The English National Health Service is unique in a lot of ways compared to the rest of the world in terms of its scale, the principle of treatments being free at the point of service and the mission to ensure that people are not afraid to get the medications and procedures they need for a healthy life.
One particularly unusual aspect of the NHS in England compared to the rest of the United Kingdom and indeed the rest of the world is that whilst prescription medicines are free in Wales (as of 2007), Northern Ireland (as of 2010) and Scotland (As of 2011) and can cost variable amounts in other countries, prescriptions in the UK have a fixed price.
This price, currently set at £9.90 per item for NHS prescriptions, does have a lot of exceptions for children, teenagers in full-time education, people with some means-tested benefits, people over 60, pregnant women, and people with some long-term conditions such as cancer, diabetes and long-term chemotherapy.
It is an unusual charge to set and was established for somewhat unusual reasons.
Breaking Nye Bevan’s Vision
The NHS was founded in 1948 by then-Minister of Health Aneurin “Nye” Bevan, who had been inspired by the Medical Aid Society in his hometown of Tredegar, a location that also inspired A.J. Cronin to write The Citadel, a novel that also proved influential in the founding of the NHS.
The vision was to expand the subscription-based medical provision of the Aid Society to span the entire country, ensuring everyone could access free health care at the point of service, paid for through taxation.
This is, with some exceptions, how it works today. However, Mr Bevan’s intention was for the NHS to provide all aspects of healthcare for free, including medication, and prescriptions are indeed free in Wales, Scotland and Northern Ireland through campaigns that channelled the name of Nye Bevan.
In England, this is not the case, and the reason for this has nothing to do with affordability or cost, but instead through the exact opposite of healthcare.
The NHS initially struggled in the aftermath of the Second World War, and as early as 1949, it was under such strain that then-Prime Minister Clement Attlee asked the nation via radio to only go when they needed to. Mr Beven argued that the initial cost was due to a lack of investment in the decades before the Second World War.
However, the NHS (Amendment Act) 1949 allowed for the implementation of a charge for prescriptions to help fill the financial hole the NHS had in that initial year, but Mr Bevan threatened to quit his post if it was ever put into force.
His resistance lasted for two years until the escalation of the Korean War from an effective civil war caused by the nation’s partition after the Second World War into a conflict involving several world powers led to the United Kingdom getting involved in another military conflict.
Hugh Gaitskell, the Chancellor of the Exchequer and Herbert Morrison, the Foreign Secretary, both agreed to fund the war by charging for dentures and glasses, forcing Mr Bevan’s resignation. After a general election the same year, Winston Churchill’s government introduced charges to medications as well.