Abstract
This paper examines some of the key characteristics of a socialist health care system using the example of the British National Health Service (NHS). It has been claimed that the NHS has socialist principles, and represents an island of socialism in a capitalist sea. However, using historical analysis, this paper argues that while the NHS claims some socialist ends, they could never be fully achieved because of the lack of socialist means. The socialist mechanisms which were associated with earlier plans for a national health service such as a salaried service, health centres, elected health authorities and divorcing private practice from the public service were discarded in negotiation. Moreover, even these would have achieved socialism merely in the sense of distributing health care, without any deeper transformation associated with doctor-patient relationships and prevention. In short, the NHS is more correctly seen as nationalised rather than socialised medicine, achieving the first three levels of a socialist health service identified here. It can be said to have socialist principles in the limited distributional sense and has some socialist means to achieve these. However, it lacks the stronger means to fully achieve its distributional goals, and is very distant from the third level of a radical transformation of health care.
Similar content being viewed by others
References
Deacon, B. (1983).Socialism and Social Policy, Pluto, London.
Allsop, J. (1990). Does socialism necessarily mean the public provision of health care? In,Socialism and the NHS, ed. by J. Carrier and I. Kendall, Avebury, Aldershot.
Player, D. and Barbour-Might, D. (1988).Health For All. The Practical Socialism of the National Health Service, Tribune, London.
Thunhurst, C. (1982).It Makes You Sick. The Politics of the NHS, Pluto Press, London.
Carpenter, M. (1980). Left orthodoxy and the politics of health.Capital and Class 11, 73–98.
Murray, D. Stark (1971).Why a National Health Service? Pemberton Books, London.
Powell, M. (1997)Evaluating the NHS, Open University Press, Buckingham.
Foot, M. (1973).Aneurin Bevan 1945–1960, Paladin, St Albans.
Mishra, R. (1981).Society and Social Policy, 2nd edn, Macmillan, London.
George, V. and Manning, N. (1980).Socialism, Social Welfare and the Soviet Union, Routledge & Kegan Paul, London.
Labour Party. (1943).A National Service for Health, Labour Party, London.
George, V. and Wilding, P. (1985).Ideology and Social Welfare, Routledge and Kegan Paul, London.
Doyal, L. (1979).The Political Economy of Health, Pluto, London.
Mitchell, J. (1984).What Is To Be Done About Illness and Health? Penguin, Harmondsworth.
Iliffe, S. (1988).Strong Medicine. Health Politics for the Twenty-first Century, Lawrence and Wishart, London.
Socialist Health Association (1996).The Campaign for a Socialist Health Service, SHA, London.
Griffith, B., Iliffe, S. and Rayner, G. (1987).Banking on Sickness. Commercial Medicine in Britain and the USA, Lawrence and Wishart, London.
Bevan, A. (1978) [first pub. 1952])In Place of Fear, Quartet Books, London.
Webster, C. (ed.) (1991).Aneurin Bevan on the National Health Service, Wellcome Unit for the History of Medicine, Oxford.
Shaw, G. B. (1946 [first pub. 1911]).The Doctor’s Dilemma, Penguin, Harmondsworth.
Navarro, V. (1978).Class Struggle, the State and Medicine, Martin Robertson, London.
Campbell, J. (1987).Nye Bevan and the Mirage of British Socialism, Weidenfeld and Nicolson, London.
Brooke, S. (1992).Labour’s War, Clarendon Press, Oxford.
Webster, C. (1988). Labour and the origins of the National Health Service. In,Science, Politics and the Public Good, ed. by N. Rupke, Macmillan, Basingstoke.
Earwicker, R. (1982).The Labour Movement and the Creation of the National Health Service 1906–1948, University of Birmingham, Unpublished PhD thesis.
Honigsbaum, F. (1979).The Division in British Medicine, St. Martin’s Press, New York.
Cooper, M. (1975).Rationing Health Care, Croom Helm, London.
Culyer, A. J. (1976).Need and the National Health Service, Martin Robertson, London.
Townsend, P. and Davidson, N. (1982).Inequalities in Health, Penguin, Harmondsworth.
Tudor-Hart, J. (1994).Feasible Socialism. The National Health Service: Past, Present and Future, Socialist Health Association, London.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Powell, M. Socialism and the British National Health Service. Health Care Anal 5, 187–194 (1997). https://doi.org/10.1007/BF02678377
Issue Date:
DOI: https://doi.org/10.1007/BF02678377