The conjoint was a basic medical qualification in the United Kingdom administered by the United Examining Board . It is now no longer awarded. The Conjoint Board was superseded in 1994 by the United Examining Board, which lost its permission to hold qualifying medical examinations after 1999.
131-545: Medical education at the London Teaching Hospitals began centuries before there was a university in London to award medical degrees. Those who had taken BAs at Oxford or Cambridge , or occasionally started their pre-clinical education at universities further afield, could return there to take medical examinations, but it was open to most to take the examinations of the London medical corporations. As
262-472: A Bronze Age bridge were found on the south River Thames foreshore, upstream from Vauxhall Bridge . Two of the timbers were radiocarbon dated to 1750–1285 BC. In 2010, foundations of a large timber structure, dated to 4800–4500 BC, were found on the Thames' south foreshore downstream from Vauxhall Bridge. Both structures are on the south bank of the Thames, where the now-underground River Effra flows into
393-542: A 3.4% increase in funding every year to 2024, which would allow it to receive an extra £20bn a year in real terms funding. [dead link] There is concern that a high proportion of this money will go to service NHS debts rather than for improved patient care. In June 2018, it was reported that there were calls for the government to write off the NHS debt. Saffron Cordery of NHS Providers said that hospitals needed help to do their work without being up in deficit, as two-thirds were in
524-800: A Licence in Medicine and Surgery ( LMSSA ) as a complete qualification. The surgeons then teamed up with the Royal College of Physicians of London who paired their Licentiate diploma ( LRCP ) with the MRCS to create the English Conjoint Diploma in 1884. The London LRCP had previously been a means for Bachelors or licentiates in medicine from Oxford and Cambridge (and a few MDs from elsewhere) to qualify to practise in London as physicians (i.e. internal medicine specialists, as distinct from surgeons or apothecaries). The old LRCP also allowed
655-484: A National Health Service in 1944 with his consultative White Paper "A National Health Service" which was circulated in full and short versions to colleagues, as well as in newsreel. When Clement Attlee 's Labour Party won the 1945 election he appointed Aneurin Bevan as Health Minister . Bevan then embarked upon what the official historian of the NHS, Charles Webster , called an "audacious campaign" to take charge of
786-542: A larger area, similar in size to Greater London, although some outer districts are excluded and some just outside included. The Greater London boundary has been aligned to the M25 motorway in places. Further urban expansion is now prevented by the Metropolitan Green Belt , although the built-up area extends beyond the boundary in places, producing a separately defined Greater London Urban Area . Beyond this
917-612: A lot of coverage in the media. The Welsh and UK governments announced a partnership on 23 September 2024 to reduce NHS waiting lists in England and Wales during the Labour Party Conference in Liverpool. This collaboration aimed to share best practices and tackle common challenges. Previously, Eluned Morgan rejected a Conservative proposal for treating Welsh patients in England. The Welsh Conservatives welcomed
1048-408: A notional full set of pre-clinical subjects (anatomy, physiology, pharmacology, pathology, etc.) from which those who had university passes or another final medical qualification would be exempted: but fees might still have to be paid. The closure of this portal, along with the recent recategorisation of junior doctors from student to worker status for immigration purposes, may hasten the changeover of
1179-403: A population density of 802 per acre (325 per hectare). In addition to the growing number of stores selling goods, such as Harding, Howell & Co. —one of the first department stores —located on Pall Mall , the streets had scores of street sellers . London's overcrowded conditions led to cholera epidemics, claiming 14,000 lives in 1848, and 6,000 in 1866. Rising traffic congestion led to
1310-573: A population of 7,172,036 in 2001 and a population density of 11,760 inhabitants per square mile (4,542/km ). The extended area known as the London Metropolitan Region or the London Metropolitan Agglomeration, comprises a total area of 3,236 square miles (8,382 km ) has a population of 13,709,000 and a population density of 3,900 inhabitants per square mile (1,510/km ). Modern London stands on
1441-580: A post- Brexit exodus of stock listings from the London Stock Exchange , London remains a European economic powerhouse, and one of the world's major financial centres . It hosts Europe's largest concentration of higher education institutions , some of which are the highest-ranked academic institutions in the world: Imperial College London in natural and applied sciences , the London School of Economics in social sciences , and
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#17327723252781572-575: A safety net in that medical students unsure whether they would pass or fail would have two chances if they took both. By far the greatest use of the Conjoint and similar qualifications in recent years was as a means for foreign medical graduates to obtain British qualifications, which eased their problems of obtaining registration and employment in the U.K., and also made it easier to go on to work in third countries. The scheme of examinations included
1703-483: A state medical examination separately from or instead of a university degree. In the English provincial cities, some medical schools developed separately from the new Redbrick universities, so the Conjoint diplomas were at first usually taken. Armed forces officer cadets would be promoted from second lieutenant to lieutenant on qualifying, which included the conjoint qualification. The difference in pay between
1834-551: A temperate oceanic climate ( Köppen : Cfb ). Rainfall records have been kept in the city since at least 1697, when records began at Kew . At Kew, the most rainfall in one month is 7.4 inches (189 mm) in November 1755 and the least is 0 inches (0 mm) in both December 1788 and July 1800. Mile End also had 0 inches (0 mm) in April 1893. The wettest year on record is 1903, with a total fall of 38.1 inches (969 mm) and
1965-644: Is 1,049.8 millibars (31.00 inHg) on 20 January 2020. Summers are generally warm, sometimes hot. London's average July high is 23.5 °C (74.3 °F). On average each year, London experiences 31 days above 25 °C (77.0 °F) and 4.2 days above 30.0 °C (86.0 °F). During the 2003 European heat wave , prolonged heat led to hundreds of heat-related deaths. A previous spell of 15 consecutive days above 32.2 °C (90.0 °F) in England in 1976 also caused many heat related deaths. A previous temperature of 37.8 °C (100.0 °F) in August 1911 at
2096-562: Is agreed that the name came into these languages from Common Brythonic ; recent work tends to reconstruct the lost Celtic form of the name as * Londonjon or something similar. This was then adapted into Latin as Londinium and borrowed into Old English. Until 1889, the name "London" applied officially only to the City of London , but since then it has also referred to the County of London and to Greater London . In 1993, remains of
2227-545: Is formed of two tiers: a citywide, strategic tier and a local tier. Citywide administration is coordinated by the Greater London Authority (GLA), while local administration is carried out by 33 smaller authorities. The GLA consists of two elected components: the mayor of London , who has executive powers , and the London Assembly , which scrutinises the mayor's decisions and can accept or reject
2358-707: Is headquartered in Thames House on the north bank of the River Thames and the foreign intelligence service ( MI6 ) is headquartered in the SIS Building on the south bank. Crime rates vary widely across different areas of London. Crime figures are made available nationally at Local Authority and Ward level. In 2015, there were 118 homicides, a 25.5% increase over 2014. Recorded crime has been rising in London, notably violent crime and murder by stabbing and other means have risen. There were 50 murders from
2489-592: Is held by an independent . The ministerial post of minister for London was created in 1994, however as of 2024, the post has been vacant. Policing in Greater London, with the exception of the City of London , is provided by the Metropolitan Police ("The Met"), overseen by the mayor through the Mayor's Office for Policing and Crime (MOPAC). The Met is also referred to as Scotland Yard after
2620-564: Is known as London . It is the capital of the United Kingdom and of England by convention rather than statute. The capital of England was moved to London from Winchester as the Palace of Westminster developed in the 12th and 13th centuries to become the permanent location of the royal court , and thus the political capital of the nation. Greater London encompasses a total area of 611 square miles (1,583 km ) an area which had
2751-545: Is regardless of whether they derive a salary or wage from the organisation, or receive any type of funding or assistance from the organisation for the purposes of working overseas. This is in recognition of the fact that most missionaries would be unable to afford private health care and those working in developing countries should not effectively be penalised for their contribution to development and other work. Those who are not ordinarily resident (including British citizens who may have paid National Insurance contributions in
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#17327723252782882-523: Is the vast London commuter belt . Greater London is split for some purposes into Inner London and Outer London , and by the River Thames into North and South , with an informal central London area. The coordinates of the nominal centre of London, traditionally the original Eleanor Cross at Charing Cross near the junction of Trafalgar Square and Whitehall , are about 51°30′26″N 00°07′39″W / 51.50722°N 0.12750°W / 51.50722; -0.12750 . Within London, both
3013-517: The 2012 Summer Olympics . London is an ancient name, attested in the first century AD, usually in the Latinised form Londinium . Modern scientific analyses of the name must account for the origins of the different forms found in early sources: Latin (usually Londinium ), Old English (usually Lunden ), and Welsh (usually Llundein ), with reference to the known developments over time of sounds in those different languages. It
3144-540: The Black Death in the mid-14th century, London lost nearly a third of its population. London was the focus of the Peasants' Revolt in 1381. London was a centre of England's Jewish population before their expulsion by Edward I in 1290. Violence against Jews occurred in 1190, when it was rumoured that the new king had ordered their massacre after they had presented themselves at his coronation. In 1264 during
3275-589: The Canary Wharf development. This was born out of London's increasing role as an international financial centre in the 1980s. Located about 2 miles (3 km) east of central London, the Thames Barrier was completed in the 1980s to protect London against tidal surges from the North Sea . The Greater London Council was abolished in 1986, leaving London with no central administration until 2000 and
3406-672: The Corn Laws in 1846 was specifically aimed at weakening Dutch economic power. London then overtook Amsterdam as the leading international financial centre. With the onset of the Industrial Revolution in Britain, an unprecedented growth in urbanisation took place, and the number of High Streets (the primary street for retail in Britain) rapidly grew. London was the world's largest city from about 1831 to 1925 , with
3537-539: The European Health Insurance Card . Those from other countries with which the UK has reciprocal arrangements also qualify for free treatment. Since 6 April 2015, non-EEA nationals who are subject to immigration control must have the immigration status of indefinite leave to remain at the time of treatment and be properly settled, to be considered ordinarily resident. People not ordinarily resident in
3668-568: The Georgian era , new districts such as Mayfair were formed in the west; new bridges over the Thames encouraged development in South London . In the east, the Port of London expanded downstream. London's development as an international financial centre matured for much of the 18th century. In 1762, George III acquired Buckingham House , which was enlarged over the next 75 years. During
3799-583: The Institute for Fiscal Studies had stated a 5% real-terms increase was needed for real change. Paul Johnson of the IFS said the 3.4% was greater than recent increases, but less than the long-term average. In July 2016, health experts said the money would "help stem further decline in the health service, but it's simply not enough to address the fundamental challenges facing the NHS, or fund essential improvements to services that are flagging." In November 2018, it
3930-634: The King's Road , Chelsea and Carnaby Street . The role of trendsetter revived in the punk era. In 1965 London's political boundaries were expanded in response to the growth of the urban area and a new Greater London Council was created. During The Troubles in Northern Ireland, London was hit from 1973 by bomb attacks by the Provisional Irish Republican Army . These attacks lasted for two decades, starting with
4061-687: The London Ambulance Service (LAS) NHS Trust , the largest free-at-the-point-of-use emergency ambulance service in the world. The London Air Ambulance charity operates in conjunction with the LAS where required. Her Majesty's Coastguard and the Royal National Lifeboat Institution operate on the River Thames , which is under the jurisdiction of the Port of London Authority from Teddington Lock to
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4192-782: The Mediterranean was normally through Antwerp and over the Alps ; any ships passing through the Strait of Gibraltar to or from England were likely to be Italian or Ragusan . The reopening of the Netherlands to English shipping in January 1565 spurred a burst of commercial activity. The Royal Exchange was founded. Mercantilism grew and monopoly traders such as the East India Company were founded as trade expanded to
4323-523: The National Health Service 's dependence from Third World medical graduates to European Union doctors, who may not be asked to submit to further examination. These subtleties of the British system of medical qualifications were rarely known to patients, who may have been more impressed to see "MB BS MRCS LRCP" on a brass plate than "MD FRCP". London London is the capital and largest city of both England and
4454-613: The New Model Army entered London in 1647, and they were levelled by Parliament the same year. London was plagued by disease in the early 17th century, culminating in the Great Plague of 1665–1666, which killed up to 100,000 people, or a fifth of the population. The Great Fire of London broke out in 1666 in Pudding Lane in the city and quickly swept through the wooden buildings. Rebuilding took over ten years and
4585-564: The New World . London became the main North Sea port, with migrants arriving from England and abroad. The population rose from about 50,000 in 1530 to about 225,000 in 1605. In the 16th century, William Shakespeare and his contemporaries lived in London during English Renaissance theatre . Shakespeare's Globe Theatre was constructed in 1599 in Southwark . Stage performances came to a halt in London when Puritan authorities shut down
4716-486: The Office for Budget Responsibility said that "the rising trend in health and social care spending and pensions will be adding something like another £75 billion spending over the next five years, £150 billion, potentially over the next decade" as if treatments are available to keep people alive longer, then people will want them. In July 2022, The Telegraph reported that the think tank Civitas found that health spending
4847-612: The Old Bailey bombing . Racial inequality was highlighted by the 1981 Brixton riot . Greater London's population declined in the decades after the Second World War, from an estimated peak of 8.6 million in 1939 to around 6.8 million in the 1980s. The principal ports for London moved downstream to Felixstowe and Tilbury , with the London Docklands area becoming a focus for regeneration, including
4978-662: The Second Barons' War , Simon de Montfort 's rebels killed 500 Jews while attempting to seize records of debts. During the Tudor period , the Reformation produced a gradual shift to Protestantism . Much of London property passed from church to private ownership, which accelerated trade and business in the city. In 1475, the Hanseatic League set up a main trading base ( kontor ) of England in London, called
5109-601: The Second World War . The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services , provided without charge for residents of the United Kingdom apart from dental treatment and optical care. In England , NHS patients have to pay prescription charges ; some, such as those aged over 60, or those on certain state benefits, are exempt. Taken together,
5240-606: The Socialist Medical Association , successfully proposed a resolution at the 1934 Labour Party Conference that the party should be committed to the establishment of a State Health Service. Following the 1942 Beveridge Report 's recommendation to create "comprehensive health and rehabilitation services for prevention and cure of disease", cross-party consensus emerged on introducing a National Health Service of some description. Conservative MP and Health Minister, Henry Willink later advanced this notion of
5371-585: The Stalhof or Steelyard . It remained until 1853, when the Hanseatic cities of Lübeck , Bremen and Hamburg sold the property to South Eastern Railway . Woollen cloth was shipped undyed and undressed from 14th/15th century London to the nearby shores of the Low Countries . Yet English maritime enterprise hardly reached beyond the seas of north-west Europe . The commercial route to Italy and
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5502-547: The Thames , its primary geographical feature, a navigable river which crosses the city from the south-west to the east. The Thames Valley is a flood plain surrounded by gently rolling hills including Parliament Hill , Addington Hills , and Primrose Hill . Historically London grew up at the lowest bridging point on the Thames. The Thames was once a much broader, shallower river with extensive marshlands ; at high tide, its shores reached five times their present width. Since
5633-660: The Tower of London ; the site featuring the Palace of Westminster , Church of St. Margaret , and Westminster Abbey ; and the historic settlement in Greenwich where the Royal Observatory defines the prime meridian (0° longitude ) and Greenwich Mean Time . Other landmarks include Buckingham Palace , the London Eye , Piccadilly Circus , St Paul's Cathedral , Tower Bridge , and Trafalgar Square . The city has
5764-541: The United Kingdom , with a population of 8,866,180 in 2022. The wider metropolitan area is the largest in Western Europe , with a population of 14.9 million. London stands on the River Thames in southeast England, at the head of a 50-mile (80 km) estuary down to the North Sea , and has been a major settlement for nearly 2,000 years. Its ancient core and financial centre , the City of London ,
5895-533: The Victorian era the Thames has been extensively embanked , and many of its London tributaries now flow underground . The Thames is a tidal river, and London is vulnerable to flooding. The threat has increased over time because of a slow but continuous rise in high water level caused by climate change and by the slow 'tilting' of the British Isles as a result of post-glacial rebound . London has
6026-476: The 'Centre for Health Economics' at the University of York found that between 2004/05 and 2016/17 the productivity of the NHS has increased nearly two and a half times as quickly as the larger economy. Between 2010 and 2017, there was a cap of 1% on pay rises for staff continuing in the same role. Unions representing doctors, dentists, nurses and other health professionals have called on the government to end
6157-569: The 11th century, London was clearly the largest town in England. Westminster Abbey , rebuilt in Romanesque style by King Edward the Confessor , was one of the grandest churches in Europe. Winchester had been the capital of Anglo-Saxon England , but from this time London became the main forum for foreign traders and the base for defence in time of war. In the view of Frank Stenton : "It had
6288-502: The 18th century, London was said to be dogged by crime, and the Bow Street Runners were established in 1750 as a professional police force. Epidemics during the 1720s and 30s saw most children born in the city die before reaching their fifth birthday. Coffee-houses became a popular place to debate ideas, as growing literacy and development of the printing press made news widely available, with Fleet Street becoming
6419-471: The City of London and the City of Westminster have city status . The City of London and the remainder of Greater London are both counties for the purposes of lieutenancies . The area of Greater London includes areas that are part of the historic counties of Middlesex , Kent , Surrey , Essex and Hertfordshire . More recently, Greater London has been defined as a region of England and in this context
6550-538: The City of London, historically split between the counties of Middlesex , Essex , Surrey , Kent , and Hertfordshire , which since 1965 has largely comprised the administrative area of Greater London , governed by 33 local authorities and the Greater London Authority . As one of the world's major global cities , London exerts a strong influence on world art , entertainment, fashion , commerce, finance, education , healthcare , media , science, technology, tourism , transport , and communications. Despite
6681-467: The EEA coming to the UK for a temporary stay of more than six months are required to pay an immigration health surcharge at the time of visa application, and will then be entitled to NHS treatment on the same basis as a resident. This includes overseas students with a visa to study at a recognised institution for six months or more, but not visitors on a tourist visa. In 2016 the surcharge was £200 per year, with exemptions and reductions in some cases. This
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#17327723252786812-486: The EU holding a valid European Health Insurance Card and persons from certain other countries with which the UK has reciprocal arrangements concerning health care can get emergency treatment without charge. The NHS is free at the point of use, for general practitioner (GP) and emergency treatment not including admission to hospital, to non-residents. People with the right to medical care in European Economic Area (EEA) nations are also entitled to free treatment by using
6943-403: The GP's health and that of their patients at risk. The Royal College of Physicians surveyed doctors across the UK, with two-thirds maintaining patient safety had deteriorated during the year to 2018: 80% feared they would be unable to provide safe patient care in the coming year while 84% felt that increased pressure on the NHS was demoralising the workforce. In June 2018, at a time when the NHS
7074-401: The Greenwich station was later disregarded as non-standard. Droughts can also, occasionally, be a problem, especially in summer, most recently in summer 2018, and with much drier than average conditions prevailing from May to December. However, the most consecutive days without rain was 73 days in the spring of 1893. National Health Service The National Health Service ( NHS ) is
7205-435: The London area. This called for the Corporation of the city to extend its jurisdiction and administration over expanding areas around the city. Fearing an attempt by the Crown to diminish the Liberties of London , coupled with a lack of interest in administering these additional areas or concern by city guilds of having to share power, caused the Corporation's "The Great Refusal", a decision which largely continues to account for
7336-417: The NHS England published the NHS Long Term Plan . The Guardian reported that data for 2020 suggests a change, and that the doctors' trade union and professional association , the BMA , say this was largely due to raised spending during the pandemic and the effect of Covid on the whole economy, since the GDP of the UK dropped more than that of all other G7 nations. The BMA also said in December 2022 that
7467-400: The NHS experienced "historical underfunding and under-resourcing" during the ten years before COVID. The King's Fund maintains The investment in services started in 2021 was badly needed, but despite it restoring key services and performance standards will require years. Shortages of workers and growing staff numbers experiencing burnout and thinking of leaving the NHS may stop progress. If
7598-446: The NHS has among the lowest numbers of doctors, nurses and hospital beds per capita in the western world. In May 2018, it was said that nurses within the NHS said that patient care was compromised by the shortage of nurses and the lack of experienced nurses with the necessary qualifications. In June 2018 it was reported that the NHS performed below average in preventing deaths from cancer, strokes and heart disease. In September 2018 it
7729-623: The NHS. The NHS is the largest employer in Europe, with one in every 25 adults in England working for the NHS. As of February 2023, NHS England employed 1.4 million staff. Nursing staff accounted for the largest cohort at more than 330,000 employees, followed by clinical support staff at 290,000, scientific and technical staff at 163,000 and doctors at 133,000. In June 2018, the Royal College of Physicians calculated that medical training places need to be increased from 7,500 to 15,000 by 2030 to take account of part-time working among other factors. At that time there were 47,800 consultants working in
7860-409: The Thames. Despite the evidence of scattered Brythonic settlements in the area, the first major settlement was founded by the Romans around 47 AD, about four years after their invasion of 43 AD. This only lasted until about 61 AD, when the Iceni tribe led by Queen Boudica stormed it and burnt it to the ground. The next planned incarnation of Londinium prospered, superseding Colchester as
7991-442: The UK are in general not entitled to free hospital treatment, with some exceptions such as refugees . People not ordinarily resident may be subject to an interview to establish their eligibility, which must be resolved before non-emergency treatment can commence. Patients who do not qualify for free treatment are asked to pay in advance or to sign a written undertaking to pay, except for emergency treatment. People from outside
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#17327723252788122-464: The UK can use the NHS without being asked to pay the full cost of the service, though NHS dentistry and optometry do have standard charges in each of the four national health services in the UK. In addition, most patients in England have to pay charges for prescriptions though some patients are exempted. Aneurin Bevan , in considering the provision of NHS services to overseas visitors wrote, in 1952, that it would be "unwise as well as mean to withhold
8253-404: The UK had increased by more than any country despite the significant drop in national income due to the COVID pandemic. The Labour Government elected in 2024 stated that their policy was that the "NHS is broken". They announced an immediate stocktake of current pressures and the reasons for them led by Labour peer Lord Ara Darzi. This was to be followed by development of a new "10 year plan" for
8384-456: The UK of which 15,700 were physicians. About 20% of consultants work less than full-time. Brexit , in 2020, was predicted to affect medical practitioners from EU countries who worked in the NHS, accounting for more than 1-in-10 doctors at the time. A 2017 survey suggested 60% of these doctors were considering leaving, with a record 17,197 EU staff leaving the NHS in 2016. The figures led to calls to reassure European workers over their future in
8515-438: The UK. A study by the Centre for Progressive Policy called for NHS trusts to become "exemplar employers" by improving social mobility and pay especially for those "trusts in poorer places where they can play a particularly large role in determining the economic wellbeing of the local population." They found the NHS to be " a middle ranking employer in comparison to other large organisations and falls short on social mobility and
8646-415: The United Kingdom's population and over 16% of England's population. The Greater London Built-up Area is the fourth-most populous in Europe, with about 9.8 million inhabitants as of 2011. The London metropolitan area is the third-most populous in Europe, with about 14 million inhabitants as of 2016, making London a megacity . Four World Heritage Sites are located in London: Kew Gardens ;
8777-405: The Viking incursions formally agreed by the Danish warlord , Guthrum and the West Saxon king Alfred the Great in 886. The Anglo-Saxon Chronicle records that Alfred "refounded" London in 886. Archaeological research shows this involved abandonment of Lundenwic and a revival of life and trade within the old Roman walls . London then grew slowly until a dramatic increase in about 950. By
8908-495: The cap on health service pay, claiming the cap is damaging the health service and damaging patient care. In 2017, the pay rise was likely to be below the level of inflation and to mean a real-terms pay cut. In 2017, the House of Commons Library research predicted that that real-terms NHS funding per head was to fall in 2018–19, and stay the same for two years afterwards. In January 2018, The Guardian reported that GPs faced excessive workloads throughout Britain and that this put
9039-437: The centre of the British press. The invasion of Amsterdam by Napoleonic armies led many financiers to relocate to London and the first London international issue was arranged in 1817. Around the same time, the Royal Navy became the world's leading war fleet, acting as a major deterrent to potential economic adversaries. Following a fire in 1838, the Royal Exchange was redesigned by William Tite and rebuilt in 1844. The repeal of
9170-425: The city's metropolis. The City of London at its core once comprised the whole settlement, but as its urban area grew, the Corporation of London resisted attempts to amalgamate the city with its suburbs , causing "London" to be defined several ways. Forty per cent of Greater London is covered by the London post town , in which 'London' forms part of postal addresses. The London telephone area code (020) covers
9301-412: The city, to intimidate the inhabitants. In 1097, William II began building Westminster Hall , near the abbey. It became the basis of a new Palace of Westminster . In the 12th century, the institutions of central government, which had hitherto followed the royal English court around the country, grew in size and sophistication and became increasingly fixed, for most purposes at Westminster , although
9432-600: The combined revenue expenditure by London councils and the GLA amounted to just over £22 billion (£14.7 billion for the boroughs and £7.4 billion for the GLA). The London Fire Brigade is the statutory fire and rescue service for Greater London, run by the London Fire and Emergency Planning Authority . It is the third largest fire service in the world. National Health Service ambulance services are provided by
9563-405: The comprehensive University College London . It is the most visited city in Europe and has the world's busiest city airport system . The London Underground is the world's oldest rapid transit system. London's diverse cultures encompass over 300 languages. The 2023 population of Greater London of just under 10 million made it Europe's third-most populous city , accounting for 13.4% of
9694-626: The creation of the Greater London Authority . To mark the 21st century, the Millennium Dome , London Eye and Millennium Bridge were constructed. On 6 July 2005 London was awarded the 2012 Summer Olympics , as the first city to stage the Olympic Games three times. On 7 July 2005, three London Underground trains and a double-decker bus were bombed in a series of terrorist attacks . In 2008, Time named London alongside New York City and Hong Kong as Nylonkong , hailing them as
9825-559: The creation of the London Underground , the world's first urban rail network . The Metropolitan Board of Works oversaw infrastructure expansion in the capital and some surrounding counties; it was abolished in 1889 when the London County Council was created out of county areas surrounding the capital. From the early years of the 20th century onwards, teashops were found on High Streets across London and
9956-592: The department is making 4,000 training positions available for GPs every year, which help create an extra 50 million appointments annually. In 2023, a report revealed that NHS staff had faced over 20,000 sexual misconduct from patients from 2017 to 2022 across 212 NHS Trusts. Some of the claims included rape, sexual harassment, stalking, and sexualised remarks at staff from patients. In the report, female staff members were told by hospitals to continue caring for patients even after there were issues regarding abuse or harassment without further safeguards in place. Other parts of
10087-713: The driest is 1921, with a total fall of 12.1 inches (308 mm). The average annual precipitation amounts to about 600mm, which is half the annual rainfall of New York City . Despite relatively low annual precipitation, London receives 109.6 rainy days on the 1.0mm threshold annually. London is vulnerable to climate change , and there is concern among hydrological experts that households may run out of water before 2050. Temperature extremes in London range from 40.2 °C (104.4 °F) at Heathrow on 19 July 2022 down to −17.4 °C (0.7 °F) at Northolt on 13 December 1981. Records for atmospheric pressure have been kept at London since 1692. The highest pressure ever reported
10218-633: The early 19th century law restricting medical employment in the British military to those who had qualifications in both medicine and surgery was taken to require diplomas from different organisations, it became customary to take both the Licence of the Society of Apothecaries (LSA) and the Membership of the Royal College of Surgeons of England (MRCS). These corporations diverged: the Society of Apothecaries added surgery to their examination, to grant
10349-609: The first Muslim mayor of a major Western capital. The mayor's statutory planning strategy is published as the London Plan , which was most recently revised in 2011. The local authorities are the councils of the 32 London boroughs and the City of London Corporation . They are responsible for most local services, such as local planning, schools, libraries, leisure and recreation, social services , local roads and refuse collection. Certain functions, such as waste management , are provided through joint arrangements. In 2009–2010
10480-457: The first of many controversies over changes to the NHS throughout its history. From its earliest days, the cultural history of the NHS has shown its place in British society reflected and debated in film, TV, cartoons and literature. The NHS had a prominent slot during the 2012 London Summer Olympics opening ceremony directed by Danny Boyle , being described as "the institution which more than any other unites our nation". Everyone living in
10611-603: The form the NHS finally took. Bevan's National Health Service was proposed in Westminster legislation for England and Wales from 1946 and Scotland from 1947, and the Northern Ireland Parliament 's Public Health Services Act 1947. NHS Wales was split from NHS (England) in 1969 when control was passed to the Secretary of State for Wales . According to one history of the NHS, "In some respects
10742-545: The former became known as the Triple Qualification . In the 19th century, the new University of London Bachelor of Medicine and Bachelor of Surgery degrees were regarded as more academic than the Royal Colleges' diplomas, so many people qualified and started practice with the Conjoint before taking the M.B. and B.S. a year or two later. This paralleled the practice in some European countries of taking
10873-424: The four services in 2015–16 employed around 1.6 million people with a combined budget of £136.7 billion. In 2024, the total health sector workforce across the United Kingdom was 1,499,368 making it the seventh largest employer and second largest non-military public organisation in the world. When purchasing consumables such as medications, the four healthcare services have significant market power that influences
11004-663: The free service from the visitor to Britain. How do we distinguish a visitor from anybody else? Are British citizens to carry means of identification everywhere to prove that they are not visitors? For if the sheep are to be separated from the goats both must be classified. What began as an attempt to keep the Health Service for ourselves would end by being a nuisance to everybody." The provision of free treatment to non-UK-residents, formerly interpreted liberally, has been increasingly restricted, with new overseas visitor hospital charging regulations introduced in 2015. Citizens of
11135-628: The global price, typically keeping prices lower. A small number of products are procured jointly through contracts shared between services. Several other countries directly rely on Britain's assessments for their own decisions on state-financed drug reimbursements. Calls for a "unified medical service" can be dated back to the Minority Report of the Royal Commission on the Poor Law in 1909. Somerville Hastings , President of
11266-466: The holder by custom to be addressed as "doctor" without holding a university doctorate: this privilege became generalised in the 19th century to all licentiates and Bachelors of Medicine. The nomenclature of the diplomas may have contributed to the nearly-obsolete practice of general practitioners styling themselves as "Physician and Surgeon": previously they were mostly regarded as Apothecaries . There were also Scottish and Irish conjoint qualifications:
11397-640: The location of its original headquarters in a road called Great Scotland Yard in Whitehall. The City of London has its own police force – the City of London Police . First worn by Met police officers in 1863, the custodian helmet has been called a "cultural icon" and a "symbol of British law enforcement". Introduced by the Met in 1929, the blue police telephone box (basis for the TARDIS in Doctor Who )
11528-409: The mayor's budget proposals each year. The GLA has responsibility for the majority of London's transport system through its functional arm Transport for London (TfL), it is responsible for overseeing the city's police and fire services, and also for setting a strategic vision for London on a range of issues. The headquarters of the GLA is City Hall , Newham. The mayor since 2016 has been Sadiq Khan ,
11659-705: The most museums , art galleries, libraries, and cultural venues in the UK, including the British Museum , National Gallery , Natural History Museum , Tate Modern , British Library , and numerous West End theatres. Important sporting events held in London include the FA Cup Final , the Wimbledon Tennis Championships , and the London Marathon . It became the first city to host three Summer Olympic Games upon hosting
11790-675: The most diverse cities in the world. In 1951, the Festival of Britain was held on the South Bank . The Great Smog of 1952 led to the Clean Air Act 1956 , which ended the " pea soup fogs " for which London had been notorious, and had earned it the nickname the "Big Smoke". Starting mainly in the mid-1960s, London became a centre for worldwide youth culture , exemplified by the Swinging London sub-culture associated with
11921-700: The needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay. Three years after the founding of the NHS, Bevan resigned from the Labour government in opposition to the introduction of charges for the provision of dentures, dentists, and glasses ; resigning in support was fellow minister and future Prime Minister Harold Wilson . The following year, Winston Churchill 's Conservative government introduced prescription fees. However, Wilson's government abolished them in 1965; they were later re-introduced but with exemptions for those on low income. These charges were
12052-451: The new funding is to be efficiently used the NHS will need a comprehensive and fully funded workforce strategy to ensure future supply of staff. In March 2022, Rishi Sunak doubled the annual efficiency target for the NHS in England. The 2.2 per cent target would deliver annual savings of saving of £4.75 billion. At the same time the additional Covid funding is being removed in 2022–23. At the same time Sir Charles Bean , recently leader of
12183-592: The new partnership as overdue, while Plaid Cymru criticized it as insufficient for addressing deeper issues within the Welsh NHS. There was a concern that a disorderly Brexit might have compromised patients' access to vital medicines. In February 2018, many medical organisations planned for a worst-case Brexit scenario because "time is running out" for a transition deal to follow the UK's formal exit that occurred in March 2019. Pharmaceutical organisations working with
12314-467: The number of GPs has fallen by 1,622. Some family doctors have 2,500 patients each, forcing patients to attend A&E instead. Certain regions have fewer than 50 GPs per 100,000 people, while other regions have more than 70, presenting a challenge to the NHS's founding principle of equal treatment. A growing number of family doctors are reporting unsustainable workloads, and many have chosen to work part-time. A Health and Social Care spokesperson said that
12445-467: The old Roman city. By about 680 the city had become a major port again, but there is little evidence of large-scale production. From the 820s repeated Viking assaults brought decline. Three are recorded; those in 851 and 886 succeeded, while the last, in 994, was rebuffed. The Vikings applied Danelaw over much of eastern and northern England, its boundary running roughly from London to Chester as an area of political and geographical control imposed by
12576-420: The past) are liable to charges for services. There are some other categories of people who are exempt from the residence requirements such as specific government workers and those in the armed forces stationed overseas. In 2016, the systems were 98.8% funded from general taxation and National Insurance contributions, plus small amounts from patient charges for some services. As of 2016, about 10% of GDP
12707-538: The patients. In wards which had not closed staff sometimes worked under stress due to staff shortages. It was also predicted then, that Brexit was likely to aggravate those problems. In November 2019, it was reported that due to the shortage of nurses the NHS was then relying on less qualified staff like healthcare assistants and nursing associates. For the period between 2010 and 2018 the Health Foundation funded research by Birmingham University said there
12838-425: The personal relationship between doctor and patient. Conservative MPs voted in favour of their amendment to Bevan's Bill to maintain local control and ownership of hospitals and against Bevan's plan for national ownership of all hospitals. The Labour government defeated Conservative amendments and went ahead with the NHS as it remains today; a single large national organisation (with devolved equivalents) which forced
12969-490: The principal city of the Roman province of Britannia in 100. At its height in the 2nd century, Roman London had a population of about 60,000. With the early 5th-century collapse of Roman rule, the walled city of Londinium was effectively abandoned, although Roman civilisation continued around St Martin-in-the-Fields until about 450. From about 500, an Anglo-Saxon settlement known as Lundenwic developed slightly west of
13100-448: The real Living Wage", and ranked trusts using a 'good employer index'. Ambulance trusts were ranked worst. On 6 June 2022, The Guardian said that a survey of more than 20,000 frontline staff by the nursing trade union and professional body, the Royal College of Nursing , found that only a quarter of shifts had the planned number of registered nurses on duty. The NHS is facing a shortage of general practitioners . From 2015 to 2022,
13231-419: The remaining 20% split between buildings, equipment, training costs, medical equipment, catering and cleaning. Nearly 80% of the total budget is distributed by local trusts in line with the particular health priorities in their areas. When the NHS was launched in 1948 it had a budget of £437 million (equivalent to £20.07 billion in 2023). In 2016–2017, the budget was £122.5 billion. In 1955/56 health spending
13362-437: The report showed that staff were pressured into not reporting grievances. In June 2023, the delayed NHS Long term Workforce Plan was announced, set up to train more doctors and nurses and create new roles within the health service. In 2024, multiple NHS hospitals started mandating radiographers to ask all male patients aged 12 to 55 if they were pregnant. This policy was instated as part of an 'inclusivity' drive and received
13493-466: The resources, and it was rapidly developing the dignity and the political self-consciousness appropriate to a national capital ." After winning the Battle of Hastings , William, Duke of Normandy was crowned King of England in newly completed Westminster Abbey on Christmas Day 1066. William built the Tower of London , the first of many such in England rebuilt in stone in the south-eastern corner of
13624-641: The rest of Britain, with Lyons , who opened the first of their chain of teashops in Piccadilly in 1894, leading the way. The tearooms, such as the Criterion in Piccadilly, became a popular meeting place for women from the suffrage movement. The city was the target of many attacks during the suffragette bombing and arson campaign , between 1912 and 1914, which saw historic landmarks such as Westminster Abbey and St Paul's Cathedral bombed. London
13755-460: The royal treasury came to rest in the Tower . While the City of Westminster developed into a true governmental capital, its distinct neighbour, the City of London , remained England's largest city and principal commercial centre and flourished under its own unique administration, the Corporation of London . In 1100, its population was some 18,000; by 1300 it had grown to nearly 100,000. With
13886-546: The sea. London is the seat of the Government of the United Kingdom . Many government departments, as well as the prime minister's residence at 10 Downing Street , are based close to the Palace of Westminster , particularly along Whitehall . There are 75 members of Parliament (MPs) from London; As of June 2024 , 59 are from the Labour Party , 9 are Conservatives , 6 are Liberal Democrats and one constituency
14017-424: The start of 2018 to mid April 2018. Funding cuts to police in London are likely to have contributed to this, though other factors are involved. However, homicide figures fell in 2022 with 109 recorded for the year, and the murder rate in London is much lower than other major cities around the world. London, also known as Greater London , is one of nine regions of England and the top subdivision covering most of
14148-693: The theatres in the 1640s. The ban on theatre was lifted during the Restoration in 1660, and London's oldest operating theatre, Drury Lane , opened in 1663 in what is now the West End theatre district. By the end of the Tudor period in 1603, London was still compact. There was an assassination attempt on James I in Westminster, in the Gunpowder Plot of 5 November 1605. In 1637, the government of Charles I attempted to reform administration in
14279-474: The times of the two exams would more than pay for the entry fee, and seniority in the officer corps was enhanced by those few months. The conjoint diploma of the London Royal Colleges ( Royal College of Surgeons of England and Royal College of Physicians of London ) was more reputable in its day, but after World War II, it was regarded as a practice exam before university finals. It provided
14410-431: The transfer of ownership of hospitals from local authorities and charities to the new NHS. Bevan's principle of ownership with no private sector involvement has since been diluted, with later Labour governments implementing large scale financing arrangements with private builders in private finance initiatives and joint ventures. At its launch by Bevan on 5 July 1948 it had at its heart three core principles: That it meet
14541-524: The umbrella term for the publicly funded healthcare systems of the United Kingdom , comprising the NHS in England, NHS Scotland and NHS Wales . Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 (NHS Wales /GIG Cymru was founded in 1969) as part of major social reforms following
14672-715: The unique governmental status of the City . In the English Civil War , the majority of Londoners supported the Parliamentary cause. After an initial advance by the Royalists in 1642, culminating in the battles of Brentford and Turnham Green , London was surrounded by a defensive perimeter wall known as the Lines of Communication . The lines were built by up to 20,000 people, and were completed in under two months. The fortifications failed their only test when
14803-537: The war had made things easier. In anticipation of massive air raid casualties, the Emergency Medical Service had brought the country's municipal and voluntary hospitals into one umbrella organisation, showing that a national hospital service was possible." Webster wrote in 2002 that "the Luftwaffe achieved in months what had defeated politicians and planners for at least two decades." The NHS
14934-639: The world's three most influential global cities . In January 2015, Greater London's population was estimated to be 8.63 million, its highest since 1939. During the Brexit referendum in 2016, the UK as a whole decided to leave the European Union , but most London constituencies voted for remaining. However, Britain's exit from the EU in early 2020 only marginally weakened London's position as an international financial centre. The administration of London
15065-413: The year to 2018. It was also said that some expressed doubt over whether May could carry out this proposed increase in funding. The next day, Health Secretary Jeremy Hunt backed the extra £20bn annual increase in NHS funding and responded to criticism by stating that taxation would be used to carry out the funding and that details would be revealed at the next budget. In June 2018 it was reported that
15196-957: Was bombed by the Germans in the First World War , and during the Second World War , the Blitz and other bombings by the German Luftwaffe killed over 30,000 Londoners, destroying large tracts of housing and other buildings across the city. The tomb of the Unknown Warrior , an unidentified member of the British armed forces killed during the First World War, was buried in Westminster Abbey on 11 November 1920. The Cenotaph , located in Whitehall ,
15327-454: Was 11.2% of the public services budget. In 2015/16 it was 29.7%. This equates to an average rise in spending over the full 60-year period of about 4% a year once inflation has been taken into account. Under the Blair government spending levels increased by around 6% a year on average. Between 2010 and 2017 spending growth was constrained to just over 1% a year. A 2019 report said that a study by
15458-417: Was born out of the ideal that healthcare should be available to all, regardless of wealth. Although being freely accessible regardless of wealth maintained Henry Willink 's principle of free healthcare for all, Conservative MPs were in favour of maintaining local administration of the NHS through existing arrangements with local authorities fearing that an NHS which owned hospitals on a national scale would lose
15589-536: Was costing about £10,000 per household in the UK. This, they said, reflected the third highest share of GDP of any nation in Europe. This was said to show that the UK "has one of the most costly health systems – and some of the worst outcomes". The findings were made before the government increased health spending significantly, with a 1.25% increase in National Insurance , in April 2022. Civitas said this showed evidence "runaway" spending as health spending in
15720-456: Was founded by the Romans as Londinium and has retained its medieval boundaries. The City of Westminster , to the west of the City of London, has been the centuries-long host of the national government and parliament . London grew rapidly in the 19th century , becoming the world's largest city at the time . Since the 19th century, the name "London" has referred to the metropolis around
15851-482: Was increased to £400 in 2018. The discounted rate for students and those on the Youth Mobility Scheme will increase from £150 to £300. From 15 January 2007, anyone who is working outside the UK as a missionary for an organisation with its principal place of business in the UK is fully exempt from NHS charges for services that would normally be provided free of charge to those resident in the UK. This
15982-547: Was insufficient and falling NHS capital spending that put patient care and put staff productivity at risk. The Health Foundation said that £3.5 billion more a year would be required to get capital spending to the OECD average. Spending limits were effecting service efficiency, and patient care. Shortages of equipment and equipment failures had an impact as did relying on ageing diagnostic equipment. In 2018, British Prime Minister Theresa May announced that NHS in England would receive
16113-437: Was once a common sight throughout London and regional cities in the UK. The British Transport Police are responsible for police services on National Rail , London Underground , Docklands Light Railway and Tramlink services. The Ministry of Defence Police is a special police force in London, which does not generally become involved with policing the general public. The UK's domestic counter-intelligence service ( MI5 )
16244-551: Was reported that Cancer Research UK maintained that more NHS cancer personnel were needed to enable the UK to catch up The NHS in England was expanding early diagnosis services with the goal of increasing the proportion of cancers diagnosed early (at stages 1 and 2) from 53% to 75% in the decade to 2028. In September 2018, it was reported that the NHS was the first health service in Europe to negotiate coverage for novel CAR-T cancer therapy, with agreement reached within 10 days of its European marketing authorisation. On 7 January 2019,
16375-462: Was reported that death rates from breast cancer were falling faster in Britain than in any other of the six largest countries in Europe, and were estimated then to have improved beyond the European average. In October 2018, according to Breast Cancer Care , 72% of NHS trusts across the UK did not provide dedicated specialist nurses for patients with incurable breast cancer." In September 2019 it
16506-479: Was reported that staff shortages at histology departments were delaying diagnosis and start of treatment for cancer patients. In England and Scotland cancer wards and children's wards have to close because the hospital cannot attract sufficient qualified doctors and nurses to run the wards safely. In November 2018 it was reported that cancer patients and child patients were having to travel very long distances to get treatment and their relatives had to travel far to visit
16637-424: Was short of doctors, foreign doctors were forced to leave the UK due to visa restrictions. A study reported in November 2018 found that a fifth of doctors had faced bullying from seniors in the previous year due to pressure at work. In May 2018 it was reported that the NHS was under-resourced compared to health provisions in other developed nations. A King's Fund study of OECD data from 21 nations, revealed that
16768-540: Was spent on health and was the most spent in the public sector. In 2019, the UK spent roughly 10.2% of GDP on healthcare compared to 11.7% in Germany and 11.1% in France. The money to pay for the NHS comes directly from taxation. The 2008/09 budget roughly equated to a contribution of £1,980 per person in the UK. Some 60% of the NHS budget is used to pay staff. A further 20% pays for pharmaceuticals and other supplies, with
16899-465: Was supervised by polymath Robert Hooke . In 1710, Christopher Wren 's masterpiece, St Paul's Cathedral , was completed, replacing its medieval predecessor that burned in the Great Fire of 1666. The dome of St Paul's dominated the London skyline for centuries, inspiring the artworks and writing of William Blake , with his 1789 poem " Holy Thursday " referring to 'the high dome of Pauls'. During
17030-501: Was thought that inflation may erode the real value of this funding increase. As part of the 2018 funding increase the UK Government asked the NHS in England to produce a 10-year plan as to how this funding would be used. In September 2019, it was reported that cancer survival rates in the UK had been rising fast but probably still lagged behind the best results internationally, mainly because of late diagnosis. In March 2019 it
17161-524: Was unveiled on the same day, and is the focal point for the National Service of Remembrance held annually on Remembrance Sunday , the closest Sunday to 11 November. The 1948 Summer Olympics were held at the original Wembley Stadium , while London was still recovering from the war. From the 1940s, London became home to many immigrants, primarily from Commonwealth countries such as Jamaica, India, Bangladesh and Pakistan, making London one of
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