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Author Archives: Ian Greener

2018 marks the seventieth anniversary of the founding of the NHS, but also the fiftieth anniversary of the 1968 Green Paper that marked the beginning of a series of attempts to reorganise the NHS that lasts up to today. What were these other reorganizations about, and did they work? A most basic organisational challenge the NHS continues to face is the split between NHS, GP and community health services (including social care). This was the result of a political compromise in the founding of the NHS. The big idea in 1968 was bringing NHS organisational boundaries in line with those […]
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Health systems financing Allocating financing to healthcare is fairest through general taxation (hence the UK’s strong scores in international comparisons on this criterion), but the risk is of healthcare being systemically underfunded (as it has been through most of the history of the NHS), or, especially in an era of political austerity, of need becoming detached from what is politically expedient to allocate. General taxation funding, however, appears the lesser of the evils available as this is likely to lead to a fairer healthcare service. Changes to the provision of services. The purchaser/provider split has been a massive source of […]
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