Royal College of Physicians, London, United Kingdom.
Ann Intern Med. 2011 Oct 4;155(7):465-9. doi: 10.7326/0003-4819-155-7-201110040-00009.
The general election in the United Kingdom in May 2010 resulted in the election of a new government, a coalition between Conservative and Liberal Democrat parties. Six weeks after the election, a white paper, "Equity and Excellence: Liberating the NHS," that proposed profound changes to the structure and organization of the health service was published. The change that generated the most discussion was the proposal that general practitioners be placed at the center of the system and given control of about 80% of the National Health Service's £100 billion budget. The proposals were greeted with considerable concern by many health care professionals, patient representatives, and the media. In response, the government organized an independent review, and proposals have been altered in response. This article outlines the current organization of the National Health Service, the rationale for change, and government proposals.
2010 年 5 月，英国举行大选，保守党和自由民主党联合组阁，新政府上台。大选结束六周后，发布了一份题为“公平与卓越：解放国民保健制度”的白皮书，提议对卫生服务的结构和组织进行深刻变革。其中最受关注的一项变革是建议将家庭医生置于体系的中心位置，并让他们控制国民保健制度约 1000 亿英镑预算中的 80%。这些提议引起了许多医疗保健专业人员、患者代表和媒体的极大关注。为此，政府组织了一次独立审查，相关提议也进行了调整。本文概述了国民保健制度的现行组织架构、变革的基本原理以及政府的提议。
