Adam Smith Institute

Britain's tax funded health system is no longer the world's envy, but a quaint oddity. It will remain in financial crisis until we bring far more private spending on healthcare. Health costs cannot be met by taxation alone. The institute highlights three areas where funding could be changed. The first is competing funds where 'NHS tax' contributions are paid into a number of 'social insurance funds' of their own choice.The second is charges where there should be co-payments for some minor services, as already happens in europe. The third is cost,taking the responsibility for healthcare funding out of central government and handing it to private or non profit social insurance funds,will increase what we spend on healthcare.

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Professor Alain Enthoven is one of the world's leading health policy analysts. In this paper for ASI, he reflects gloomily on the prospects for real improvements in NHS delivery unless there are more radical reforms than the politicians are contemplating.

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The regulation of clinical practice must focus on the clinical service standards that are delivered to patients, and not on protecting professional self-interest. It must be accepted and trusted as such by the public. We envisage therefore a single regulatory authority that is independent of the healthcare professions. It should be dominated by lay representatives, and perhaps chaired by a lawyer rather than a clinician.

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5 per cent of doctors are estimated to be making the wrong decisions - that amounts to 5,000 doctors with 100,000 patients. There is a need for improved regulation of the medical profession with the emphasis centred on the patient. Currently the public is untrusting of the medical profession, This briefing paper sets out guidelines for a new shape to regulation.

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Despite a supportive government and half a century of above inflation inflation increases, the National Health Service is still under strain. In the past few weeks alone, doctors have critised it for long waiting times, diagnostic mistakes and it's poor record of treating heart disease, cancer and other serious diseases. Everyone accepts that we need to upgrade ond modernise Uk healthcare. But to do that most effectively we must develop a wider involvement in the process, with real partnerships between the NHS, the private sector and the patients themselves.

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