A new look NHS


According to the government, the driving force in the new health service is the patient. The theory goes like this: the English NHS is becoming like a market, with different NHS and private organisations competing against each other for business. Patients can supposedly shop around for their care, in the same way that they can choose between Tesco and Sainsbury's for their food. This choice, it is argued, will mean GPs, hospitals and health workers will raise their game and become more responsive. The health service will be remoulded around patients’ priorities.

In this vision, NHS staff are dismissed as 'producers' who are unwilling to change, while patients are the 'consumers' who are in the driving seat of NHS reform.

In reality, of course, all power is not with the patients. The key decisions are taken well above their heads – by ministers in Whitehall; by managers in Strategic Health Authority board meetings; by lawyers drafting contracts between the NHS and the private sector. A thousand decisions have been made, and millions of pounds spent, before the patient is presented with a limited choice of hospitals in which to have an operation.

This brave new world for the NHS is exemplified by the flood of 'independent' providers, with a number of US companies in the vanguard, eager to take over particular services.

See US Private Health Assault for the background.


 

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