Britain Plans to Decentralize National Health Care

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.

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Posted in * International News & Commentary, England / UK

5 comments on “Britain Plans to Decentralize National Health Care

  1. Katherine says:

    But, no! Our new head of Medicaid/Medicare, who loves the NHS, says that only “leaders with plans” can make decisions about treatments and procedures. How could the NHS let him down at such a crucial moment?

  2. dwstroudmd+ says:

    NHS and BP … there’s a nagging reality in there just waiting to be capped (which you can take in a literalist sense or slang, either will do but the results will be similar).

  3. Branford says:

    And our new head of Medicaid/Medicare, Katherine, has a life-time guarantee of private insurance, bought and paid for. From Byron York’s column:

    The institute [a nonprofit organization Berwick founded, the Institute for Healthcare Improvement] has also been very good to Berwick personally. He received $2.3 million in compensation in 2008 (a figure that included retirement funds), and was paid $637,006 in 2007 and $585,008 in 2006. On top of that, investigators discovered a little-noticed paragraph in an audit report revealing that in 2003 the institute’s board of directors gave Berwick and his wife health coverage “from retirement until death.”

    Millions of Americans worry about securing coverage and paying for it. Berwick, who advocates rationing for the masses, will never be one of them. . .

  4. RichardKew says:

    The NHS is an easy target for those who are ideologically opposed to any kind of universal healthcare system, and I would be the first to admit that it certainly has its shortcomings — and I have now been using it for three years. Like every vast organization it needs regular overhauling, but then, in the three decades that I was served by the US healthcare ‘system,’ it too, seemed to be constantly under reconstruction with prices sky-rocketing and millions left uncovered. Also, having lived and worked in one of the centers of the hospital industry in the USA, there were (and probably still are) fortunes being made out of a system where rationing is not according to need but according to ability to pay.

    Another factor, too, about the NHS is not only that everyone is covered, but also there are none of those endless hassles dealing with insurance companies, payments, co-payments, what they will and will not cover, who owes what to who, etc, etc. If administration of the NHS is cumbersome, I shudder to think how many billions the de-centralized, profit-driven American system would save if it cut down some of the bureaucracy — but then there are vested commercial interests who would lose a lot of money if such a thing were to happen.

    Let me declare my experience and my interest. I have a daughter who is a physician in the USA, but was trained and began her career in the UK, so have looked at the comparative systems through her professional eyes. I have coverage in my present job in Cambridge, England, through the National Health Service, and in the USA through my wife’s healthcare insurance with her online job with Middle Tennessee State University. Tomorrow, as a US Citizen living abroad, I am to be interviewed by the Embassy in London for enrolment in Medicare, for which I become eligible next month — never have I been so well taken care of!

    Interestingly, there are thousands of American living and working in the Cambridge area and using the National Health Service, they are all sorts and conditions of men and women. I hear far less grumbling about healthcare from them than I used to hear from their peers living and working in the USA.

  5. Emma Grey says:

    Well sorry my language but that would be stupid! Why would they want to decentralize the public health care system? I’ve got my Kinesiotherapy diploma at Birmingham U. and now I work in the US at a massage Tucson facility. They already tripled the prices in the UK for one year of study, what are they thinking?