Update from Across the Pond
I must be growing up... finally. I'm spending more time on LinkedIn than Facebook these days. I belong to groups relative to public health and to one called Physiotherapist UK as well. The chatter on the UK discussion board is disturbing.
For the past two years while living in England, I had blogged that Prime Minister David Cameron and his minister of health (then Andrew Lansley, recently replaced by Jeremy Hunt) were keen to "Liberate the NHS" from the bureaucracy accumulated over the years to be more like the market-driven health system we enjoy here in the USA. Hunt was the former minister of culture, a role obviously well suited to prepare him to run the world's fourth-largest employer with the remit of providing healthcare to an entire country. It gets worse.
Not long ago, the department of health passed "Any Qualified Provider," which in theory allows patients to choose who they want to provide their services, fostering controlled competition and improved outcomes. What has actually happened is the emergence of managed-care corporations that are passing on referrals from GPs to the lowest bidders. I've read reports of £13 per 30-minute session. There is no way any practice could survive on that!
However, with a glut of new graduates and limited work opportunities, some entrepreneurs are hiring these new, inexperienced therapists to provide all their services. One can't blame the new grads, they're desperate to work. These new services require GP orders for treatment, unlike the NHS-based work, which allowed me complete autonomy. The paperwork and administrative responsibilities have all increased as well. Outcomes? The only outcome being looked at right now is the immediate bottom line.
In the end, the therapists are working harder, for less, and have no support. The patients will suffer from impaired access to decent service and in the long run, the costs will be greater. It's essentially the same situation that we were in, here in the USA, when managed care started two decades ago.
Congratulations Mr. Cameron, you have advanced the health service to 1994!