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Учебное пособие НАР.ШАМ. 2008.doc
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The National Health Service in Great Britain

The National Health Service was established throughout the United Kingdom on the 5th of July 1948. Similar services operate in England and Wales, in Scotland and in Northern Ireland, but with administrative difference.

The introduction of the new types of health services did not mean a complete break with the past. On the contrary all that was good in the existing services was absorbed into a new scheme. The National Health Service made it possible that the benefits once available only to insured persons or those who could afford to pay for them, or as a form of charity, became available to everyone.

The Service consists of three main parts: the general practitioner (including dental) services, the hospital and specialist services, and the local health authority services (comprising a range of home and clinical services for prevention, treatment or care).

The public is free to use the service, or any independent part of it, as it pleases.

The patient is free to choose his doctor, and to apply to another if he wishes to do so. The doctor may accept private patients while taking part in the Service. About 97 per cent of the whole population of Great Britain is using the Service. The great majority of specialists and general practitioners are taking part in the Service.

Practitioner Services

The practitioner services consist of the Family Doctor Service, the Dental Service, and the Pharmaceutical Service. All these services provide the patient with the individual medical attention that he needs.

Family Doctor Service

The professional attention of a family doctor is available to everyone. Patients may choose the doctor they wish, provided only that he is enrolled in the Service and that he agrees to attend them. They may also change their doctor. The doctor has the same freedom to accept or refuse patients as he wishes. He cannot be forced to attend any person against his will. The doctor working in the Service is entitled to attend paying patients who have not joined the Service, if he cares to do so.

The doctor in the Family Doctor Service is free to treat his patients exactly as the family doctor treated them in the past. If a serious illness develops or diagnosis is difficult, he may call in a consultant and get hospital treatment without reference to any outside authority.

The maximum permitted number of patients' names to be put on one principal's list is 3,500 and the present average number is about 2,200.

A doctor in public service is remunerated by a capitation payment for each patient registered with him, with an addition for every patient within the range of 501 to 1,500 on his list.

At present the Family Doctor Service includes the doctors of the own surgeries, to whom the patients go for advice and treatment unless the doctor visits them at home. A few doctors work in the health centers. Many general practitioners work only with one assistant. To become an assistant of the general practitioner (the principal) is a common method of entering general practice.