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April 1992

Dermatology in the United Kingdom

Author Affiliations

Department of Dermatology University of Liverpool PO Box 147 Liverpool, England L69 3BX

Arch Dermatol. 1992;128(4):535-536. doi:10.1001/archderm.1992.01680140115015

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In the United Kingdom, the whole system of health care is under review with an agenda that is likely to see many changes affecting all branches of medicine, including dermatology. Because these changes are fast and furious, their general nature must be outlined before we consider dermatology specifically. For the last 45 years, since the formation of the National Health Service (NHS) in 1948, the central government has funded health care as a nationalized industry. Various organizational tiers have controlled the funds; these are regions comprising a number of districts, each of which contain a number of "units," such as hospitals and clinics. The administrators controlled what services were available and, hence, could plan strategically to coordinate facilities. Primary medical care is given by general medical practitioners (family doctors), with consulting rooms readily accessible to the population. These doctors refer problems on to appropriate specialists in the hospital setting. Most

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