“The National Health Service is the closest thing the English have to a religion.”
(Nigel Lawson, former Tory chancellor)
Hearing this quote for the first time, it was clear to me, that the NHS is an important matter to the British people. There are several convincing reasons for this attitude towards the National Health Service. Currently, radical changes take place and maybe this is the proper time to ask whether these changes constitute an homage or heresy.
In the government´s NHS White Paper, “Equity and excellence: Liberating the NHS”, it says: “The NHS is a great national institution. The principles it was founded on are as important now as they were then: free at the point of use and available to everyone based on need, not ability to pay. But we believe that it can be so much better – for both patients and professionals.” (Liberating the NHS, Department of Health, 2010) Summarizing the changes in near future, we can take down the salient points: a patient-oriented service, measured against results of patients health conditions and an increased involvement of doctors and nurses in the decision-making process.
Fair enough, but let´s get straight down to the nitty-gritty. In order to extend patients choice on health services offered, the “liberated” NHS will provide the patient with the “choice of any willing provider”. The most competitive health care provider will create the best service, that´s the basic idea. This provider will do its best to do a heck of a job to mould the best service. But being a part of the private sector, its main concern can never be a patient-oriented but rather a profit-oriented point of view. Competition is a characteristic feature of the market economy. According to the allocation theory, the amount of money, a person is willing to pay, is a good indicator for allocation mechanism. Let me get this straight: that´s not really an issue, but only if the government is determined to focus on its core task: to retain the central idea of the NHS, namely being “available to everyone based on need, not ability to pay.”
Where do we go from here?
To be continued.