The Structure of the NHS
The NHS is publicly funded. This means that rather than the government paying for the entirety of its resources, hospitals, stock, salaries and equipment, we, the public pay for it instead. They gain money from tax amongst other incomes, but when this is all added together, the sum can be quite large. For example, in 2018/2019, the NHS gained through its income, a total of £130.3 billion, around £2,300 for every person in England. This money comes from everyone who is working, from the taxes that they pay as well as from an extra smaller tax that we pay on top, called National Insurance, NI. We each have a NI number, specific to us. This payment assures a system of social security so that we can benefit from payments if we lose our job for example, and the number of years you work and pay your NI for can affect your state pension when you retire.
What happens to this money, how is it passed down through the NHS to fund it?
The money first goes to The Department of Health and Social Care where this money is used for a variety of reasons. It spends some of the money maintaining hospitals, buying in medicines, paying salaries, training new members of staff etc etc. the remainder is passed onto NHS England. NHS England looks to use this money nationwide. If you think about it, big cities like London, Manchester and Birmingham will often need the most looking after, as they’re the most populated areas, and therefore will require the most attention. this doesn’t mean that less populated areas aren’t affected. This is what NHS England tries to cover with its portion of the money. One example might be cancer treatments. Cancer doesn’t just affect major populations, it unfortunately doesn’t discriminate against anyone, and can be found just about anywhere. This is why in 2018/19, NHS England spent £28.2 billion on services for special cancer treatments, as well as putting some of the money back into reserves.
Finally, the last major movement of money goes to the Clinical Commissioning Group, also known as the CCGs. These CCGs are essentially everything medically related in a specific area. This includes hospitals, your local friendly clinic that is your general practitioner doctors, GPs, as well as maybe specialised surgeries and everything in between. The remainder of the money is then divided by the specific need and demand of each Clinical Commissioning Group CCG. For example, a larger CCG would require more funding as it would most likely deal with more people, who potentially need a greater deal of attention due to more serious medical emergencies. In a nutshell, this is how we the public fund the NHS, and how our money is used. Now you might be thinking that it’s unfair to pay, what are essentially medical bills despite potentially never needed to go the hospital, or have a check-up. But that’s where life comes in. Life is unpredictable, you never know what could happen to you or a loved one. And the last thing you’ll want to deal with after going through a medical emergency is being faced with a hefty bill. To put it simply, if you’re paying for other people’s medical emergencies now, when you’re in that situation, just remember that they’ll be paying for yours.