How are reforms carried out?
Prof. Dr. Dr. Thomas Gerlinger is professor at AG 1: Health Systems, Health Policy and Health Sociology at the Faculty of Health Sciences at Bielefeld University
Born 1970, political and health scientist, substitute professor in the social and health department at the Gochschule Ludwigshafen am Rhein.
Continuity and Change under New Labor (1997 to 2010)Despite numerous criticisms from the opposition, the Labor government that followed in 1997, under the leadership of Tony Blair, retained the organizational establishment of an internal market in the National Health Service (NHS), but pushed more for the various professional groups in the national health service to work together.
In other areas, however, the government has set new priorities, particularly with the initiation of numerous programs to combat socially induced health inequalities, the importance of which was denied by the conservative previous government. In addition, the Labor government relied on a consistent state strategy to improve the quality of health care, whereby it established a whole series of new (quasi) state authorities.
"The NHS Plan" - a ten year plan to reinvent the NHSThe demographic change of modern societies, medical-technological innovations and the higher demands of patients and citizens towards the NHS make it essential, according to New Labor, to fundamentally reorganize the national health service. New Labor's health strategy focuses on strengthening primary health care over the traditional national health service, which is heavily influenced by hospitals. In 2000 the British government - legitimized by numerous, increasing health scandals and the media scandalized effects of the flu wave with overcrowded hospital corridors and hospital rooms in the winter of 1999/2000 - with the NHS plan ("The NHS Plan - A Plan for Investment, A Plan for Reform ") presented an ambitious ten-year plan with which the English national health service should be fundamentally modernized. The central cornerstones of New Labor's modernization strategy are:
- the fight against the waiting list problem by increasing the care capacities and above all an increase in the number of doctors and nurses in the English NHS
- improving the quality of health care, clinical outcomes and the health of the population
- a stronger interlinking of health and social care for older people against the background of demographic change
- a more intensive use of the capacities of the private sector to reduce waiting lists and to increase the options for patients and
- the establishment of a stronger patient orientation and patient voice in the national health service through new representation structures and more freedom of choice
In an international comparison, the share of public health expenditure in total health expenditure in Great Britain has increased significantly since the NHS plan was announced and went against the trend of decreasing importance of public health expenditure in Germany, the Netherlands and Sweden (see figure "Public health expenditure in Country comparison ").
literatureBaggott, Rob (2004): Health and Health Care in Britain. Third Edition, Houndsmill / New York
Baggott, Rob (2007): Understanding Health Policy, Bristol
Boyle, Séan (2011): Health Care Systems in Transition: United Kingdom (England), Copenhagen: European Observatory on Health Care Systems.
King's Fund (2006): An independent Audit of the NHS under Labor (1997-2005). London
Klein, Rudolf (2006): The new politics of the NHS. From creation to reinvention. Fifth Edition, Oxford / Seattle
Organization for Economic Co-Operation and Development (OECD) (2013): OECD Health Data 2013. http://www.oecd.org/berlin/themen/gesundheit.htm (accessed: November 26, 2013)
Talbot-Smith, Alison / Pollock, Allyson M. (2006): The new NHS. A guide, Milton Park / New York
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