Overview of health care system
Health care in the UK is administered by the publicly funded National Health Service (NHS). Each country in the UK (England, Wales, Scotland, and Northern Ireland) administers its own system, but they have a reciprocity understanding where there is little differentiation if a patient must receive care across a border. All of the systems are similar, but are managed by separate legislative entities, causing each one to be unique. Funding comes from taxation of the general public.
Provisions for primary care, specialists, surgeons, hospitals and many other aspects of health care are made by the NHS. Dental care is provided by sub-contracted dentists who are in private practice.
The administrative bodies of the NHS are the trusts, and these are broken down into categories such as Primary Care Trusts (PCT's), NHS Hospital Trusts, NHS Ambulance Services Trusts, etc. Managing these is the responsibility of the Strategic Health Authorities (SHA's), and above this body is the Department of Health division of the UK government.
The NHS is not only the largest employer in the UK but also ranks in the top globally as well. The majority of hospital doctors and nurses are directly employed. General Practitioners, optometrists, and dentists are on contract with NHS but are essentially private practice and operate autonomously.
Health care for the individual is usually initiated with the General Practitioner. This doctor manages the non-serious illnesses of his patients and refers them to specialists when necessary. Patients usually have a choice of doctor but the doctor must be chosen locally, and the doctor is generally required to accept the patient. He writes prescriptions which are filled by privately-owned pharmacies who are contracted with the NHS. The rules for prescription charges vary amongst the four countries, but in Wales, all prescriptions are free. Scotland is working on achieving this goal. In England, Scotland, and Northern Ireland prescriptions are free to those under 16 (or 19 if a full-time student) and over 59. There are also provisions for free prescribed birth control, and medications for specified conditions.
If the patient needs hospitalization the GP will notify the hospital. In cases where urgent care is needed, the patient is seen immediately. Otherwise an appointment is made. Surgeries are conducted based on the decision of where to queue the patient in regard to the needs of others who also need care. There can be anxious waits for patients, sometimes lasting longer than expedience demands. To help with this problem the NHS has a new directive to complete all initial care and start a patient's treatment within 18 weeks.