School of Health and Population Sciences, University of Birmingham.
Clin Med (Lond). 2010 Aug;10(4):336-8. doi: 10.7861/clinmedicine.10-4-336.
The NHS has long held a paradoxical position in the national psyche: a constant, reassuring presence that seems to be in a state of continual flux. This is partly because while the service is based in the public sector (with its reputation for risk aversion and change at a glacial pace), it is also exposed to the ever present currents of political pressure. Equally important is the changing nature of both medical technology and public expectation, each of which exert constant and inexorable pressures on the service. This article will briefly describe the story of the NHS from its inception in 1948 to the present day, with an emphasis on developments over the last 20 years. During this time the notion of organising healthcare has developed and formed the focus of much of the change in systems across the developed world. The narrative will highlight some of the major challenges that the NHS will face over the next few years, and introduce the series about the future of the NHS that will appear in this journal signposting some of the topics that will be followed up in these articles.
英国国家医疗服务体系（NHS）在国民心中一直处于一种矛盾的地位：它是一种持续存在的、令人安心的存在，但似乎又处于不断变化的状态。这在一定程度上是因为，尽管该体系基于公共部门（以规避风险和变革缓慢而闻名），但它也受到政治压力的持续影响。同样重要的是，医疗技术和公众期望的性质也在不断变化，这两者都对该体系施加着持续而不可阻挡的压力。本文将简要描述 NHS 从 1948 年成立至今的历史，重点介绍过去 20 年的发展情况。在此期间，医疗保健组织的理念不断发展，并成为发达世界医疗体系变革的核心。本文将重点介绍 NHS 在未来几年将面临的一些重大挑战，并介绍将在本刊发表的关于 NHS 未来的系列文章，这些文章将指出将在其中进行探讨的一些主题。
