Liberating the NHS?

摘要

Reflecting on the 2006 NHS White Paper, Professor Stephenson (now President of the Royal College of Paediatrics and Child Health) observed that successive reforms stemmed from government determination to ensure National Health Service (NHS) Trusts should break even financially. He implied that this goal might be questionable, not least because children's services were likely to suffer disproportionately. We now have yet another White Paper ('Equity and Excellence: Liberating the NHS') proposing the most fundamental changes to the health service since its inception. If adopted, these proposals will establish a full healthcare market, with all hospitals becoming Foundation Trusts and being able to expand private patient beds without limit. For patients, 'integrated care' will follow the American pattern with a tripartite model of private ownership and management of hospitals, served by clinician networks and operating on insurance-based principles. While there is no mention in the White Paper of the role of consultants (clearly not seen as an important issue), it is already certain that pay, conditions and employment prospects for many NHS employees, including doctors, are likely to suffer in the name of 'efficiency' savings.