The National Health Service (NHS) was founded in 1948 and has become the world’s largest publicly funded health service. The founding principle – to provide free health care to the whole population, based on need and not ability to pay – has not changed to this day. Residents in the United Kingdom benefit from free services ranging from GP visits to elective surgery. For a few services such as dental care or prescription drugs, fees are still required (apart from those aged under 16 or over 60 years). Running such a large service involves a lot of costs and in 2021
amounted to 213.3 billion British pounds. Nearly two-thirds of this were spent on
NHS funding
The NHS is mainly funded by general taxation, supplemented in a small part by National Insurance (NI) contributions and patient charges. Individual NHS trusts can generate additional income, such as through parking fees and treating private patients. After years of austerity, there have been many changes to NHS funding in recent years. First off, the 2018 Budget announced an
extra 20.5 billion GBP for NHS England for the next five years. However, no one could have predicted the COVID-19 pandemic that hit in 2020 nor its impact on the health care system. Additional
COVID-19 budget was put into action. Finally, the most recent addition, a permanent tax increase instead of one-off funds. On September 8, 2021, a 1.25% health and social care levy was announced to take effect from April 2023, while a temporary increase to the NI of the same percentage will be introduced in the financial year 2022/23. The health and social care levy is expected to bring about a total extra spending of 12 billion British pounds a year to be spent on health and social care services across the UK with a large majority going to the NHS. One of the main short-term goals is to reduce the backlog in NHS treatments (particularly elective procedures) that have been exacerbated by COVID-19.
NHS England spending will reach over 186 billion British pounds (in 2023/24 prices) by 2024/25.
Public opinions
The public has been fed up with a lack of staff and long waiting times, with both voted as the
biggest problems facing the health care system in England in 2023. Therefore, it is not surprising that more funding for NHS is needed. Historically, the majority of
Britons have been in favor of increasing taxes to maintain NHS services. However, after the announcement in September 2021, only a third were
supportive of the NI increase. While reasons for the respondents’ answers were not asked, their views on
how the tax raise will impact the NHS were also unfavorable, with nearly half believing that it is unlikely the NHS will improve as a result of this policy. Furthermore, opponents of the levy have voiced various criticisms, such as how it breaks the government’s manifesto of not increasing taxes and how it disproportionally affects the young and working rather than wealthy pensioners.
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