Clinical Governance in the UK National Health Service
Dr Alastair Baker
King's Colloge Hospital, London, UK
The UK National Health Service (NHS) was formed in 1948 by the Labour government. It was based on a vision of healthcare that still has a powerful influence in the UK including care for all equally 'from the cradle to the grave' and 'free at the point of delivery'. Funding was and remains from central taxation. The NHS is the largest single employer in Europe.
Initially, the NHS was administered by Area Health Authorities who exerted little influence on day-to day running of clinical services. Management was weak and doctors held the major control over service delivery in a paternalistic manner. Lines of accountability were unclear and there was no transparency in the supervision of standards by the medical professional bodies; the Royal Colleges and General Medical Council.