national health service national health service the national health service (nhs) are the publicly funded healthcare systems of the united kingdom (uk). since 1948, they have been funded out of general taxation. there are three systems which are referred to using the "nhs" name (nhs england, nhs scotland and nhs wales). health and social care in northern ireland was created separately and is often locally referred to as "the nhs". the four systems were established in 1948 as part of major social reforms following the second world war. the founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. each service provides a comprehensive range of health services, free at the point of use for people ordinarily resident in the united kingdom apart from dental treatment and optical care. in england, nhs patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt. for the individual national healthcare services of england, scotland, wales and northern ireland, see national health service (england), nhs scotland, nhs wales, and health and social care (northern ireland). logos of thenational health servicelogo of the nhs in englandlogo of hsc in northern irelandlogo of nhs scotlandlogo of nhs wales taken together, the four national health services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion. in 2014, the total health sector workforce across the united kingdom was 2,165,043. this broke down into 1,789,586 in england, 198,368 in scotland, 110,292 in wales and 66,797 in northern ireland. in 2017, there were 691,000 nurses registered in the united kingdom, down 1,783 from the previous year. however, this is the first time nursing numbers have fallen since 2008. every 24 hours it sees one million patients, and with 1.7 million staff it is the fifth biggest employer in the world, as well as the largest non-military public organisation in the world. when purchasing drugs, the four healthcare services have significant market power that, based on their own assessment of the fair value of the drugs, influences the global price, typically keeping prices lower. a small number of products are procured jointly by two or more uk healthcare services. several other countries either copy the united kingdom’s model or directly rely on britain’s assessments for their own decisions on state-financed drug reimbursements. history further information: history of the national health service, history of the national health service (england), history of nhs scotland, and history of nhs wales aneurin bevan, the founder of the nhs calls for a "unified medical service" can be dated back to the minority report of the royal commission on the poor law in 1909. somerville hastings, president of the socialist medical association, successfully proposed a resolution at the 1934 labour party conference that the party should be committed to the establishment of a state health service. following the 1942 beveridge report's recommendation to create "comprehensive health and rehabilitation services for prevention and cure of disease", cross-party consensus emerged on introducing a national health service of some description. conservative mp and health minister, henry willink later advanced this notion of a national health service in 1944 with his consultative white paper "a national health service" which was circulated in full and short versions to colleagues, as well as in newsreel. when clement attlee's labour party won the 1945 election he appointed aneurin bevan as health minister. bevan then embarked upon what the official historian of the nhs, charles webster, called an "audacious campaign" to take charge of the form the nhs finally took. bevan's national health service was proposed in westminster legislation for england and wales from 1946 and scotland from 1947, and the northern ireland parliament's public health services act 1947. nhs wales was split from nhs (england) in 1969 when control was passed to the secretary of state for wales. according to one history of the nhs, "in some respects the war had made things easier. in anticipation of massive air raid casualties, the emergency medical service had brought the country's municipal and voluntary hospitals into one umbrella organisation, showing that a national hospital service was possible." webster wrote in 2002 that "the luftwaffe achieved in months what had defeated politicians and planners for at least two decades." the nhs was born out of the ideal that healthcare should be available to all, regardless of wealth. although being freely accessible regardless of wealth maintained henry willink's principle of free healthcare for all, conservative mps were in favour of maintaining local administration of the nhs through existing arrangements with local authorities fearing that an nhs which owned hospitals on a national scale would lose the personal relationship between doctor and patient. conservative mps voted in favour of their amendment to bevan's bill to maintain local control and ownership of hospitals and against bevan's plan for national ownership of all hospitals. the labour government defeated conservative amendments and went ahead with the nhs as it remains today; a single large national organisation (with devolved equivalents) which forced the transfer of ownership of hospitals from local authorities and charities to the new nhs. bevan's principle of ownership with no private sector involvement has since been diluted, with later labour governments implementing large scale financing arrangements with private builders in private finance initiatives and joint ventures. at its launch by bevan on 5 july 1948 it had at its heart three core principles: that it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay. three years after the founding of the nhs, bevan resigned from the labour government in opposition to the introduction of charges for the provision of dentures, dentists, and glasses; resigning in support was fellow minister and future prime minister harold wilson. the following year, winston churchill's conservative government introduced prescription fees. however, wilson's government abolished them in 1965; they were later re-introduced but with exemptions for those on low income. these charges were the first of many controversies over changes to the nhs throughout its history. from its earliest days, the cultural history of the nhs has shown its place in british society reflected and debated in film, tv, cartoons and literature. the nhs had a prominent slot during the 2012 london summer olympics opening ceremony directed by danny boyle, being described as "the institution which more than any other unites our nation". eligibility for treatment