The ghost of health services past: comparing British health policy of the 1930s with the 1980s and 1990s

Abstract

It has recently been argued that British health policy of the 1990s has a number of similarities with that of the 1930s. In other words, recent years have seen a return to earlier policies, which has been termed "back to the future." The author critically examines these assertions under a number of themes: comprehensiveness, services free at the point of use, inequality, planning, coordination, adverse selection, and democracy. In many of these areas there is a good deal of similarity between the periods. Moreover, both periods appear to be inferior to the intervening period of the "classic" National Health Service. A different temporal pattern is observable in the area of democracy, where there appears to be a clear deterioration over time. However, in many ways, the ghost of health services past may return to haunt the future.