Yes, this is the point:
Campaigners\’ fears are not about pace and scale but about the underlying intent of the proposed legislation. It is clear now that the endgame is to transform the NHS into a system that finances but does not provide healthcare – a national insurance system which pays the bills while care is provided by competing private, publicly owned and voluntary organisations. There is nothing yet to suggest this has changed.
It has long been true that the French system has been ranked as the best in the world by the WHO and similar organisations. The French system is a system that finances but does not provide healthcare – a national insurance system which pays the bills while care is provided by competing private, publicly owned and voluntary organisations.
If we wish to have the best health care system in the world it doesn\’t seem all that odd that we might copy the structure of the best health care system in the world.
And yes, we do know that even the limited amount of competition currently found within the NHS does improve health care.
GP commissioning, seen by many as the heart of the reforms, is the bait with which Lansley hoped to reel in the GPs. Most have spotted the hook, and believe the price they are being asked to pay is too high. They recognise that they will be held responsible for cuts and rationing, and that that will do irreparable damage to the patient-doctor relationship. As one doctor noted: \”Do I want my GP to look at me as a patient, with a focus on curing my ailments, or as a business person focused on reducing costs and maximising income? For me it\’s simple, I prefer my GP to remain a GP.\”
Whether or not it\’s the GP who does the business calculations it is true that someone, somewhere, has to do them. One of the faults of the NHS as it is is that no one is in fact doing them. And given Hayek\’s point, that knowledge is local, the GPs probably are the right people to be performing this task: informed, on the spot, probably the best people (other than the patients themselves) to be doing it.
Yes, I\’m sure there will be problems with the reforms, the system is simply too large for there not to be. But the basic idea, the very point of it all, the introduction of more competition and that competition guided by the most informed people within the whole system, seems perfectly sensible to me.