis then moves on to
1
An
earlier version of this paper
was
presented at the
fourth
International Conference
on
Strategic
Issues
in
Health Care Management, University of St Andrews,
30
March - 1 April
2000.
39
Get this document and AI-powered insights with a free trial of vLex and Vincent AI
Get Started for FreeStart Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
