The lead Editorial in this week's Lancet says that the UK coalition government's Health and Social Care Bill will spell the end of the country's National Health Service (NHS) as we know it.
The Editorial compares the current government's proposal of allowing General Practitioners to control budgets to the UK Government's fundholding project in the 1990s. That project took years to implement and evidence of benefit was lacking. The Editorial says: "In the current Bill, health outcomes, including prevention of premature death, will be the responsibility of the NHS Commissioning Board, which has been asked to publish a business plan and annual reports on progress. That business plan is urgently needed to allow transparent appraisal of how the Board plans to monitor patients' outcomes."
The Lancet Editors also look back to an Editorial from 1948 when the NHS was formed that said: "Now that everyone is entitled to full medical care, the doctor can provide that care without thinking of his own profit or his patient's loss, and can allocate his efforts more according to medical priority. The money barrier has of course protected him against people who do not really require help, but it has also separated him from people who really do."
The Editorial says: "Now, GPs will return to the market place and will decide what care they can afford to provide for their patients, and who will be the provider... The ethos will become that of the individual providers, and will differ accordingly throughout England, replacing the philosophy of a genuinely national health service."
It concludes: "Health professionals cannot say that no change is needed—it most certainly is. But there is sufficient uncertainty and concern about the changes outlined in the Health and Social Care Bill to pause, to learn from the past, and to consider what the changes mean for patients' outcomes. As it stands, the UK Government's new Bill spells the end of the NHS."
Lancet Press Office. T) +44 (0) 20 7424 4949 E) tony.kirby@lancet.com
For full Editorials see: http://press.thelancet.com/editorials2901.pdf
For 1948 Editorial see: http://press.thelancet.com/lancet1948.pdf
Journal
The Lancet