The Labour Government, with the intention of creating a system of universal whilst also free health-care across England, established the National Health Service in 1948. Both the conservative and the Labour governments subscribed to a ballot about how the NHS should be run until 1979 when the new prime minister, Margaret Thatcher took power. The conservative reform of the NHS concentrated on four elements.

These four elements included: the principles of the free market for example, competition were introduced and encouraged in health care. GP’s become responsible for their own budgets and were known as fund holders. This is where they were able to purchase service on behalf of their patients registered to them from hospital trusts. This idea was that the service could promote efficiency whilst also reducing the costs as trusts competed with each other to provide services. The second element was that the care in the community was designed to take the disabled and mentally ill, the old and the sick out of institutional care and to put them back into the care of their family and the wider community. The third element focused on private health schemes, where this period saw an increase in private homes for the elderly. The last element was the introduction of a patient’s charter, which, was introduced in 1992 in order to understand performance standards for health care.

However, there have been many suggestions that the health service has been shaped into a three-tier system, which merely reproduces the inverse care law. Those that in need of the greatest care often receive fewer resources. Many of the middle and higher class have access to health care and or private healthcare, whereas the working class and the underclass have access to GP’s in many inner cities where they face intensive demands on their funds.

During 2000, the Labour government offered