The UK’s National Health Service has a 100 billion pound (200 billion dollar) budget that is increasing opening to foreign private investment. The BBC is reporting that after a one year review, Lord Darzi, a British surgeon, has concluded that moving the socialistic NHS further towards a capital market will improve health care for all through greater competition.
At the heart of the plan, is the ability for companies to bid for the privilege of running poly-clinics (a multi-disciplinary primary care clinic). Recent announcements from the government stress that higher quality will be the backbone of the restructuring yet a central theme is expanded hours of operation and 7 day a week access. The plans have been denounced by physicians across the Britain and have been the target of petitions to the Prime Ministers office.
The recent decision to allow third-party control seems at odds with the decade long struggle to wrestle control from the local Hospital Trusts through report cards and performance based funding. Gordon Brown claims that lack of access is a won battle and the next front is quality of care.
The current decision seems to be another manner of further separating the patient and the payee. If the US healthcare system is flawed in its breadth of coverage it is responsive to paying consumers. In Canada, the arms-length separation of practitioner and funding maintains at least the illusion of free-market choice for the patients. The proposed system in the UK will create yet another layer of bureaucracy which loosens controls, stifles free-choice and costs money. As long as primary care providers are employees of the state run NHS, the government cannot deny the link between funding and poor quality. The same will not be true when the government holds a contract rather than the burden of care.
On the 60th anniversary of the NHS, Prime Minister Gordon Brown, has been injured in current polls and the NHS rates highly in the minds of Britons. He is calling for a “once-in-a-generation” change of the NHS hoping to shake the institutions current reputation and bolster his governments image. If privatization is the road he chooses to travel, he must hand the reins of choice back to the patient and with it direct accountability.