Wednesday, January 19, 2011

Cameron Moves Forward With Major NHS Reforms


U.K. Prime Minister David Cameron is currently pursuing major changes to Britain's National Health Service (NHS), the U.K.'s publicly funded health care system. Cameron is hoping to take advantage of the Conservative-Liberal Democrat coalition that came about following the 2010 election. Specifically, Cameron hopes to seize upon the Tories' (the conservative party) interest in free markets and choice, and the Liberal Democrats’ favor for localism. Cameron has put fears that he is seeking to break up the NHS to rest by proving that he is not a "traditional Tory" to many U.K. voters, as he protected the NHS from having to suffer budget cuts last year when the government cut £81 billion from public spending. Further, the other half of the coalition, the Liberal Democrats, are considered strong supporters of the NHS.

The reforms involve a major restructuring of the NHS. They aim to make efficiency savings of 4% over the next four years, amounting to £15-20 billion cost reduction. They will also eliminate primary care trusts (PCTs) and hand over £80 billion of the NHS budget to general practitioners (GPs), who will take on the responsibilities that are currently held by the PCTs, namely, to plan and buy local medical services. Under the new regime, the government would give GPs the funds to spend on local services by 2013. GPs would also determine whether to use NHS hospitals or private care. These reforms are controversial, as critics argue such radical changes will distract the NHS from its primary role in caring for the sick. Critics also argue that because GPs are businesspersons, the reforms will lead to increased privatization because they will give more business to private care providers.

The effect that these reforms will have on the NHS is staggering. As it currently stands, the NHS provides a directly managed system of healthcare. However, if this proposal goes through, it will become more like a regulated industry of competing providers. Further, the Secretary of State will no longer have day-to-day control over the operation of the NHS, nor will he or she be able to intervene if operations fail.

A report published by the Commons health select committee argues that the new plan creates "widespread uncertainty" that will ultimately increase health care costs. Money that was initially set aside to improve NHS services is now proposed to be used to pay for the management changes if the reforms go through, according to Stephen Dorrell, the committee's chairman. Other notable organizations, including the British Medical Association and the Royal College of Nursing warned that the reforms are "potentially disastrous."

Discussion Question: Do you think that the proposed reform will improve health care services in the U.K.?

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