Jon Bright (London, OK): Gill Morgan, Chief Exec of the NHS confederation, has said that Britain now effectively has 'four NHS' systems. She's even described their different characteristics, summarised in this Beeb table:
England - NHS market created whereby hospitals and community services have to compete with the private sector for patients, resulting in big falls in waiting times
Scotland - Doctors have much more of a say in services, with limited involvement from the private sector. Meanwhile, patients enjoy free personal care, unlike the means-tested systems elsewhere
Wales - Close working relationship between the NHS and local government, which has meant more innovation on public health, but less emphasis on waiting times
Northern Ireland - Somewhat hamstrung by political situation, but re-organisation of trusts pushed through and good integration between social care and NHS
What's interesting, apart from the fact that she doesn't list England as entirely a second class service (though admittedly her organisation doesn't exist to criticise the NHS outright), is that each system is beginning to develop unique characteristics. Are we (in England) responsible for demanding an emphasis on marketisation which drives down waiting times? Do the people of Wales prefer their close relations between NHS and local government to our ruthless neoliberal efficiency? Of course it's too early to say all this, and there's plenty of politicking going on as well - but it's interesting to speculate on how, given the opportunity, four different national health services might evolve into four different reflections of some sort of national identity.
Update: Just noticed as well that Cameron today is also calling for a system of fines for patients that catch 'superbugs' (fines for the hospitals they catch them in, that is). Is such a market led solution a) Typically British? b) Typically English? Welsh? Scottish? N. irish? c) Typically neoliberal? d) insert your own?
