Has ‘Dr. Cameron’ got his diagnosis right?
The government is planning a major overhaul of the health service, where hospitals will become more like businesses. But is it the right cure?
‘These reforms aren’t about theory or ideology – they are about people’s lives, ’ said Prime Minister David Cameron this week as he unveiled new plans for the National Health Service (NHS).
The government claims that these reforms will put spending power into the hands of those who know what patients need: the doctors.
Critics say the change is poorly thought through, and too much, too soon.
Even those in the government are nervous. As one Senior Liberal Democrat said, 'There are three scenarios: it could be a disaster; it could be just about OK; or it could work. But I can’t think of a major reform where so many have regarded the outcome as so uncertain.’
So what changes are being proposed? The new ways of working will affect both doctors and hospitals, who now enter into a new business relationship with each other.
Doctors will be given 80% of the NHS’s £100 billion budget, and commission or 'buy' services for their patients; while hospitals will now compete with each other to treat these patients.
The government can point to some support from GPs. 140 groups of family doctors have agreed to take part in the new scheme.
But many others are opposed to the changes, including the NHS Confederation. This body represents the Royal College of GPs, the British Medical Association, trade unions and health service managers.
They call the proposals ‘extraordinarily risky’ and question the need for change. ‘The absence of any compelling story about why the reforms are necessary or how they will translate into improved outcomes is of concern.’
The government is wary of failure in this venture. Healthcare is an important issue for voters, which is why Mr Cameron’s Conservatives promised not to cut health spending before the election.
Critics say these NHS changes did not feature in their election manifesto, so voters have not approved them.
But for Cameron the time is now: 'Pretending that there is some 'easy option' of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction.'
The Coalition government says these health reforms will put money in the hands of local doctors, who know best what treatment to ‘buy’ for their patients.
Opponents are concerned that with hospitals competing for business in a price war, patient care will be the first casualty.
Is it the government’s job to look after us? Or are we prepared to trust our doctors – and hospitals keen for business?
- Do you think the government is responsible for our health care?
- ‘I want my hospital to see me as a patient – not a source of income.’ Discuss.
- Have a debate about health. Should the government pay for everyone, including those who eat too much, drink too much or smoke too much? If we don’t look after ourselves, why should the government?
- Yes – we need a health service that looks after everyone.
- No – people should pay for their own treatment.
- If you were Prime Minister, what would be your top three priorities for the country? Police? Education? Health care? Defence? The economy? Transport? The environment? Sport? Something else? Write a short speech to explain your point of view.
Some People Say...
“I believe in the survival of the fittest - whether its people or hospitals.”
What do you think?
Q & A
- I hear a lot about the NHS. But what is it?
- The National Health Service was created by the Labour government after the war, in 1945. The vision was to provide health care for all people, regardless of their income.
- Seems fair.
- It was, yes. Before that, you had to pay to see a doctor.
- So how will these proposals change that?
- Probably the biggest changes will take place in our hospitals. They’ll become businesses, depending on patients for their income. So they’ll only provide care that makes money.
- And if treatments don’t make money?
- They’ll stop doing them. Its predicted that many hospitals will close in the shake-up. Your doctor will have to shop around for the care you need. As patients, we may have to get used to travelling further to find the treatment we want.