Doctors' group calls for new ways to fund health care
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《英国医生杂志》
For the NHS to meet the expectations of patients in the future, it may need to be funded by a system of compulsory insurance or similar means, rather than through taxation, a new lobby group said last week.
Five hundred members of Doctors for Reform put their names to a full page advertisement in the Times last week (25 February, p 18), saying that the moment had come to look at new ways to supply and fund health care while keeping it equitably available.
"The NHS as we know it has had its day," said one of the group抯 founders, Professor Karol Sikora, in an interview with the paper. "Everything else we need today we can get very easily: air travel, holidays, cars. Why can抰 we get healthcare that easily? The form of funding is the key."
Countries such as France and Germany manage better with social insurance schemes, which allow greater choice and flexibility to patients, Doctors for Reform says. These systems "empower patients and offer real choice to all, including the most disadvantaged in society," the Times advertisement says.
Doctors for Reform was set up with the help of the think tank Reform. To coincide with the launch of the new group, it published results of an ICM poll showing that 69% of the public agree that "the NHS was the right idea when it was introduced in the 1940s, but Britain has changed and we need a different health care system now."
The poll found that 86% of the public do not object to hospitals or surgeries being run by the private sector, provided that everyone has access to care.
The BMA said the voices of 500 consultants had to be listened to. But Dr Paul Miller, chairman of the association抯 consultants committee, pointed out that the BMA抯 own report concluded in 2001 that alternative funding mechanisms would be more costly to run and would not provide equal access.
That view was also expressed in the 2002 Wanless report into the NHS, which focused on the need for greater investment and highlighted the shortage of doctors and nurses.
"Following the Wanless report, the government invested record funding into the NHS," Dr Miller said. "We are beginning to see the positive effects of this funding, but it must continue."
According to Paul Evans, director of the NHS Support Federation, how the NHS is funded is not the most important issue. The federation, whose 7000 members include about 3000 doctors, supports a system of health care financed from taxation.
"Essentially it抯 the wrong debate because what actually enables the health system to provide care to people when they need it is capacity," he told the BMJ. The success of countries such as France and Germany lie in the sheer number of doctors and nurses in their systems, Mr Evans said.
The Doctors for Reform group says that it is politically independent, but there have been accusations that it is supported by the Conservative Party. In the House of Commons on Thursday 26 February, Labour抯 Stephen McCabe (Birmingham Hall Green) called it "a Tory front organisation dedicated to undermining and dismantling the NHS."
"Surely members of this House have a right to know when a group parades as independent what its true political affiliations are, particularly where the issue is the sensitive one of health spending and protection of the values of the NHS," he said.
Tim Yeo, Shadow Secretary of State for Health and Education, said the government抯 response to the group was "outrageous." BBC news online quoted him as saying: "I find it hugely depressing that the government will not tolerate any other opinion on the NHS other than their own."(London Stephen Pincock)
Five hundred members of Doctors for Reform put their names to a full page advertisement in the Times last week (25 February, p 18), saying that the moment had come to look at new ways to supply and fund health care while keeping it equitably available.
"The NHS as we know it has had its day," said one of the group抯 founders, Professor Karol Sikora, in an interview with the paper. "Everything else we need today we can get very easily: air travel, holidays, cars. Why can抰 we get healthcare that easily? The form of funding is the key."
Countries such as France and Germany manage better with social insurance schemes, which allow greater choice and flexibility to patients, Doctors for Reform says. These systems "empower patients and offer real choice to all, including the most disadvantaged in society," the Times advertisement says.
Doctors for Reform was set up with the help of the think tank Reform. To coincide with the launch of the new group, it published results of an ICM poll showing that 69% of the public agree that "the NHS was the right idea when it was introduced in the 1940s, but Britain has changed and we need a different health care system now."
The poll found that 86% of the public do not object to hospitals or surgeries being run by the private sector, provided that everyone has access to care.
The BMA said the voices of 500 consultants had to be listened to. But Dr Paul Miller, chairman of the association抯 consultants committee, pointed out that the BMA抯 own report concluded in 2001 that alternative funding mechanisms would be more costly to run and would not provide equal access.
That view was also expressed in the 2002 Wanless report into the NHS, which focused on the need for greater investment and highlighted the shortage of doctors and nurses.
"Following the Wanless report, the government invested record funding into the NHS," Dr Miller said. "We are beginning to see the positive effects of this funding, but it must continue."
According to Paul Evans, director of the NHS Support Federation, how the NHS is funded is not the most important issue. The federation, whose 7000 members include about 3000 doctors, supports a system of health care financed from taxation.
"Essentially it抯 the wrong debate because what actually enables the health system to provide care to people when they need it is capacity," he told the BMJ. The success of countries such as France and Germany lie in the sheer number of doctors and nurses in their systems, Mr Evans said.
The Doctors for Reform group says that it is politically independent, but there have been accusations that it is supported by the Conservative Party. In the House of Commons on Thursday 26 February, Labour抯 Stephen McCabe (Birmingham Hall Green) called it "a Tory front organisation dedicated to undermining and dismantling the NHS."
"Surely members of this House have a right to know when a group parades as independent what its true political affiliations are, particularly where the issue is the sensitive one of health spending and protection of the values of the NHS," he said.
Tim Yeo, Shadow Secretary of State for Health and Education, said the government抯 response to the group was "outrageous." BBC news online quoted him as saying: "I find it hugely depressing that the government will not tolerate any other opinion on the NHS other than their own."(London Stephen Pincock)