Suchergebnisse

Why is there so much discontent about the current plans to reform the National Health Service in England? What is the government trying to do, and are the critics right to want to block reform? This paper traces the genesis of the current proposals in the Health and Social Care Bill, currently in the Lords, and why the Government has had to water down significant parts of it to appease the critics. The paper argues that the case for change has not been made to public or the 1.3 million staff in the NHS, the extent and timing of the reform is far from ideal given the need to make unprecedented efficiencies in the NHS, and that the political process to gain support has been weak. Yet many elements of the Bill push the NHS in the right direction, and without effective reform the original settlement—to provide equal access to care on the basis of need—is put at risk.

This paper reviews Labour's record on the NHS since the 1997 general election. The record shows increased financial investment especially since 2002, coupled with a marked centralisation of strategy and management which is proving counter‐productive to further modernisation.

The first term of the New Labour government was a period of change for the National Health Service. The program of change focused on improving the quality of the health care system, especially its responsiveness to patients, but several obstacles remain. First, there is a lack of funding, which the government has promised to rectify. Another problem is motivation. Competition is not an option in this system, so the government has fallen back to giving direct commands. While this approach has solved some problems, eg, long waiting lists, it leads to feelings of exclusion among system managers. The challenge now is to include these people & motivate them to help solve problems within the National Health Service. R. Larsen