Int J Health Serv. 2012;42(1):137-55. doi: 10.2190/HS.42.1l.
David Cameron's Conservative-led coalition government is pressing ahead with a highly controversial bill to "reform" the National Health Service (NHS), abolishing existing management structures, opening up provider services to private competition from "any qualified provider", and establishing a competitive market system in place of planning. The proposals fragment the structures and run counter to the founding principles of the NHS, which in 1948 transcended the limitations of markets, delivering health care on the basis of maximum risk sharing and universal access to services, free at the point of use. Evidence shows markets are a costly and inadequate mechanism to deliver universal and comprehensive health care, and private providers will only bid for services where profits are guaranteed. Opposition to the proposals is strong among health professionals and informed opinion, and the bill has divided the coalition parties--but time is running out for those who reject the bill to mount a sustained and concerted resistance.
戴维·卡梅伦领导的保守党联合政府正在推进一项极具争议的法案，以“改革”国民保健制度（NHS），废除现有的管理结构，将提供商服务向“任何合格的提供商”开放竞争，并建立竞争市场体系，取代规划。这些提议破坏了结构，违背了 NHS 的创始原则，NHS 于 1948 年超越了市场的局限性，在最大风险分担和普遍获得服务的基础上提供医疗保健，在使用点免费。有证据表明，市场是提供普遍和全面医疗保健的昂贵且不充分的机制，而且私营供应商只会在有利润保证的情况下竞标服务。该提案在卫生专业人员和知情意见中遭到强烈反对，该法案也使联合党派产生分歧——但对于那些反对该法案的人来说，要进行持续和一致的抵制，时间已经所剩无几。
