OHE Publications

In 1948 the newly created National Health Service inherited a stock of buildings which varied very widely in both quality and quantity from area to area. Hospitals formed the major part of the existing health services' physical capital stock. With some exceptions, such as private nursing homes, these had been in the hands of either local authorities or voluntary bodies with the status of charitable institutions.

It has generally been the policy of OHE, in this series of occasional papers, to avoid controversial topics directly involving the pharmaceutical manufacturers, who still provide much of the finance for our Office. We are departing from the tradition on this occasion partly by accident and partly by intent.

At the last census in 1966 there were nearly 12 million people aged between 45 and 64 in England and Wales. This age group, which for convenience will be termed 'middle age' throughout this paper, covers the second part of economically active life. It is a time during which, while many careers are still reaching a peak, a decline in physical and mental powers has already begun to set in. As middle age is entered, a new phase of life begins. Patterns of morbidity and mortality rapidly alter as degenerative diseases become increasingly more significant.

By 1990, the total cost of the National Health Service will probably have reached about £10,000 million of which about £1,300 million will be for medicines prescribed by general practitioners and hospital doctors. At 1968 prices the corresponding figures would be about £4,500 million and £600 million.