This indicates that there has been a change in the NHS since its inception, and it has been argued that pouring money into an unreformed, poorly managed system has inevitably created waste - and will continue to do so. There is an array of arguments regarding these changes in all spheres. However, there has also been considerable debate and counter-arguments and consequently a volume of literature, so that the pattern of changes and its consequences over time may be evident on a closer look. In other words, the historical development of the NHS and social care may represent structurally the reasons for changes in its presentation, and clues to them may be available through critical analysis of the health policies and their analysis based on theoretical underpinnings, academic concepts, policy initiatives, issues related to them. If a change is suggested, there is an element of comparison between the previous policies and the recent ones in order to examine the types and extent of changes in the NHS, which might be radical (Gorsky, 2008).
All health systems have a mix of financing mechanisms which are, in the terminology of Derek Wanless, social insurance, private insurance, out-of-pocket payments and taxation. As is well known, Aneurin Bevan, Minister of Health in the Labour government, nationalised the hospital system in 1948 (Campbell, 1987). Since local government was no longer to co-ordinate the NHS or to run its own hospitals or clinics, national rather than local taxes came to fund the service largely by default. Bevan also favoured this in principle for three reasons. The first was that national taxation was more redistributive, and the second was that he regarded free access to health care to be a citizen's right and not something conditional on the payment of contributions. Finally, there was the question of how, politically and administratively, the non-insured could be turned away from a universal service. He favoured a fully tax-financed system so strongly that he strove to disassociate the NHS from the other welfare services launched on 5 July 1948, 'the appointed day' and conventional birthday of the welfare state (Bone 2008).
The welfare state in Britain, of which the NHS is a major and enduring part, is complex. It originates from the Beveridge Report, which was the major plank of post-World War II social reconstruction. The report provided a set of welfare principles for improved social justice for British citizens. It thus paved the way for a legislative framework to tackle five areas of serious need that the report had identified. These are want; disease; ignorance; squalor; and idleness. The market economy had failed the population in the inter-war years when much of it experienced unemployment, poverty, poor educational standards, poor health and poor housing. Market forces had failed to supply these important social goods and to deliver essential services. The government thus felt that large-scale, collectivist state intervention was required to meet this unmet need and that only