Britain to decentralize its socialized health care system

London - Britain's socialized medical system is about to be getting a huge overhaul. It will still be socialized, but the people managing the money will change.

Britain's health care system has always been in a state of flux. But the New York Times reports a new plan is now being formulated that promises a radical reorganization of a plan that has basically been in place since 1948. UK health secretary Andrew Lansley, is promising that this new plan will put more power in the hands of patients, and put local doctors in control of much of the national health budget. This may come as a shock to the British population, since when the new coalition government came to power it said it would make big cuts in the public sector, but initially promised to leave health care alone. The goal of this reorganization is to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. The plan, would shift $100 billion to $125 billion a year to general practitioners, who would buy services from hospitals and other health care providers. Part of a huge fallout from this plan would be jobs. Tens of thousands of people are expected to lose their jobs because several layers of bureaucracy would be thrown out. The government is hoping to amass $30 billion in emergency savings by the year 2014. A government white paper outlining the plan admits that these changes will create disruption and loss of jobs. But it indicated it would be worth it.

“The current architecture of the health system has developed piecemeal, involves duplication and is unwieldy. Liberating the N.H.S., and putting power in the hands of patients and clinicians, means we will be able to effect a radical simplification, and remove layers of management.”

Under this new plan, patients will have more power. Right now, how and where patients are treated, and by whom, is determined by 150 entities known as primary care trusts, all of which would be abolished under the plan, with some of those choices going to patients. It would also get rid of the many current government-set targets, like limits on how long patients have to wait for treatment. Critics say that the plans are too ambitious, particularly in the short period of time given, and they don't think that general practitioners are the right people to decide how the health care budget should be spent. In fact, it is assumed that many such groups will have to spend money in order to hire outside managers to manage their budgets and negotiate with the providers, thus canceling out some of the savings. David Furness, head of strategic development at the Social Market Foundation, a study group, said that under the plan, every general practitioner in London would, in effect, be responsible for a $3.4 million budget.

“It’s like getting your waiter to manage a restaurant. The government is saying that G.P.’s know what the patient wants, just the way a waiter knows what you want to eat. But a waiter isn’t necessarily any good at ordering stock, managing the premises, talking to the chef why would they be? They’re waiters.”

But general practitioner groups welcome the proposals. Professor Steve Field, chairman of the Royal College of General Practitioners, representing about 40,000 to 50,000 doctors in the country says.

“One of the great attractions of this is that it will be able to focus on what local people need. This is about clinicians taking responsibility for making these decisions.”