Charity Case?
Who funds the NHS and who provides the service it offers. The answer to an apparently simple question is becoming ever more opaque
SC special 23
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Charity Case?
The NHS is commonly understood to be a government body. From its inception it has been funded by central government from taxation. Initially from National Insurance.
National Insurance is a tax that was created in 1911 specifically to help with the provision for the sick. The role of the tax expanded and immediately post war it was envisaged as a tax to fund the NHS, unemployment benefit and pensions. Since the post war years however, it has become just another tax.
Today the NHS is funded not so much by any one tax, but out of the pool of central government money, be it income from taxation or simply borrowing.
Right up until the 1980’s the vast majority of NHS services were provided in house. Since then, not only has the range of what the NHS does expanded, but so has the number of external organisations providing services to or on behalf of the NHS.
As the network of services and providers has become more complex, so the way the NHS is funded has become more opaque. What has caught our attention recently, is the increasing involvement of charities and the charity sector as a whole with the services the NHS in Somerset provides.
It would be wrong to say the charity sector dominates the NHS, but its presence is growing every year. It is a national trend, but by looking at how the NHS works in our home county, we can get a flavour of the bigger picture too.
For instance as we reported earlier this month (see SC special 22 here) the drugs and alcohol service for Somerset is now provided by a charity called Turning Point. Many people in our county are simply not aware that the although the service is paid for by the tax payer, it is neither provided by the NHS nor even Somerset Council, but by a charity instead. Yet up until 2010, drugs and alcohol was indeed an “in-house” service provided and staffed by the NHS in Somerset.
That said it is important to note that the service remains fully funded from central government funds (today the contract is with Somerset Council, previously it was with Somerset NHS).