This article reviews the experience of British social workers with the
National Health Service (NHS) to inform American social workers as th
ey advocate for changes in the U.S. health care system. The study focu
ses on the creation of the NHS in 1948, the development of local socia
l services departments in 1968, and the full implementation of communi
ty care in 1993. Of particular interest are the British view of health
care as a social service, the close relationship between the NHS and
local social services, the relationship between social workers and phy
sicians, and the impact of care management on social work. Although th
e current American political environment is not receptive to a social
orientation to health care, a bold policy position grounded in a socia
l context will provide a vision for the future.