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The National Health Service (NHS) is the publicly funded health care system of the United Kingdom, created under the National Health Service Act 1946 by the post-war Labour government of Clement Attlee. It has come under much criticism, especially during the early 2000s, due to outbreaks of antibiotic-resistant infections such as MRSA and Clostridium difficile, waiting lists, and medical scandals such as the Alder Hey organs scandal. However, the involvement of the NHS in scandals extends back many years, including over the provision of mental health care in the 1970s and 1980s (ultimately part of the reason for the Mental Health Act 1983, and overspends on hospital newbuilds, including Guy's Hospital Phase III in London in 1985, the cost of which shot up from £29 million to £152 million.) ==Access controls and waiting lists== In making health care a largely "invisible cost" to the patient, health care seems to be effectively free to its consumers - there is no specific NHS tax or levy. To reduce cost and ensure that everyone is treated equitably there are a variety of "gatekeepers." The GP functions as a primary gatekeeper - without referral from a GP, it is often impossible to gain higher courses of treatment, such as an appointment with a consultant. These are argued to be necessary - Bevan noted in a 1948 speech in the House of Commons, "we shall never have all we need... expectations will always exceed capacity". On the other hand, the national health insurance systems in other countries (e.g. Germany) have dispensed with the need for referral; direct access to a specialist is possible there. There has been concern about opportunistic "health tourists" travelling to Britain and using the NHS while paying nothing. British citizens have been known to travel to other European countries to take advantage of lower costs, and because of a fear of hospital-acquired superbugs and long waiting lists. NHS access is therefore controlled by medical priority rather than price mechanism, leading to waiting lists for both consultations and surgery, up to months long, although the Labour government of 1997-onwards made it one of its key targets to reduce waiting lists. In 1997, the waiting time for a non-urgent operation could be two years, there were ambitions to reduce it to 18 weeks despite opposition from doctors.〔 〕 It is contested that this system is fairer - if a medical complaint is acute and life-threatening, a patient will reach the front of the queue quickly. The NHS measures medical need in terms of quality-adjusted life years (QALYs), a method of quantifying the benefit of medical intervention. It is argued that this method of allocating healthcare means some patients must lose out in order for others to gain, and that QALY is a crude method of making life and death decisions.〔(【引用サイトリンク】title=So what is a QALY? )〕 There have been several fatal outbreaks of antibiotic resistant bacteria ("superbugs") in NHS hospitals, such as Methicillin-resistant ''Staphylococcus aureus'' (MRSA) Vancomycin Resistant ''Enterococci'' (V.R.E.) and ''Clostridium difficile''. This has led to criticism of standards of hygiene across the NHS, with some patients buying private health insurance or travelling abroad to avoid the perceived threat of catching a "superbug" while in hospital. However, the department of health has pledged £60 million for a "deep clean" of all NHS England hospitals. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Criticism of the National Health Service」の詳細全文を読む スポンサード リンク
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