Healthcare in the United Kingdom

Healthcare in the United Kingdom is a devolved matter and England, Northern Ireland, Scotland and Wales each has its own system of publicly-funded health care together with private healthcare and a wide variety of alternative and complementary treatments. Public healthcare is provided to all UK permanent residents and is free at the point of need being paid for from general taxation. Taken together, the World Health Organisation, in 2000, ranked the provision of healthcare in the United Kingdom as fifteenth best in Europe and eighteenth in the world.

The responsibility of healthcare in the United Kingdom lies with four executives; healthcare in England is the responsibility of Her Majesty's Government; healthcare in Northern Ireland is the responsibilty of the Northern Ireland Executive; healthcare in Scotland is the responsibilty of the Scottish Government; and healthcare in Wales is the responsibilty of the Welsh Assembly Government. Each asserts governmental influence upon a National Health Service; due to each of these health systems having different policies and priorities, a variety of differences exist between the systems.

Common features in the public health systems in the UK

General practitioners and hospitals

Each NHS system uses General Practitioners (GPs) to provide primary healthcare for patients and to make referrals to further services as necessary. GP Practices often operate from Health Centres which typically provide care that is considered more routine and less invasive than the type of surgeries and procedures that take place in the hospital, including ophthalmology, dentistry, wound dressings and re-dressing, infant check-ups and vaccinations. Hospitals provide more specialist services including diagnostic and surgical and specialist mental hospitals exist to care for patients with psychiatric illnesses. Access to hospital services is usually via referral from a general practitioner though access to Accident and Emergency (A&E) departments is an obvious exception.

Advice services

Each NHS system runs 24 hour confidential advisory services: NHS Direct provides a telephone-based service for England, NHS Direct Wales/Galw Iechyd Cymru provides a similar service in Wales while Scotland has NHS24.

Ambulance services

Each public healthcare system provides free ambulance services for emergencies, when patients need the specialist transport only available from ambulance crews or when patienets are not fit to be travel home by public transport. These services are generally supplemented when necessary by the voluntary ambulance services (British Red Cross, St John Ambulance and the St Andrews Ambulance Association). In addition, patient transport services by air are provided by the Scottish Ambulance Service and by county or regional air ambulance trusts (sometimes operated jointly with local police helicopter services) throughout England and Wales. In specific emergencies, emergency air transport is also provided by naval, military and air force aircraft of whatever type might be appropriate or available on each occasion. On more than one occasion this has led to new-born babies needing special care being flown long distances in Hercules transport aircraft or similar.

Cost recovery in exceptional circumstances

Being paid for from general taxation, the public health services do not bill for services rendered. Each NHS system, however, reserves the right to claim compensation for treatment required as a result of the negligence of others such as from insurance companies through the Injury Costs Recovery Scheme following the determination of fault in motor accidents.

Dentistry

Each NHS system provides dental services through private dental practises and dentists can only charge NHS patients at set rates (though the rates vary between countries). Patients opting to be treated privately do not receive any NHS funding for the treatment. About half of the income of dentists in England comes from work sub-contracted from the NHS, however not all dentists choose to do NHS work.

Pharmacies

Each NHS system uses pharmacies to supply prescription drugs. Pharmacies (other than those within hospitals) are privately owned but have contracts with the relevant health service.