Modernisation or reform? The NHS approach

As Australia reflects on healthcare directions after a quarter of a century of Medicare, what has the UK done to update its rather older National Health Service (NHS)? In 2000, the “NHS Plan” (www.nhs.uk/nationalplan/) set out an ambitious attempt at modernisation — “to give the people of Britain a health service fit for the 21st century”. It promised record investment and a number of defined dividends for that investment, such as extra hospital beds and more nurses and doctors. Modernisation became the catchword. A Modernisation Board was convened to oversee the process, a Modernisation Agency created to spread good practice, and a number of other organisations established. These include the National Institute for Clinical Excellence, which reviews drugs, new technology and procedures and then issues guidelines; and the Commission for Health Improvement (already re-engineered once), an independent inspection body that publishes reports, including performance ratings.