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U.K.: Britain's National Health Service Facing Overhaul

  • Jan Jun

Britain's National Health Service has been criticized by both patients and the medical profession for years. The critics say it does not seem to be able to cope. All the successive governments have tried to improve the system, but results are few and far between. Last week, the British Medical Association and Health Secretary Alan Milburn unveiled yet another overhaul plan -- allegedly the most far reaching since 1960s.

London, 26 February 2003 (RFE/RL) -- British doctors have to work excessively long hours; nurses have to be recruited abroad, lately mainly in Asia; and hospitals are crowded. There are long waiting lists for operations and patients are now being sent for treatment to other countries, such as France and Belgium.

The British government seems to be trying its best to do something about the poor state of the National Health Service (NHS), yet critics say it is too little and too late.

On 21 February, the British Medical Association (BMA) and Health Secretary Alan Milburn unveiled yet another overhaul plan, this time aimed at helping the 36,000 doctors, the general practitioners, who suffer the burden of long hours, heavy workload, and sagging morale.

The plan would offer doctors higher pay that would be linked to the numbers of patients they see and the types of illnesses they treat. Doctors could also opt out of certain services, as well as night and weekend work. The doctors would have a month to decide whether to accept the proposal and vote on it.

Fiona Simpson, a spokesperson for the BMA, told RFE/RL that many doctors welcome the plan. "We have a major problem at the moment. We are very, very short of family doctors and we are hoping that this new investment in general practice, which is worth about 33 percent over the next three years, will really improve patient care and also improve the morale of doctors and improve the service," Simpson said.

Health Secretary Milburn has proposed that patients, starting in 2005, would be able to choose from four or five national health or private hospitals when in need of an operation or treatment.

This would fulfill a government promise to offer patients "greater choice and diversity" and increase overall medical standards. All the involved hospitals would be paid the same fee and would compete on speed and quality. At the same time, both private and foreign hospitals would temporarily receive higher payments until the NHS establishes a network of planned new surgery centers.

The government is looking to increase the amount of compulsory national-medical-insurance contributions by 1 percent, as the Treasury has indicated it may not have enough money available. In the meantime a medical staff union has claimed it wants an audit of the NHS. It alleges that, according to a survey, the number of public hospital beds has fallen by 20 percent over the past 13 years, while the number of managers in NHS hospitals increased by some 30 percent.

As for patients on long waiting lists, many of them have been sent abroad for treatment -- for example, to France. Just a few days ago the health secretary signed an agreement with his Belgian counterpart to allow for some 1,000 British NHS patients to be treated in hospitals in Belgium per year.

The snag is that the NHS reportedly will have to pay Belgian rates for treatment, plus the travel expenses, so it won't be cheap. The BMA's Fiona Simpson feels it is a needed short-term help. "In the long term, we would like to do all that work ourselves in our own NHS, but in the short term we are very grateful to have the help of our colleagues in other European countries," she said.

Experts hope that if the latest government plans work, some of the notorious cases of make-do improvisations, such one widely reported incident where a surgeon had to use a dessert spoon on a patient during a hip-replacement operation, could become the thing of the past.