Department of Social Sciences, Edge Hill University, Ormskirk, UK.
Int J Soc Determinants Health Health Serv. 2025 Jan;55(1):76-87. doi: 10.1177/27551938241280175. Epub 2024 Oct 7.
This article assesses how and why the National Health Service (NHS) has remained at the forefront of British politics and society for 75 years amid significant economic pressures, organizational strain, shifting ideological trends, ongoing reforms, and an unprecedented public health emergency. The postwar "years of consensus" evolved into alleged decline and ostensible neglect during the 1980s, while New Labour sought to rejuvenate this core public service after 1997, featuring investment and often controversial reforms that challenged the party's social democratic values. Amid the New Labour era, NHS powers filtered down to devolved administrations, while from 2008 retrenchment and austerity ensued, fueled by global recession. Austerity eventually subsided, yet from early 2020 the NHS swiftly faced the extreme conditions of the globalized Covid-19 pandemic. The service continues to face challenges regarding its longer-term viability, and this article analyzes this scenario, within the context of the NHS's 75-year historical legacy, its contemporary status, comparative international trends, and likely future evolution.
本文评估了在经济压力、组织紧张、意识形态转变、持续改革和前所未有的公共卫生紧急情况下,国民保健制度在 75 年中如何以及为何一直处于英国政治和社会的前沿。战后的“共识年代”在 20 世纪 80 年代演变成所谓的衰落和明显的忽视,而新工党试图在 1997 年后重振这一核心公共服务,其特点是投资和经常有争议的改革,挑战了该党的社会民主价值观。在新工党时代,国民保健制度的权力下放到权力下放的行政机构,而从 2008 年开始紧缩和紧缩随之而来,这是由全球经济衰退引发的。紧缩最终有所缓解,但从 2020 年初开始,国民保健制度迅速面临着全球化的新冠疫情的极端条件。该服务在其长期生存能力方面仍面临挑战,本文分析了在国民保健制度 75 年的历史遗产、其当前地位、国际比较趋势和可能的未来发展背景下的这种情况。