LONDON (Reuters) - Britain set out plans on Wednesday for a shake-up of its publicly-funded healthcare system that could turn into a political disaster for the ruling coalition if the reforms founder.
The head of the National Health Service (NHS), the world’s largest public healthcare system, has said the changes to how 80 billion pounds ($128 billion) are spent are so enormous they can be “seen from space.”
The reform is part of a series of radical changes to public services driven by a cost-cutting, Conservative-led coalition which took power last May.
Prime Minister David Cameron said expected rising demand for health services meant there was no alternative to modernizing the NHS, founded in 1948 promising cradle-to-grave healthcare for all and now employing 1.3 million people in England.
He said the reforms would save 1.7 billion pounds ($2.7 billion) a year now spent on bureaucracy, while enabling doctors to make local decisions in the best interests of their patients.
“This government is reforming the NHS so we have the best in Europe,” he told parliament.
But if the reforms misfire, Cameron risks undermining the work he has done to free his Conservative Party from a reputation for caring too little about the NHS.
The opposition Labour Party has long accused the Conservatives of preferring private over public health provision and is ready to exploit public dissatisfaction if hospitals start to close and queues for treatment lengthen.
The streets around parliament have been rocked by demonstrations against the coalition’s increases in student fees and disputes over the health service could prompt further protest.
Labour says Cameron has broken a promise made by the coalition government in May that it would stop “top-down” reorganizations of the NHS which impeded patient care.
Doctors and health unions say the changes are fraught with risk, coming as the service is being squeezed to find 20 billion pounds ($32 billion) of annual savings to pay for more expensive treatments and the needs of an aging population.
Under the proposals to reform the NHS in England, two layers of bureaucracy will be removed and responsibility for spending 80 billion pounds a year of hospital and specialist care passed to family doctors.
Private health providers will be able to compete with state-funded hospitals to offer treatment to patients, with a regulator monitoring quality of care.
The British Medical Association, a doctors’ union, said price competition could lead to patients suffering.
“With scarce resources there is a serious danger that the focus will be on cost, not quality,” it warned in a joint letter signed by six health unions.
The NHS commands widespread support among the British public and is being protected from deep spending cuts sought elsewhere to tackle a record budget deficit.
It’s ideal of free healthcare available to all still enjoys near-universal approval and remains unchanged by the reform.