What is the NHS and how did it all begin?
The NHS - or National Health Service - is a publicly funded healthcare system which provides medical care for free to residents of the United Kingdom. It is often referred to as being "free at the point of use" which means the care is provided based on what the patient needs, rather than how able they are to pay for it.
It offers a huge range of services and it is very likely that you or someone you know has used the NHS many times.
But how free is it? How much is it costing the taxpayer? And what threats does it face? Find out the answers below.
1. When did it all begin?
The NHS was launched on 5 July 1948.
It meant that Britain became the first country to offer free medical care to the whole population.
The idea was inspired by Wales’ Tredegar Medical Aid Society, which, at the time, offered free health and dental care to its members for a penny a week. MP Aneurin Bevan was aware of the scheme as he had been born in Tredegar and came up with the idea of the NHS as a result.
The first patient was 13-year-old Sylvia Diggory, who was treated at Trafford General Hospital.
2. What challenges did the NHS face?
The NHS faced some challenges after it was launched.
- In its first year, the NHS cost £248 million to run, nearly £140 million more than the original estimate.
- A sum of £2 million had been set aside to pay for free glasses over the first nine months of the NHS, but the amount was spent in a matter of weeks.
- The government estimated that the NHS would cost £140 million a year to run by 1950, but by the beginning of 1949 the cost reached around £400 million.
- In 1951, the Labour government introduced a fee for some dental treatment and prescriptions and Aneurin Bevan resigned because of this.
The NHS is still facing budget difficulties among other challenges today.
- Lack of money means that there are now waiting lists for many operations. Some people have been refused costly services and medicines.
- As life expectancy has increased so has the ageing population which has led to an increase in demand for services from the NHS.
3. How many people work for the NHS?
More people work for the NHS than any other organisation in the country with 1.3m people counting the health service as their employer.
That works out at about one in every 40 people – so it’s very likely you know at least one person who works for the NHS, though they may not be in a clinical or patient-facing role.
Examples of NHS job roles might include:
- Doctors
- Nurses
- Paramedics
- Secretary
- Receptionist
- Support worker
- Clerk
4. How much does the NHS cost?
A LOT of money is spent on healthcare in the UK. In 2023/2024, the Department for Health and Social Care spent a whopping £188.5 billion! Some of this money comes from people around the country paying An amount of money that must be paid to the government by individual citizens and companies. This pays for public services, such as education and healthcare.. The money is spent on things like your local GP services, ambulances, mental health, community and hospital services.
The cost to the NHS for treatment we might receive varies, dependent on the level of medical care we need.
For example, someone attending an urgent care centre and receiving the lowest level of investigation and treatment costs £114 on average. But if you are taken to hospital in an ambulance, this alone – before any investigation or treatment – costs £459.
And if you are having an operation, say if you fractured your hip, this will cost the NHS anywhere between £2,354 to £7,648.
5. What is my NHS number?
Your NHS number is a 10-digit number that is completely unique to you. It's used to help healthcare staff identify you and match your details to your health record.
You should have an NHS number if you are registered for NHS care in England, Wales or the Isle of Man, but you don't actually need it to access healthcare services. It also does not mean you are automatically entitled to all NHS services free of charge. Usually in England you have to pay towards some NHS services (like dental appointments or prescriptions).
In Scotland, the NHS number is known as the Community Health Index (CHI) but like in England and Wales, it is a 10-digit number and it operates in a very similar way.
In Northern Ireland, it is called a Health and Care number (H&C number).
If you're not sure of your number, you can check documents that have been sent to you by the NHS, or call your GP surgery and ask them to give it to you. Alternatively, you can head to the NHS website where you would need to enter some details to find out.
Find out more about the NHS
Find out more about healthcare and the NHS in the UK with these resources from BBC Bitesize.
