The Future of the National Health Service
Even the British National Health Service is to be affected by the recession which has exhorted the coalition government to make savings in the social care; a total of £20bn by the end of 2015.This reform seems to disregard the fact that the demand for health services has increased, requiring the NHS to become 4% more productive each year. Yet the Health care system is to offset this needs with less budget, but also with more involvement from the private sector; involvement that has provoked the indignation of the public and GPs who considered this amendment as the opening of an Inter-Hospital competition.
According to the BBC, currently, the involvement of the private sector and charities in NHS is 5%; put it in perspective, £1 of every £20 spent in the NHS goes to a non-NHS provider. With the reform, the private sector will be more engaged with the Social care, this change is addressed by the government as an efficient reform in order to release pressures of NHS regarding costs and rationing. However, counterparts referred to the latter as the implementation of a market within the NHS that would leave no room for the articulation of the collective, leading to any decisions about the nature and location of major infrastructure to become impossible¹.
The past concerns predicted by the proponents, foresee a Health service wherein the element of competition would affect the efficient use of capital, making the latter less productive and deepening the waiting times problems. Dr Phil Hammond describe that in a struggle to reduce costs, the market of the NHS would be “picking the easy cases to decrease expenses” affecting the equity of the system: – the offer of individual patient choice would be exploited more effectively by better-off, better-educated, lower-need patients, and the fixed (average) price payment system would encourage discrimination against more costly, higher need patients².
Nevertheless, this more market-based approach is defended with the indicators of improvement from 1997 onwards that shows shorter waiting times, access to cardiac surgery and increases in overall satisfaction; favorable outcomes that are wrongly attributed to the introduction of the Market in the Social care back then. However, an insightful study shows that this trends follow the big increase in NHS funding and not the help of the former. In fact, there was an increase in capital costs due the implementation of the market reforms which were made, allegedly, to release the governmental expenditures.
The grass is greener on the other side; and when it comes to Social care, the country with the greenest grass is now looking to emulate other health care systems in which the grass is not as green as they think. European models like the one used in France, have a more market based approach with insurance models that is not as efficient as the English NHS. The British government wants to adopt reforms due the economic circumstances that let it to be excited at the prospect of a better health system, with less expenditures and more quality. But this prospect seems to clash with reality that has proven that the margins between Market and Health need to be kept wide. Otherwise, there will be exclusions as the byproduct of this mentioned intrusion in Health services. Affecting the decision making about the nature and location of infrastructure.
As Dr. Hammond acutely remarked: In the legislation for Integration Services, the word competition is written 68 times, the word cooperation 0 times and the word integration 0 times. This definitely reveals a pattern of a would be disintegration in the NHS if the reform go into effect. Provider competition might prevent the sort of collaboration between primary and secondary care that was increasingly being seen as the way to improve the care of people with complex, long-term health problems ³.
¹ ² ³ New labour’s Market Reforms (The king’s Fund)
Question Time 13/10/2011 (BBC)
From Dilnot to Delivery: The politics of social care reform (Richard Humphries.The Kings’Fund)
Q&A: Lords debatin NHS shake-up Bill (BBC)
According to the BBC, currently, the involvement of the private sector and charities in NHS is 5%; put it in perspective, £1 of every £20 spent in the NHS goes to a non-NHS provider. With the reform, the private sector will be more engaged with the Social care, this change is addressed by the government as an efficient reform in order to release pressures of NHS regarding costs and rationing. However, counterparts referred to the latter as the implementation of a market within the NHS that would leave no room for the articulation of the collective, leading to any decisions about the nature and location of major infrastructure to become impossible¹.
The past concerns predicted by the proponents, foresee a Health service wherein the element of competition would affect the efficient use of capital, making the latter less productive and deepening the waiting times problems. Dr Phil Hammond describe that in a struggle to reduce costs, the market of the NHS would be “picking the easy cases to decrease expenses” affecting the equity of the system: – the offer of individual patient choice would be exploited more effectively by better-off, better-educated, lower-need patients, and the fixed (average) price payment system would encourage discrimination against more costly, higher need patients².
Nevertheless, this more market-based approach is defended with the indicators of improvement from 1997 onwards that shows shorter waiting times, access to cardiac surgery and increases in overall satisfaction; favorable outcomes that are wrongly attributed to the introduction of the Market in the Social care back then. However, an insightful study shows that this trends follow the big increase in NHS funding and not the help of the former. In fact, there was an increase in capital costs due the implementation of the market reforms which were made, allegedly, to release the governmental expenditures.
The grass is greener on the other side; and when it comes to Social care, the country with the greenest grass is now looking to emulate other health care systems in which the grass is not as green as they think. European models like the one used in France, have a more market based approach with insurance models that is not as efficient as the English NHS. The British government wants to adopt reforms due the economic circumstances that let it to be excited at the prospect of a better health system, with less expenditures and more quality. But this prospect seems to clash with reality that has proven that the margins between Market and Health need to be kept wide. Otherwise, there will be exclusions as the byproduct of this mentioned intrusion in Health services. Affecting the decision making about the nature and location of infrastructure.
As Dr. Hammond acutely remarked: In the legislation for Integration Services, the word competition is written 68 times, the word cooperation 0 times and the word integration 0 times. This definitely reveals a pattern of a would be disintegration in the NHS if the reform go into effect. Provider competition might prevent the sort of collaboration between primary and secondary care that was increasingly being seen as the way to improve the care of people with complex, long-term health problems ³.
¹ ² ³ New labour’s Market Reforms (The king’s Fund)
Question Time 13/10/2011 (BBC)
From Dilnot to Delivery: The politics of social care reform (Richard Humphries.The Kings’Fund)
Q&A: Lords debatin NHS shake-up Bill (BBC)