Richard Hoey in the Health Care Blog on the latest iteration of reform of the NHS in England (reforms don’t apply to Scotland, Wales or N. Ireland). The system remains tax financed, with health care mostly free at the point of service, with a few exceptions, which has been the organizing principle of the system since its inception in 1947. The big reform ideas are:
….hugely controversial. Firstly, it abolishes a whole tier of NHS management and hands its powers instead to the family doctors at the frontline – the general practitioners, or GPs, as they are known here. Secondly, it loosens the constraints on the NHS’s internal market, providing scope for private companies to compete to run many more NHS services. The two reforms are intended to work together to drive efficiency across the health service, and the efficiencies required are pretty frightening – 4% a year for the next four years. (emphasis mine)
One of the knocks on the U.S. system of government is that it cannot make big changes like parliamentary systems can. The government in the U.K. is of course a parliamentary coalition between the Conservatives and Liberal Democrats, and due to shared power, no one got exactly what they wanted. As Hoey notes, that should sound familiar on this side of the Atlantic:
Just as with President Obama’s legislation, however, the real question will be whether it can achieve, in rather diluted form, what it was intended to do.