Britain Plans to Decentralize Health Care

[Synicus Maximus]

Source: NY times

LONDON — Perhaps the only consistent thing about Britain’s socialized health care system is that it is in a perpetual state of flux, its structure constantly changing as governments search for the elusive formula that will deliver the best care for the cheapest price while costs and demand escalate.

Even as the new coalition government said it would make enormous cuts in the public sector, it initially promised to leave health care alone. But in one of its most surprising moves so far, it has done the opposite, proposing what would be the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948.

Practical details of the plan are still sketchy. But its aim is clear: to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. Under the plan, $100 billion to $125 billion a year would be meted out to general practitioners, who would use the money to buy services from hospitals and other health care providers.

Read more: http://www.nytimes.com/2010/07/25/world/europe/25britain.html?_r=2&hp

[SnakeEyes]

1. Can someone from the UK

or with knowledge of what is going on there please explain? What's wrong with their system and why are they trying to change it? I thought it was a model for others. And the coalition government includes the lib-dems. Why would they support changes? The conservatives trying to change things isn't a surprise right?

[dipsydoodle]

3. Some of the changes had already occured

These days when you need treatment as an out patient you can pick one of the Private Hospitals if you wish.Changing over to paying the Doctors to do the administration is really no big deal. Previous governments had already stopped building hospitals and keeoing them on the governments books - they use
PFI's, Private Finance Initiatives , to build them then rent them back. There are however some oddities :

NHS pays £63bn for PFI hospitals ‘worth £11bn’

‘These figures reveal the disastrous reality of Labour’s stewardship of the NHS,’ said Lib Dem health spokesman Norman Lamb, who described hospitals across Britain being ‘mortgaged to the hilt’.

>

The first payments for hospital PFIs began in 1999 and the NHS still owes £58billion on 106 contracts over the next three decades.

V

But the Department of Health insisted PFI payments were for services such as cleaning, catering and maintenance as well as the initial building cost.

http://www.metro.co.uk/news/812132-nhs-pays-63bn-for-pfi-hospitals-worth-11bn

There is another side to that last para. Using private contractors removes the liablity for public sector pensions.

[Raggz]

7. The wealthy keep their medical care

Those who can afford private health insurance are not impacted so much.

These cuts will really hurt those who do not have private insurance.

[jwirr]

2. I like local control as long as it has some fed regulations. Also as

far as saving money it cuts out the top brass and thins out the bureaucracy so that the ones who actually do the work are in control. Front line doctors and nurses.

[glinda]

5. Friend of mine from the UK said that now the Doctors will

have to figure out the costs themselves. She is very upset at what has happened on all fronts since the Conservatives have taken over. She may loose her farm as a result of the changes.

[harmonicon]

12. but isn't that a horrible thing?

I certainly think it is. Why should those people be given even more work? Especially more work that they have no training for? As someone is brilliantly quoted in the NYT article says:

“It’s like getting your waiter to manage a restaurant,” Mr. Furness said. “The government is saying that G.P.’s know what the patient wants, just the way a waiter knows what you want to eat. But a waiter isn’t necessarily any good at ordering stock, managing the premises, talking to the chef — why would they be? They’re waiters.”

What I have always thought is so great about the NHS is that doctors and surgeons only have to worry about being doctors and surgeons. These proposed changes are potentially disastrous for patients in terms of receiving the care they need.

[ProgressiveProfessor]

4. As I understand it different localites already have different policies, This would only make it

worse.

[w4rma]

6. Looks like a bad and expensive plan. (nt)

[roamer65]

8. The CONS were out of power for so long for a reason.

Cameron will remind the British people why they put them out of power in 1997. They did not get a majority gov't because the vast majority of the British people do not trust them.

[SnakeEyes]

9. My question is...

How will it affect their coalition partner?

[harmonicon]

13. good question

I imagine that in the long term this deal will mean political suicide for the LibDems - it was a gamble from the beginning. Unless they break their agreement, as I understand it, they can abstain from voting on some of these proposals but cannot vote against them, which means that the Cons win, having a plurality of seats in parliament. I hope that at some point - and this would sure be that point for me - enough libdems will break ranks and vote against some of these things, forcing a new election. The first campaign ad I saw for this last election was Cameron's prep-school face and the words "I will never touch your NHS", or something to that effect. Woe to any fool who believed it.

[liberation]

11. The problem is that "new" labour has been governing almost like the "old" tories.

Just like the "new" Dems look, walk and quack like the "old" Repugs.

It is the new brave world, where you can pick any political party you want, as long as it is pro-corporate. Just like Ford Model Ts were offered in all those fancy different colors.

[2Design]

10. Ah yes - similar to the years before hilter came to power -

It is really heating up - glad I have no children who will have to live through this mean-spirited hateful time coming up in the guise of religion or any other bs

[Vinca]

14. Is it safe to assume that all the general practitioners are completely honest

and would not use large amounts of money for their own personal gain? Unlikely. Spread it out, break it up and next thing you know the Brits are begging for medical care just like us.