The National Health Service plan: Further reform of British health care?

Less than three years after initiating a series of health service reforms, the Blair government has launched another plan for the U.K. National Health Service. This article considers the origins and contents of the plan. A ma jor investment program is designed to bring health care spending up to Euro pean averages over the next five years. In return, the government seeks to challenge the existing settlement between organized medicine and the state through tighter regulatory control, altered contractual frameworks, and a n ew public-private concordat. The plan does not represent a radical change i n government policy but rather reaffirms existing approaches to increasing access to health services, integrating health and social care, and empoweri ng users. Notwithstanding arrangements to increase the autonomy of health s ervice organizations, the plan increases central control through a range of new bodies and regulatory frameworks. It represents an incremental adjustm ent of the existing tax-funded system. Should this reinvigoration of the st ate monopoly fail, alternative sources of funding will no doubt have to be reconsidered.