The National Health Service Act was passed through Parliament in 1946 and in 1948 this Act received the Royal assent and was brought into operation.

Similar services operate in England, Wales, Scotland and Northern Ireland. Further administrative changes were introduced by a number of other Health Service Acts.

Most medical treatment in Great Britain is free, but charges are made for drugs, spectacles and dental care. Free emergency medical treatment is given to any visitor from abroad who becomes ill while staying in England. But those who come to England specifically for treatment must pay for it.

The National Health Service provides free medical care both in hospital and in the out-patient clinic. People may use the NHS or they may go to doctors as private patients. In big cities there are some private hospitals which people may use. Many people who have enough money still prefer to be private patients because they think that they can in that way establish a closer relationship with the doctor or because they do not want to be put in a large room with other patients.

A patient can choose between NHS and private treatment at any time. Moreover he can take some of his medical care through the NHS, and some privately. If a patient is dissatisfied with his NHS family doctor or dentist, he may change to another one. In fact, 97 per cent of the population uses the NHS.

The role of the family doctor (General Practitioner) is very important. Not all patients need highly specialized attention and the GP does invaluable work by filtering off 90 per cent or so of the total medical work.

The freedom of choice applies to doctors and dentists too. They can choose whether they want to join the NHS or not, and whether they will have NHS patients or private ones. In fact, the majority work in the NHS.

They have modern hospitals but half of the buildings are over 100 years old. 70 per cent of their hospitals are small, with only about 200 beds. Such hospitals are not economical and cannot provide a full range of service, which requires a district hospital of 800 beds or more. Now they have more than 150 health centers in the U.K. The first Scottish health centre was opened in Edinburgh in 1953. These health centers are an integral part of a unified comprehensive health service. Health centers provide all the special diagnostic and therapeutic services which family doctors may need, such as electrocardiography, X-ray, physiotherapy and good administrative and medical records systems. Family doctors work in close cooperation with the hospital doctors. Health centers are the basis of primary care.

There are centers which provide consultant services in general medicine and surgery, ear-nose-throat diseases, obstetrics and gynecology, ophthalmology, psychiatry and orthopedics. All consultations in the centre are by appointment only. The patient is given a definite time at which to attend. This is recorded on a card for him. Each doctor decides for himself how many patients he can examine in one hour. They believe that the patient is the most important person in the health centre and that we should direct all our energy towards helping him as much as possible.

A typical day.

A typical day as a clinical or counseling psychologist is difficult to describe because the work is so varied. A psychologist in private practice may have some extra responsibilities than one working in a hospital or clinic setting. Regardless, each clinical and counseling psychologist encounters many of the same things throughout a typical day.

The beginning of the day starts with the psychologists getting the files ready of the clients being seen that day. Typically a psychologist will see no more than five clients per day. Psychologists see a variety of clients ranging from children to adults and couples to families. Each client brings along their own personal problems and individual needs. All this must be taken into account when deciding which therapy is best for each specific client.

Children and adolescents are the most difficult population to work with, typically because it may be difficult to gain the parents’ cooperation with therapy. Disorders such as depression and anxiety are on the average easy to treat. More difficult to treat are obsessive-compulsive disorder and bipolar disorder, depending on the severity of each.

At the end of the day, which sometimes lasts up to 12 hours, psychologists must complete the appropriate paperwork for the clients seen that day. This can be a very tedious task because insurance companies require detailed paperwork on clients.

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