Taking a fresh look at the origins and evolution of the National Health Service (NHS)?the four single-payer publicly funded healthcare systems in the United Kingdom?this argues that the ?reforms” have begun to transform the system into a European-style social health insurance fund, with purchasing services from a variety of private- and public-sector providers. The examination also places the NHS in an international context and discusses the recent tendencies of Scottish, Welsh, and Northern Irish governments to follow alternative lines of policy. The books concludes with a look at the alternatives for the future development of the NHS and by asking such question as Will ministers roll the wheel of history further back towards a more radical market system? Or will they move forward to a public service based on greater accountability and responsiveness to the needs and wishes of local people and those with greatest health needs?