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Britain passes NHS reforms amid controversy

The British government’s highly controversial “Health and Social Care Bill” finally completed its bruising 15-month journey through the Houses of Parliament in March, in the teeth of opposition from doctors, nursing unions, public health professionals, and mounting public concern. The debate on the merits and implications of the proposals is far from over.

John Lister, AHCJ's European web coordinator, explains the restructuring of the publicly funded National Health Service, which will shift the pool of taxpayers’ money used to purchase services.

Controversy over breast implants spreads across Europe

John Lister
John Lister

By John Lister

British clinics delivering cosmetic surgery were thrown into crisis by the decision last month of the French government to fund the removal of thousands of breast implants manufactured by the now-closed French company Poly Implant Prostheses (PIP). The implants were found to have used industrial grade silicone made for use in mattresses.

In the story, John Lister explores the controversy of these breast implants in Europe, including the lack of data on how many women in the United Kingdom received the implants, how the UK's National Health Service has been drawn into the business of removing the implants and the regulatory system that allowed the implants in the first place.

Brief 'pause' in British government plans for NHS

The British Conservative-led coalition government is currently in the midst of a brief "pause" in its efforts to push through their sweeping restructuring of England's National Health Service. Health Secretary Andrew Lansley's Health and Social Care Bill is based, with minimal changes, on last July's White Paper "Liberating the NHS."

The bill was published as legislation in mid-January, and whizzed through the first stages of parliamentary procedures with little evidence that any MPs (or journalists) had read or understood it. For example, BBC summaries have for the most part ignored the bulk of the Bill's content to describe it as "plans to hand greater powers to GPs."

NICE official: Rumours of demise greatly exaggerated

Kalipso Chalkidou
Kalipso Chalkidou

Andrew Lansley, the United Kingdom's health secretary, recently announced plans to reorganize the National Institute for Health and Clinical Excellence (NICE), which was established to vet the cost-effectiveness of new drugs and treatments and give national guidance on whether they should be prescribed by doctors within Britain's National Health Service.

The announcement set off concerns among some about the potential for unequal access to drugs from one district to another. The British press warned of cases in which patients denied a drug by a doctor will shop around until they find a physician who will give them what they want.  

John Lister recently sat down with Kalipso Chalkidou, the international director of NICE, to find out what the changes really mean for the agency.

NICE loses power to control availability of drugs

U.K. Health Secretary Andrew Lansley has announced plans to strip the key power – deciding which drugs should be approved nationally – from The National Institute for Health and Clinical Excellence or NICE.

The institute was set up under Tony Blair's government to vet the cost-effectiveness of new drugs and treatments, and give national guidance on whether they should be prescribed by doctors within Britain's National Health Service.

Using evidence-based criteria, NICE quickly became a global leader in evaluating the benefits of new medicines, but angered drug companies when it blocked or delayed approval for a number of high cost drugs to treat cancer and rare medical conditions.

Turkey opts for costly hospital finance scheme

The Turkish government has begun to select bids for the first of a "large number" of major hospital projects, estimated at $5 billion over the next five years. But the Turkish government has opted for a system of financing based on a model that is causing major problems for hospitals in the United Kingdom.

London-based journalist John Lister writes that the British experience with hospitals funded through Private Finance Initiatives or  Public-Private Partnerships presents a cautionary tale for the Turkish government and others considering this model.

Irish protests continue over hospital cuts

Protests over the €1.23 billion spending cuts for health and children’s services imposed last year to combat a massive government deficit are growing in Ireland and even causing some ministers to rethink their positions.

Two Teachta Dálas, members of the lower house of the Irish Parliament, angered by health cuts are threatening to withdraw their support for the ruling coalition government. Mattie McGrath, a maverick TD for Tipperary, said his future support for the Fianna Fáil/Green/Progressive Democrat coalition for which he was elected would depend upon the future of South Tipperary General Hospital in Clonmel.

McGrath’s political break followed a similar announcement from the west coast, with Galway West Independent TD Noel Grealish announcing at a protest in Galway attended by some 350 people that he was withdrawing his support for the coalition.

England's National Health Service: Liberation or devastation?

Flag- EnglandThe British government has unveiled plans for sweeping and controversial changes to the National Health Service in England, which would see its workforce of about 1 million reduced to nearly nothing zero within five years, with a combination of large-scale cuts and job losses, and staff hived off to the private sector and 'social enterprises'. While services would still be available to all free at point of use, and funded from taxation, the NHS would effectively be reduced from a public service to a 'single payer' fund of taxpayers' money to be used to purchase health care from a range of private nonprofit and for-profit providers.

UK journalist John Lister lays out the situation for journalists who should be watching the developments.

OECD health policy: Seeking evidence for market reforms

Health Ministers from 30 of the world's richest countries, the Organization for Economic Cooperation and Development (OECD), will meet in Paris on Oct. 7 and 8 to discuss "Health system priorities in the aftermath of the crisis."

Austerity plans in Greece, Spain, Italy, Ireland and elsewhere demand outright cuts in spending, but will private providers help reduce costs or simply carve out services they see as profitable?

Journalists wanting to understand their own country's health services and the policies of their governments may find it useful to follow the debates leading up to the OECD conference. Here's some background that can help.

Case study: New effort to privatize health care in England

The new coalition government in the United Kingdom is expected to resume the process of outsourcing of primary care and community services, which employ about 250,000 people. Until recently these services were directly delivered in England by local Primary Care Trusts (PCTs) but they will now be opened up to bids from "any willing provider," including for-profit companies. Time will tell if this latest move toward privatizing some aspects of the National Health Service will bear fruit or will simply be expensive experiments in the end.

What health systems of other countries can teach us

An international roster of panelists at Health Journalism 2008 discussed the health care systems in Canada, England, the Netherlands and France. Attendees learned the four systems have little in common except that they all provide universal access to a certain level of care and each accounts for 10 percent or less of its nation's gross domestic product.