London School of Hygiene and Tropical Medicine, London, United Kingdom.
Int J Health Serv. 2012;42(3):539-47. doi: 10.2190/HS.42.3.i.
Reforms to the British National Health Service introduce major changes to how health care will be delivered. The core elements include the creation of new purchaser organizations, Clinical Commissioning Groups, which unlike their predecessors will be able to recruit and reject general practices and their patients without geographical restriction. The Clinical Commissioning Groups are to transition from statutory bodies to freestanding organizations, with most of their functions privatized and an increasingly privatized system of provision, In this paper, we explore the likely consequences of these proposals, drawing in particular on the experience of managed care organizations in the United States, whose approach has influenced the English proposals extensively. We argue that the wrong lessons are being learned and the English reforms are likely to fundamentally undermine the principles on which the British National Health Service was founded.
英国国民医疗服务体系的改革对医疗保健的提供方式带来了重大变化。核心要素包括创建新的采购组织——临床委托团体，与以往不同的是，它们将能够不受地域限制招募和拒绝一般实践及其患者。临床委托团体将从法定机构过渡到独立组织，其大部分职能私有化，提供服务的系统日益私有化。在本文中，我们特别借鉴了美国管理式医疗组织的经验，探讨了这些建议可能带来的后果。我们认为，人们吸取了错误的教训，英国的改革可能从根本上破坏英国国民医疗服务体系建立的原则。
