Britain: An official handbook > 1993

BRITAIN 1993: AN OFFICIAL HANDBOOK
for reducing risk behaviour (for example, the
percentage of smokers to no more than 20
per cent of the population by the year 2000).
While the NHS will have a central role in
working towards the targets, the strategy also
emphasises that there is a role for everyone in
improving the nation’s health. Progress
towards these targets will be monitored, and
the strategy will be reviewed periodically with
a view to adding further areas.
The White Paper also sets out the
Government’s objective of ensuring the
provision of effective family planning services
for those people who want them. The
conception rate for those under 16 years is a
matter of particular concern.
Strategies have also been developed for
Scotland, Wales and Northern Ireland.
National Health Service
The NHS is based upon the principle that
there should be a full range of publicly
provided services designed to help the
individual stay healthy. The services are
intended to provide effective and appropriate
treatment and care where necessary while
making the best use of available resources. All
taxpayers, employers and employees
contribute to its cost so that those members
of the community who do not require health
care help to pay for those who do. Some
forms of treatment, such as hospital care, are
provided free; others (see p 119) may be
charged for.
Growth in real spending on the health
service is being used to meet the needs of
increasing numbers of elderly people and to
take full advantage of advances in medical
technology. It is also used to provide more
appropriate types of care, often in the
community rather than in hospital, for
priority groups such as the elderly, the
mentally ill and people with learning
disabilities (mental handicap). Increased
spending has, in addition, been allocated to
combat the growing health problems arising
from alcohol and drug misuse; and to remedy
disparities in provision between the regions of
Britain.
The Government stresses the need for a
partnership between the public and private
health sectors and for improving efficiency in
order to secure the best value for money and
the maximum patient care. Measures to
achieve more effective management of
resources in the NHS have included:
• appointing at regional, district and unit
levels general managers drawn from
inside and outside the health service;
• improving the accountability of health
authorities for the planning and
management of their resources;
• increasing the proportion of total staff
who provide direct patient care, such as
doctors and nurses; and
• introducing a range of programmes to
provide services at lower cost.
Considerable savings have been made
through competitive tendering for hospital
cleaning, catering and laundry services. At
the end of 1991 the Government announced
that total annual savings from competitive
tendering amounted to £156 million.
Economies are also made in prescribing by
restricting the use of expensive branded
products in favour of cheaper but equally
effective equivalent medicines.
ADMINISTRATION
The Secretary of State for Health in England
and the Secretaries of State for Scotland,
Wales and Northern Ireland are responsible
for all aspects of the health services in their
respective countries. The Department of
Health is responsible for national strategic
planning in England. The Scottish Office
Home and Health Department, the Welsh
Office and the Department of Health and
Social Services in Northern Ireland have
similar responsibilities.
District health authorities in England and
Wales and health boards in Scotland are
responsible for securing hospital and
community health services in their areas.
England, because of its greater size and
population, also has regional authorities
responsible for regional planning, resource
allocation, major capital building work and
certain specialised hospital services best
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