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.
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.
Britain Plans to Decentralize National Health Care
Decentralize ... is that the equivalent of the US terminology "privatize"? In the end, might makes right. Nothing has changed since the caveman.
the issue is as much about who controls and for whose benefit. Right now the NHS is run by medical staff for medical staff and patient comfort and convenience, let alone cost are way way down the list. Procedures require effective management for efficiency and, although in the medium term costs will be reduced, in the short term disruption costs may be very high with parallel practices to maintain continuity.
This requiress a centralised control of expensive expertise to manage.
Equally the choice of medicine may seem like a no-brainer, but cost effectiveness is best maintained centrally. there are treatments for cancer which are simply not cost effective, however attractive they may be. For instance there is a new cancer treatment which costs £50 K a month and prolongs life by about 6 - 9 months. If it was a cure, I would agree that it we pay the price. but it isn't, it simply lengthens the dying. Now, however much I can understand that a dying person might think that an extra day, let alone half a year is worth any price worth paying, across a population it simply cannot be justified.
those decisions at local level are political poison, careers can be ruined. but an national level they can be justified and enforced.
this policy is stupid, short-sighted, expensive and massively counter-productive. All in all, a typical poltician's intervention keep to the Fen Causeway
So, what is it that they propose to "decentralise"? By laying out pros and cons we risk inducing people to join the debate, and losing control of a process that only we fully understand. - Alan Greenspan
