NATIONAL HEALTH SERVICE

(NHS) in Great Britain, a comprehensive public-health service under government administration, established by the National Health Service Act of 1946 and subsequent legislation. Virtually the entire population is covered, and health services are free except for certain minor charges. The services provided are administered in three separate groups: general practitioner and dental services, hospital and specialist services, and local health authority services. General practitioners or family physicians give primary medical care to a group of persons who register with them. These doctors and dentists operate their own practices but are paid by the government on a per capita basis (i.e., according to the number of people registered with them). Their services are organized locally by an executive council. Physicians are free to contract in or out of the service and may have private patients while within the scheme. Hospital and specialist services are provided by professionals on government salaries working in government-owned hospitals and other facilities that are under the direction of regional authorities called hospital boards. Local health authority services provide maternity and child welfare, posthospital care, home nursing, immunization, ambulance service, and various other preventive and educational services. They may also operate family-planning clinics, as well as day nurseries for children. The National Health Service is financed primarily by general taxes, with smaller contributions coming from local taxes, payroll contributions, and patient fees. The service has managed to provide generally high levels of health care while keeping costs relatively low, but the system has come under increasing financial strain because the growth of medical technology has tended to make hospital stays progressively more expensive.