Universality Under Siege
The Empire Club of Canada Addresses (Toronto, Canada), 3 Oct 1996, p. 111-124
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Universality Under Siege

The pride that Canadians feel for their national health service, similar to that felt by the British people for their national health-care system. The principles on which the original National Health Service (NHS), founded in 1945, rested on; the four major tenets: that it should be a comprehensive service; that it should be universally available; that there should be equality of access; and that it should be free at the point of use. The survival of these four tenets, and that the NHS should provide the very best it could, through modifications and cuts to aspects of the welfare state, even through changes made by Mrs. Thatcher as prime minister. A discussion of the future of the NHS and three other issues: the strengths and weaknesses of the NHS until 1990; a look at the philosophy which underlies the changes which were introduced and what the expectations were from those changes of 1990; an assessment of the consequences of these changes and where the British are going with health care. From that, some lessons for Canada. Five strengths of the NHS, with discussion. Four weaknesses, also with brief discussion. A summary up to 1979. Events under Mrs. Thatcher's prime ministership. The reforms in 1990. Changes since then. Concerns with the present structure of the NHS. What the Labour Party proposes to do. Lessons for Canada. Enabling control over the total spent on health care. The simplicity of the administrative system of registration with a General Practitioner. The attempt to introduce a market and to use competition as a means of increasing efficient unsuccessful and carrying undesirable consequences because of the emphasis put on balancing the books rather than the quality of health care. Problems shared by Canada and Britain, if they wish to retain a universal system of health care: a look at each case. How a universal health care system can contribute to a sense of unity.