Choices for Health Care

Abstract

From the standpoint of social security, a health service providing full preventive and curative treatment of every kind to every citizen without exceptions, without remuneration limit and without an economic barrier at any point to delay recourse to it, is the ideal plan…. The primary interest of the Ministry of Social Security is not in the details of the national health service or in its financial arrangements. It is in finding a health service which will diminish disease by prevention and cure[1].

Before the National Health Service was created, choices for health care were clearly recognised by the public, most of whom had to judge for themselves the occasions on which they could afford to seek medical care — as well as those on which they could not ‘afford’ to do without. When the health service was established, the need for choices did not disappear but it did become obscured by a number of factors. The philosophy expressed at that time was that the health service should and would provide the best possible medical care for everyone. The stock of ill health would gradually be eroded by the quality and comprehensiveness of the services so that, ultimately, the health of the population would increase, the demands made on the service would diminish and the proportion of the gross national product devoted to health care would fall[26].