Why the NHS needs to remain a National Health Service in the 21st Century

1.A Free Health Service
2.A Communal Responsibility
3.State Funding of the NHS
4.The NHS is not a Welfare State
5.Triumphant Collective Action
6.The Cautious Medical Profession
7.Pay Beds in the NHS
8.The Equipment of a Civilized Society

Pay Beds in the NHS

Another defect in the Service, which was seen from the beginning, is the existence of pay-beds in hospitals. The reason why this was tolerated at all, was because it was put to me by the representatives of the royal colleges that in the absence of pay-bed sections in the hospitals the specialists would resort in greater measure to nursing homes.

As the full range of medical facilities are available only in the hospitals as a general rule, the specialists should be there, on the spot, as much as possible.

The argument is sound, but there can be no doubt that the privilege has been abused. Pay beds are a profitable source of income to the specialists, and there is therefore a disposition to prefer patients who can afford them at the expense of others on the hospital waiting lists. The number of pay beds should be reduced until in course of time they are abolished, unless the abuse of them can be better controlled.

The number of "amenity beds" should be increased. These are beds for which the patient pays a small sum for privacy alone, all the other services being free.

These changes would mean a loss of revenue to the National Health Service, but they would cut out a commercial practice which undermines the principle of equality of treatment that is fundamental to the whole conception of the scheme.

(Excerpts from Bevan, A. 1952. “A Free Health Service”. In “In Place of Fear”: 77-97)

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Page Updated: 27 May, 2017


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