阅读下列短文，从每题所给的A、B、C和D项中，选出最佳选项，并在答题卡上将该项涂黑。

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 centre 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 neighbours.

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.

41. We can know from the first paragraph that ______________.

A. the original aim of the NHS was to provide equal basic health care for everybody

B. people didn’t have to pay for health care since the NHS was set up

C. patients were charged for receiving health care before 1948

D. the NHS was an organization which gave free advice to villagers

42. What do we know about the NHS?

A. It’s managed by the central government.

B. Its cost is mainly paid for by the National Insurance contributions.

C. It hires more people than any other unit in Europe.

D. Fewer patients go to its hospitals than before because they spend less on health care.

43. All the following statements about GPs are true except that they ____________.

A. take care of the local people’s health

B. often take part in competitions to see who is the best

C. work under high pressure nowadays

D. have more responsibilities than before

44. What does the underlined word “exempt” probably mean?

A. suffering B. different 　 C. prevented D. free

45. The biggest problem for the NHS is ______________.

A. many hospitals are too old to be used

B. some services are in the charge of individuals

C. more and more patients go to GPs for treatment

D. there is not enough money for further reform

【答案与解析】 41—45 CCBDD

国家保健中心由中央政府直接负责，但由地方当局管理。建立国家保健中心的最初目的

是为农村居民提供免费的基本健康护理，尤其儿童、孕妇等可享受免费治疗。

41. C。细节理解题。根据最后一自然段最后一句可知，建立国家保健中心的最初目的是为农村居民提供免费的基本健康护理，而不是针对所有的人，所以前两项错误。

42. C。细节理解题。根据第4自然段“The NHS is the biggest employer in Europe…”可知。从第二自然段第一句可以看出国家保健中心由中央政府直接负责，但由地方当局管理，所以A项错误。

43. B。细节理解题。根据最后一自然段话“and encouraging GPs to compete for patients”可知政府鼓励全科医生之间相互竞争，而不是让他们进行竞赛，看谁的医术高明。

44. D。猜测词义题。前面提到医生开药方及给病人治疗牙病需要收费，再结合but一词可推断儿童、孕妇等可享受免费治疗。

45. D。细节理解题。根据最后一自然段最后一句可知。