Pullen I
Royal Edinburgh Hospital.
BMJ. 1993 Mar 13;306(6879):710-2. doi: 10.1136/bmj.306.6879.710.
The implementation of the community care changes throughout the United Kingdom from 1 April will mark the culmination of a series of major health and social care reforms. The avowed aims of achieving value for money and improved consumer choice through the introduction of competitive internal markets have yet to be tested. The political complexion of Scotland means that any proposed change to the NHS has tended to be greeted with a mixture of suspicion and resistance. As a result very few self governing trusts and fundholding general practices exist north of the border. And although Scotland has not had a wide reaching policy of moving psychiatric patients out of hospitals, community care for mentally ill people has advanced spontaneously.
从4月1日起，全英国社区护理的实施将标志着一系列重大医疗和社会护理改革的高潮。通过引入竞争性内部市场来实现资金价值和改善消费者选择这一公开目标尚未得到检验。苏格兰的政治形势意味着，对国民保健制度的任何提议改革往往会遭到怀疑和抵制。因此，边境以北几乎不存在自治信托机构和基金持有型全科诊所。尽管苏格兰没有广泛推行将精神病患者迁出医院的政策，但针对精神疾病患者的社区护理却自然而然地发展起来了。
