The BMJ Commission on the Future of the NHS

ANALYSIS

Fig 1 | The NHS Act 1946

The Act explicitly refers to the NHS as being comprehensive, free of charge, and, by implication, available to everyone equally. Neither the legislation nor health minister Aneurin Bevan ’ s speeches mention founding principles, but review of extensive discussion at

the time suggests it is reasonable to identify five founding principles: the NHS as a comprehensive service, universally available, based on clinical need, free at the point of need, and funded through collective contributions.

the bmj | BMJ 2024;384:e078903 | doi: 10.1136/bmj-2023-078903

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