Medicine Interview Hot Topics: The NHS (History, Structure & Role)
The NHS was created, officially, on the 5th July 1948. Aneurin Bevan, the health minister responsible for its creation, visited Park Hospital in Manchester. Park Hospital is now Trafford General, and known as the birthplace of the NHS. Bevan met the first NHS patient, a 13 year old with acute nephritis.
The creation of the NHS had huge support amongst members of the public, although it was (perhaps somewhat ironically) threatened by a potential boycott from members of the BMA - the British Medical Association. By the NHS launch day, 94% of the British public had enrolled with the NHS, and it took control of 2751 of Britain’s 3000 hospitals. Bevan’s goals for the NHS were lofty, and he made it clear that his vision of the NHS would see it provide the best care to all - not just be a last resort for those who couldn’t afford care elsewhere.
The March toward our Modern NHS
The NHS would be at the forefront of many advances over the next 30 to 40 years, including ‘test tube babies,’ the discovery of DNA, the use of CT scans, and the introduction of screening for breast cancer. In 1991, with Thatcher in power, the NHS had its first huge overhaul, with the introduction of the internal market. Health authorities would now buy care from hospitals in their area. The providers of care would become the first NHS Trusts. In 1997, Blair came into power on a manifesto that claimed voters had ‘24 hours to save the NHS’ from the Conservatives. In 2003, Blair’s government would bring in a target that all NHS A&E patients must be treated, and discharged or admitted, within four hours. That goal remains, albeit slightly tempered down to 95%.
Changing face of the NHS
In 2011, the health and social care bill was published by the Coalition Government’s health secretary. Some feared that it would mean the end of the NHS as we had become accustomed to it, with David Nicholson, the service’s chief executive saying that the change was so big, one could ‘probably see it from space.’ Many doctors denounced the proposal. The plan was to abolish primary care trusts, and to create CCGs - Clinical Commissioning Groups. These would be doctor led, with consultants and GPs both in charge, with nurses also in the leadership frame. It became law in 2012, and its effects began in 2013. Further changes were made in 2013, in light of a public inquiry into events at Mid Staffordshire NHS Foundation Trust, where poor care was found to be largely a result of staff shortages. Changes were made by the then health secretary, Jeremy Hunt, with the goal of reducing mortality and making the NHS the safest healthcare system in the world. In 2015 the Conservatives introduced the idea of a 7 day NHS, that was in place by 2020. It means that one should be able to visit the GP on any day of the week, as well as in the evenings, and that the same quality of hospital care should be available on the weekend as during the week.
The NHS’s role and structure
The role of the NHS can perhaps be best understood by studying its seven core values. These are: working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. From this we can deduce that the NHS is a public body that works for its patients, respects its patients, and is dedicated to improving their lives. It treats all patients, and aims to provide the same high standard of treatment for anyone, irrespective of who they are. To find out more about the structure of the NHS, read our separate guide entitled NHS Structure.
Potential questions which may be asked in your interview
- When was the NHS founded?
- Who founded the NHS?
- Why was the NHS created?
- How has the NHS changed since its inception?
- How has the NHS changed since 1990?
- What do clinical commissioning groups do?
- Do you think that the NHS is a force for good in the UK, or is too much emphasis put on a name and a perhaps outdated organisational system?
- Would moving to a government insurance model, such as Germany’s or Canada’s, be a sensible decision for the UK?
How to answer questions on the NHS
Make sure you have a good knowledge of the history of the NHS, especially some of the recent changes that have been made to the way care is paid for and provided. Try to remain neutral when answering questions about the NHS, and give balanced answers that show the breadth of your understanding rather than a particular opinion.