by Abdul-Kareem Ahmed
Several months after the U.S. finally “reformed” its healthcare system, Britain caught the bug and decided to do the same. Fortunately for premed students, it seems the fate of physicians is rosier in this round.
To understand the British healthcare system’s change, it is helpful to recollect the U.K. National Health Services’ inception and structure. The NHS was born out of the aftermath of World War II. Hospitals formerly run on a volunteer basis and often funded by the government were strung together under this new banner.
Today, but not for long, Britain enjoys socialized medicine, in the true sense of the term. Citizens pay a certain percentage in tax, which the government uses to provides healthcare for all citizens. Barring recurrent tax, everyone receives treatment free of charge and the allowable cost of a prescription drug is capped at $12, according to Time Magazine.
There are also caps in other parameters. You might have heard of a panel that puts a price tag on life, what some on this side of the Atlantic would call “death panels.” Ironically called NICE, the National Institute for Health and Clinical Excellence, it determines the permissible efficiency of treatment. That means in the interest of providing everyone health care, no treatment is eligible for funding if it costs more than $45,000 to extend one year of life.
Fortunately — or unfortunately depending on your belief system — all citizens are equal to one another; a year gained by an 85-year-old gentleman is equivalent to a year gained by a bonny boy of 12.
NHS services are commissioned to hospitals by trusts, which also overlook fiscal matters, all as deemed appropriate by the Department of Health. Trusts determine how, where and by whom patients are treated, and each covers a different region. It seems these same trusts will be no more in the near future.
Britain, but not the entire U.K., plans to decentralize its healthcare system. As a way to moderate the budget, the government plans to dispose of the trusts and other bureaucratic sector altogether. Anticipating an annual budget of $100-120 billion, a drastic fall from $160 billion, money will be distributed to general practitioners. These clinicians would use the money to fund services from hospitals and other providers, according to The New York Times.
Clinicians would determine which services to buy and be able to offer. Clinicians would be managing their own shop, sort of speak.
While the average clinician might happily await the plan’s implementation, others are more critical. For instance, eliminating the health bureaucracy means a major loss in jobs. Tens of thousands of jobs, at that, according to The New York Times. And then there is the concern that general practitioners will be entrenched in administrative work when there are clinical services to be delivered. Inescapably, the proposed plan puts considerable trust in personnel that were trained to treat, and not to manage.
However, these are only minor kinks that, with a little persistent ironing, will surely go right away. If this experiment holds strong, Britain will have found a way to cut costs and improve patient satisfaction. Secondly, the world will learn a little more on the versatility of clinicians. They might not just be technicians after all.