The British National Health Service (NHS) was set up in 1948 and was designed to provide equal basic health care, free of charge, for everybody in the country. Before this time health care had to be paid for by individuals. Nowadays central government is directly responsible for the NHS, although it is administered by local health authorities. About 83 percent of the cost of the health service is paid for by general taxation and the rest is met from the National Insurance contributions paid by those in work. There are charges for prescription and dental care but many people, such as children, pregnant women, pensioners, and those on Income Support, are exempt from payment. Most people are registered with a local doctor (a GP, or General Practitioner) who is increasingly likely to be part of a health center which serves the community. As the population of Britain gets older, the hospital service now treats more patients than before, although patients spend less time in hospital. NHS hospitals—many of which were built in the nineteenth century — provide nearly half a million beds and have over 480, 000 medical staff. The NHS is the biggest employer in Europe although Britain actually spends less per person on health care than most of her European neighbors. During the 1980s there was considerable restructuring of the Health Service with an increased emphasis on managerial efficiency and the privatization of some services (for example, cleaning). At the end of the 1980s the government introduced proposals for further reform of the NHS, including allowing some hospitals to be self-governing, and encouraging GPs to compete for patients. Patients would be able to choose and change their family doctor more easily and GPs would have more financial responsibility. The political questions continue of how much money should be provided to support the NHS and where it should come from.