NHS needs reality check at 60

By Kate Kelland

LONDON (Reuters) - The National Health Service is famous for being free at the point of need, but analysts say that if the 60-year-old NHS is to serve an ageing and expanding population, the reality of its cost must be accepted.

The anniversary of the NHS, launched on July 5, 1948 by then Labour Health Minister Aneurin Bevan as a cradle-to-grave system, has prompted an avalanche of reviews and studies into its -- and the nation's -- future health.

Views vary on how to provide the best service for the NHS's 60 million users, but analysts agree on one point: The public and its politicians must accept that the cost of the world's largest publicly funded health service is going up, and acknowledge it is a luxury, albeit one this society can afford.

"We have become fixed on the idea that the NHS is somehow free," David Furness, a health service analyst at the Social Market Foundation think-tank, told Reuters.

"It is not free. We all pay for it through taxation, and it's free at the point of use -- that's something quite different. There are no blank cheques, but we should be celebrating the fact that our health system can give so much more than anyone ever imagined it would in 1948."

In terms of sheer size of personnel, only China's People's Liberation Army, America's giant Wal-Mart supermarket chain and India's enormous railway system compare with the NHS.

With a workforce of 1.5 million people across Britain, it is Europe's largest employer, and it deals with eight patients every second.

Analysts say a reluctance to recognise the costs of the NHS leads to a lack of realism when it comes to discussing reforms or possible limits on what it can and should provide.