The United Kingdom began its National Healthcare System (NHS) in 1948 with a mission to make healthcare available to all regardless of their ability to pay. Since its creation, the NHS has grown in its capacity to prevent illnesses and improve the mental and physical health of the population.

Numerous local and national organizations support the NHS such as clinical commissioning groups, charities and research institutes. These all compile to create the healthcare system. A general and payroll tax primarily fund the NHS, allowing patients in England to receive NHS services without charge. From emergency to non-urgent cases, healthcare in the U.K. seeks to put patients first by surveying the success of patients’ outcomes.

For those “ordinarily resident” in England or those with a European Health Insurance Card, coverage is universal. In fact, in most cases coverage is free. The NHS Constitution states that patients have rights to drugs and treatments when deemed necessary and approved by their physician. Through the NHS’s services, primary care, specialized care, longterm care, after-hours care and mental health care available.

What is the Role of the Government?

The Health Act (2006) requires that the Secretary of State has a legal duty to promote comprehensive healthcare services to the public free of charge. The NHS Constitution outlines the rights for those eligible for national healthcare, including access to care without discrimination and prompt hospital care. While the Department of Health supervises the overall health system, the day-to-day responsibilities rest with NHS England. In addition, the local government authorities hold the budgets for public health.

Ensuring Quality and Reducing Disparities

Research shows healthcare quality is worse for those living in poverty in England. The health gap between the rich and poor has widened over the past few years. The more economically deprived an area is, the more quality-deprived those same struggling areas are. Underfunded local services lead to poorer health of the most vulnerable.

Strategies to reduce inequality include monitoring statistics of access and outcomes, particularly for at-risk groups. The requirement to host “health and well-being boards” mitigates local government authorities’ relative autonomy in creating budgets for public health in their communities. These boards aim to improve the coordination of local services and reduce disparities.

What is the Impact of COVID-19?

The COVID-19 pandemic makes health inequalities in the United Kingdom more visible. Those who live in the most deprived areas have a higher risk of contracting the virus. Fortunately, citizens have largely obeyed the government’s social distancing pleas, limiting the spread of the virus. However, this comes with social and economic consequences for those who were already suffering from inequality.

The weight of the pandemic does not fall evenly on society. Adjusting for age, those who live in poorer areas have faced more than double the deaths compared to those in richer areas. Additionally, research has found that minority ethnic communities have a higher risk of death from the virus. The reasons for this are complicated and research on these issues is advancing. However, discrimination and the resulting lack of socio-economic opportunities for these groups in education and employment can lead to their overall health being disproportionately impaired.

Solutions

To help healthcare in the United Kingdom obtain equal accessibility and quality, acting against the systemic barriers facing minority groups and encouraging overall economic development that will enable healthier living for all is necessary. Increased government support for the NHS and its relating voluntary and community sectors could mitigate the pandemic’s devastating effects.

Well Communities is an example of a nonprofit organization in the United Kingdom that empowers local communities to reduce inequalities. By working on the neighborhood level, Well Communities addresses specific concerns in improving local coordination through training and engagement around a themed project. Past projects have promoted healthy eating, exercise, mental health, employment, green spaces, culture and arts.

More than 18,700 individuals participated in Well Communities’ Well London activities, representing 35 percent of the population in that neighborhood. The outcome exceeded the targeted goals. Strikingly, 82 percent reported increases in physical activity and 54 percent reported an increase in mental wellbeing. Additionally, 60 percent reported increased levels of volunteering.

These statistically significant changes in the community indicate the value of organizations like Well Communities’ work. With more organizations implementing programs like these, there is hope to reconcile the increasing inequalities of healthcare in the United Kingdom.

COVID-19 and its lockdown will deepen inequalities unless the U.K. mounts a great effort. Through much-needed increased government support for the NHS and its relating voluntary and community sectors, the U.K. is working to abolish inequality in healthcare.

– Mia McKnight 
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