I arrived here in London on Sunday morning to work with UK’s National Health Service on a new project around health and well-being and the big news in the UK today is a fundamental restructuring of the entire NHS. This is the equivalent of totally redesigning and restructuring the entire healthcare system. They can do this in the UK. And they can also deliver higher quality care at half the cost of our embarrassing mess of a “sickness industrial complex” in the US:
The NHS is to be slimmed down, smartened up and democratised to deliver better quality care, Andrew Lansley, the Health Secretary, announced yesterday.
Groups of GPs organised into consortia are to be given freedom and responsibility for buying care from local hospitals and other providers, including private organisations, in a major switch of purchasing power from central management to the surgery. They will control upwards of 70 per cent of the NHS budget, which will be managed by staff whom they will hire. The changes will not take full effect until 2013-14 and the incentives and penalties for failure have still to be clarified, but Mr Lansley said: “GPs can’t generate a surplus and pocket it, nor if they fail will they become personally liable.”
Patients will get more choice and control, including the freedom to register with any GP practice regardless of where they live, to choose any hospital to be treated in (as now) and any consultant, as private patients can. Unlike private patients, however, they may have to be content with seeing a member of the consultant’s team.
This will be backed by an “information revolution” to involve them in their care, ensure it is designed around them and achieve what Mr Lansley summed up in a new catchline: “No decisions about me, without me.” The losers in the reform are management, which is to be cut by more than 45 per cent over the next four years. The 302 Primary Care Trusts in England will by abolished by 2013, to be replaced by several hundred GP consortia; the number is not yet known. Strategic Health Authorities will also go. Other jobs will be at risk as the NHS must find £20bn of efficiency savings at the same time as it is driving through the reforms.