Enquanto aqui se debate se o SNS sobrevive à custa do contribuinte e não à custa dos seus promotores, na Grã-Bretanha, pretende-se acabar com o tradicional NHS, que subsiste desde 1946. Nem Margareth Tatcher conseguiu ir tão longe, como David Cameron e o Ministro da Saúde britânico, Andrew Lansley, querem ir:
- Andrew Lansley will this week publish the biggest single bill in the history of the National Health Service – one far larger than the 1946 act that set the service up.
- It will, in effect, turn the NHS from what is still, broadly, a directly managed system of healthcare into something much more like a regulated industry of competing providers – and one over which the secretary of state will no longer have day-to-day control.
- “By 2014, the NHS will no longer be a system which still contains many of the characteristics of an organisation. For example, it still has a chief executive and a management chain that stretches out from the Department of Health. Instead it will be a regulated industry in which that management chain no longer exists.”
- “The secretary of state will no longer have the power to intervene in NHS organisations which will stand or fail on their own.
- “There will be a failure regime for hospitals and other providers. But there will be no power for the secretary of state to prop them up, or intervene if something goes badly wrong.
- And unless a service is designated as protected, it will also be possible for a hospital or other healthcare provider simply to stop providing a service or operating a site from which it can no longer make money.
- Mr Lansley is committed to allowing “any willing provider” to enter the NHS market. “But with a budget that is not growing, new organisations can only enter by displacing an existing provider,” Mr Edwards says. “So there will be pressure for exit.”
- The regulator will have a duty to promote competition. How vigorously or subtly it does so, and how far it allows hospitals, for example, to integrate community and GP services providing a complete chain of provision, will depend not just on what the bill says, but on the decisions taken by a chairman, chief executive and regulatory board that has yet to be appointed. The changes are, however, profound.
Mudança. Concorrência. Revolução? Veremos. Não se pode continuar como em Portugal, em que tudo é feito contra quem paga o serviço, que é o contribuinte. E tudo é feito para defender os interesses dos prestadores (médicos do SNS, Indústria farmacêutica, administradores hospitalares, burocratas do Ministério da Saúde, outros técnicos de saúde e vários Acordos com fornecedores).
