Posted on Jan 20, 2011 by Sergio Ulloa
The UK Government published its 350-page health bill detailing the proposed reform of the established British National Healthcare System (NHS). Implementation of the plans contained in the bill and associated documents - released on the 19th January 2011 - will see an unprecedented reform of the British healthcare system.
The pro-market based shake-up of the UK healthcare system is expected to save the government many billions in the future and improve the delivery of patient care. The changes - reflecting the most significant upheaval of the NHS since its inception in 1948 - will be overseen by David Cameron's Coalition government. Under the new healthcare proposals, the government expects to save the UK taxpayer around £10 billion (US$ 15.7 billion) over the next decade.
As part of the new health legislation, private healthcare providers will see an increased opportunity to offer patient care through being allowed to compete with state funded NHS hospitals. The changes will see the government hand General Practitioners (GPs) 80 percent of the country's massive healthcare budget in a radical move to make the NHS more cost efficient.
A key part of the reform will result in 24,000 management staff involved with the current NHS being eliminated at a controversial initial outlay of £1.4 billion (US$ 2.2 billion). Out of the £1.4 billion, payments for staff redundancies will cost around £1 billion (US$ 1.57 billion), with another £400 million being spent on IT and property costs.
The government's proposals have been widely criticized especially the spending of such a large sum of money on changes, planned for implementation by 2013, at a time when austerity measures are being applied to other parts of the UK economy. However, the UK government contend that the initial financial outlay will be more than offset by long-term savings in running costs for this national institution. According to government calculations £5 billion (US$ 7.8 billion) will be saved by 2015 just by staff reductions.
Critics of the new health bill believe the reforms will be largely disruptive for the NHS and are unnecessary at a time when the government should be saving money rather than spending on changes.
Under the proposals published in the Health and Social Care Bill, the government plan aims to:
* Give GPs greater power and responsibility for buying care from hospitals, being allowed to form consortiums to carry this out.
* Give hospitals autonomy outside the control of the government body - the Department of Health. Under the new proposals, if a hospital fails it can be taken over by private operators in order to become financially efficient.
* Provide each region with a local HealthWatch organisation, which will ensure patients and carers have a voice.
* Introduce a 'Care Quality Commission' which will have the responsibility of ensuring all standards in the NHS are regulated and monitored. The commission will have powers to shut down any healthcare service failing to meet required standards.
* Introduce a hospital regulator with powers to decide how much hospitals receive for treatments. Additional powers will provide for the regulator issuance of licenses to healthcare providers and promoting competition within the healthcare sector.
The UK government is carrying out the reforms of the NHS partly to save expenditure on the NHS - where funding levels have increased significantly in recent years and are still considered inadequate - expecting to shed 4 percent from the national budget annually over the next four years. The other aspect of the reform is the modernization of the UK healthcare system as the country faces increasing medical costs due to an ageing, ailing population seeking access to more sophisticated but expensive medical treatments.
A major part of the proposals is the axing of Primary Care Trusts, which are part of the NHS primary healthcare services working at a community level. The Primary Care Trusts (PCTs) take up 80 percent of the overall NHS budget and, since created, have cost more to run in administration than the provision of front line patient care. The abolition of the PCTs is responsible for incurring the initial cost of £1 billion (US$ 1.57 billion) in redundancy payments, but once implemented is expected to save the NHS £1.7 billion (US$ 2.6 billion) every year.
The creation of new GP consortiums, with the responsibility for primary healthcare services, will be closely monitored through the HealthWatch network. The proposals highlight the emphasis on improvements to patient care, with patients having a greater choice in the supply of services. The GP consortiums will have a cap on administration costs and will be expected to do "more for less". A fundamental element of the creation of GP consortiums is to cut out middle management and bureaucracy and to speed up delivery of services on a more personal basis.
The expectation is that patients are unlikely to see much difference in the way healthcare services are provided in the short term, however, in the long term the government premise is that patient care will improve as a result of the changes being introduced.
So far as hospitals are concerned, the reforms will give them independence from the central government as they become Foundation Trusts. While hospitals are given greater autonomy, they are required to be efficient with the prospect of being taken over if they fail to deliver to the standards required. Part of the reforms will see no limits on the number of patients a hospital can treat, allowing hospitals to become more cost effective. As a safeguard, the healthcare regulator will have budget provisions for the retention of essential services if a Foundation Trust is relieved of responsibilities under the new process.
Private healthcare providers will be allowed to compete for the treatment of NHS patients under the proposals, with the scope to take over failing NHS hospitals. The pro-market based reform of the UK's NHS is expected to give the private healthcare sector good opportunities for growth with inclusion in the supply of medical services for the national system.
While there is considerable opposition to the proposals in the Health Bill, the UK government is intent on progressing with full implementation over the next two years, with pilot schemes already being put in place with selected GPs.