An overview of the major healthcare issues across the pond
Healthcare reform in the UK has been in limelight due to the ongoing debate about overhauling the National Health Services (NHS), which has traditionally anchored the UK’s healthcare system. The Health and Social Care Bill, which was introduced to Parliament in January, is currently tabled. This bill that calls for NHS reform proposes:
· Shifting the responsibility of “commissioning” from Primary Care Trusts (PCTs) to General Practitioners (GPs)
· Launching an ‘NHS Information Revolution’ to enhance clinical informatics
· Promoting the use of “Shared Services”
Huge public outcry and lengthy political debates on health reform have exposed the weaknesses of the UK’s first coalition government. The UK government has traditionally been amongst the frontrunners in encouraging private sector participation in the healthcare industry. In 2003, when most EU nations had still not actively involved private healthcare players , the UK government engaged British Telecom and other service providers to create a centralized data spine and implement electronic care records. In 2011, this approach continues, with the UK government throwing open the door for competition between the public and private sectors as part of recently announced healthcare reforms.
But the current proposal for more public-private participation within the healthcare industry is raising considerable conflict as the private sector will not just be enablers of technology solutions for the public sector, but could also be actively involved in provisioning healthcare services. In fact, NHS hospitals, private firms and GPs will now be competing for the same patients. Plus, the rules capping revenues that public hospitals can earn from private patients will be scrapped to create a more competitive market for private care.
Additionally, the Commons' Public Accounts Committee (PAC) has raised concerns about the proposed healthcare reform, pointing out that the reorganization of the NHS takes the focus away from achieving £20 billion in efficiency gains by 2014-15 essential to bridge the gap between flat funding and rising demand for healthcare. The efficiency savings expected of individual hospitals to reach this goal is already on the rise. The Health Regulator Monitor released a letter to NHS foundation trusts on April 27, 2011, predicting that hospitals would need to make efficiency savings of up to 50 percent, which was higher than previous projections. This revision was made necessary because of higher than expected inflation levels and has far reaching implications. For example, the Hull and East Yorkshire Hospitals NHS Trust has to make £95 million in efficiency savings by 2015. This means axing 300 beds or reducing 2 wards every year till 2015!
The UK government committed to drive these reforms, while ensuring £20 billion in "efficiency savings". However, after the public backlash against the proposed NHS transformation, the government announced in April 2011 that it is re-thinking its earlier reform proposal. While reformation of the system is clearly necessary, the present re-think aims at strengthening safeguards and implementing measures to ensure that suppliers do not only provide profitable services and that competition is based on quality, rather than price. The coalition government is discussing:
· Measures to enhance transparency and increase GP’s accountability as they take on the commissioning responsibility
· New clauses to ensure that payments match the complexity of treatment so that “lucrative” treatments are not preferred over others
· Ways of implementing strict regulatory oversight by redefining the regulator’s role
Just goes to show the road to healthcare reform is rocky no matter where it is being implemented.
Richard Strong is Healthcare Director for Dell Services’ in the UK and has more than 25 years’ experience working in the healthcare and healthcare IT, both within the NHS and in the private sector. Having joined Dell (formally Perot Systems) in 2007, Richard has held a number of senior roles. As Healthcare Director, he created and developed Dell Service’s Healthcare Consulting practice and is currently responsible for all aspects of healthcare services in the UK.
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