The controversial reform of the NHS in England

England’s National Heath System (NHS) is currently undergoing its most significant structural reform since its creation in 1948. The reform has been widely criticized, particularly by doctors in public hospitals.

Championed by David Cameron’s government as of 2010 and adopted by Parliament on March 27, 2012 despite strong opposition, this reform aims to do away with direct Health Ministry oversight of the administration, thus “denationalizing the NHS,” in the words of Health Minister Andrew Lansley. It entrusts a substantial portion of NHS management to physicians, assembled in 212 Clinical Commissionning Boards (CCGs). The NHS will also be open to competition from the private sector, which will charge the same rates as the public sector for healthcare services. Thanks to this reform, the Health Ministry hopes to save £4.5 billion (€5.6 billion) in administrative costs by 2015.

Nonetheless, more than 90% of healthcare practitioners were opposed to this reform, which will require them to manage decentralized budgets on their own, as well as handle purchases and rationalize healthcare services for their patients. Doctors’ organizations express particular concern that such decentralization will destabilize NHS hospitals and aggravate health inequalities by exposing the system to market forces. Physicians are not alone in their support of the NHS; public opinion is particularly attached to the administration as well, and is likely to pay close attention to the application of the “Health and Social Care Act.”