①When it was established, the National Health Service (NHS) was visionary: offering high- quality, timely care to meet the dominant needs of the population it served. Nearly 75 years on, with the UK facing very different health challenges, it is clear that the model is out of date.
②From life expectancy to cancer and infant mortality rates, we are lagging behind many of our peers. With more than 6.8 million on waitlists, healthcare is becoming increasingly inaccessible for those who cannot opt to pay for private treatment; and the cost of providing healthcare is increasingly squeezing our investment in other public services. As demand for healthcare continues to grow, pressures on the workforce — which is already near breaking point — will only become more acute.
③Many of the answers to the crisis in health and care are well rehearsed. We need to be much better at reducing and diverting demand on health services, rather than simply managing it. Much more needs to be invested in communities and primary care to reduce our reliance on hospitals. And capacity in social care needs to be greater, to support the growing number of people living with long-term conditions.
④Yet despite two decades of strategies and a number of major health reforms, we have failed to make meaningful progress on any of these aims. That is why the Reform think tank is launching a new programme of work entitled “Reimagining health”, supported by ten former health ministers. Together, we are calling for a much more open and honest conversation about the future of health in the UK, and an “urgent rethink” of the hospital-centric model we retain.
⑤This must begin with the question of how we maximise the health of the nation, rather than “fix” the NHS. It is estimated, for example, that healthcare accounts for only about 20% of health outcomes. Much more important are the places we live, work and socialise — yet there is no clear cross-government strategy for improving these social determinants of health. Worse, when policies like the national obesity strategy are scrapped, taxpayers are left with the hefty price tag of treating the illnesses, like diabetes, that result.
⑥Reform wants to ask how power and resources should be distributed in our health system. What health functions should remain at the centre, and what should be given to local leaders, often responsible for services that create health, and with a much better understanding of the needs of their populations?
1.1.According to the first two paragraphs, the NHS _
A is troubled by funding deficiencies.
B can hardly satisfy people’s needs.
C can barely retain its current employees.
D is rivalled by private medical services.
解析：选B。1.B细节理解题。第一段首句先提及NHS创立之初很有远见：提供优质、及时的护理，以满足全体国民的首要需求。下一句随即指出NHS的模式现在已经过时（暗示已经无法满足国民需求）。第二段第二句则明确指出，680多万人在排队等候，许多无力支付私立医疗费用的人越来越难以获得医疗保健服务。可见，作为公共医疗服务机构的NHS几乎不能满足人们对医疗保健服务的需求，选项准确概括第一段以及第二段第二句内容。故选B。
2.2.One answer to the crisis in health and care is to _
A boost the efficiency of hospitals.
B lighten the burden on social care.
C increase resources for primary care.
D reduce the pressure on communities.
解析：选C。2.C细节理解题。C选项契合第三段第三句所述办法“在社区护理和初级医疗方面投入更多”,其中increase对应文中的比较级Much more，resources契合文中invest这一行为的内涵（resources 指向“资金、物力、人力等资源”，invest指向“投入资金”）。故选C。
3.3.“Reimagining health” is aimed to
A reinforce hospital management.
B readjust healthcare regulations.
C restructure the health system.
D resume suspended health reforms.
解析：选C。3.C细节理解题。第四段第二句引出“重新构想健康”工作计划，第三句介绍该工作计划意在达成的目的：就英国医疗的未来进行更开放和更坦诚的对话并“迫切反思”以医院为中心的模式。选项体现其内涵：将目前以医院为中心的医疗体系（即资源、服务等集中在医院，患者的大多医疗需求要靠医院满足）调整为多层级、分散化的医疗服务模式（比如加强社区医疗、家庭医疗等）。故选C。
4.4.To maximise the nation’s health, the author suggests
A introducing relevant taxation policies.
B paying due attention to social factors.
C reevaluating major health outcomes.
D enhancing the quality of healthcare.
解析：选B。4.B推理判断题。第五段第一句指出，我们必须从“如何最大限度地增进国民健康”这一问题而非“修补”NHS入手。随后第二三句具体解释：影响国民健康最大的因素并非医疗保健，而是社会因素（生活、工作和社交场所），政府却未制定相关战略来改善这些决定性因素。换言之，要最大限度地增进国民健康，就应该对这些社会因素给予应有的关注，制定政策战略来改善国民的生活、工作和社交环境。选项契合这一逻辑关系。故选B。
5.5.It can be inferred that local leaders should
A exercise their power more reasonably.
B develop a stronger sense of responsibility.
C play a bigger role in the health system.
D understand people’s health needs better.
解析：选C。5.C推理判断题。第六段首句和第二句前半句点明改革智库提出的问题：我们的医疗体系应该如何分配权力和资源？哪些医疗职能应保留在中央，哪些应交由地方领导人？第二句后半句补充地方领导人（localleaders)）的优势：往往负责提供带来健康的服务，而且更了解当地民众的需求。结合前文可推断本段暗含的逻辑：当前英国医疗体系的权力和资源分配不均，主要集中在中央/国家层面的机构（如NHS），但地方领导人有其明显优势，因此医疗系统的权力和资源分配应适当向地方层面倾斜，让地方领导人发挥更大的作用。C项准确体现这一逻辑。故选C。
