UNITED KINGDOM
Quote here kpkp
pk pkpk pk ppkp
pk pkpk pkpk pk
kpkp pk pkpk pk
ppkp pk pkpk
pkpk pk kpkp pk
pkpk pk ppkp
pk pkpk pkpk pk
kpkp pk pkpk pk
ppkp pk pkpk
pkpk pk kpkp
Could you present two/three elements on
the impact of such reforms on hospital and/
or healthcare sectors that your organisation/
country has identified?
The first challenge concerns the monitoring of
costs when there is a market-based system
(production driven) while the demand for care
is constantly growing.
The new financial structure has had its
challenges. Doctors have formed separate medical
specialist companies within the hospital
structure. Hospitals have been struggling for
longer to find the best ways to incorporate such
companies within the hospitals. Nonetheless the
Dutch Health Authority (NZa) concluded in 2018
that this reform has had positive effects on this
cooperation (professionalisation, efficiency,
shared responsibility).
Decentralisation of tasks does not simply lead
to a reduction of costs. When you decentralise the
long-term care without transferring enough
funds, in the long run it might even have an
adverse effect. One example is the closing of
nursing homes, which led to a rise in the number
of vulnerable elderly patients in hospitals.
Mr Niall Dickson
HOPE Governor, NHS Confederation
Decentralisation
of tasks does
not simply lead
to a reduction
of costs. When
you decentralise
the long-term
care without
transferring
enough funds, in
the long run it
might even have
an adverse effect
Could you describe the last hospital and/
or healthcare reforms implemented in your
country in the past 5 years?
NHS Long-Term Plan
In January 2019, NHS England published the
Long-Term Plan, setting out a strategy for the
health service for the next ten years. It is a wide
ranging and ambitious document, articulating
a new service model with greater emphasis
on primary and community care; increased
emphasis on mental healthcare, prevention and
health inequalities; a clear focus on quality and
outcome improvement in areas where greater
progress is seen as necessary; some workforce
reforms; wholesale rebalancing of the NHS
relationship with digital services and significant
changes to the financial regime. The plan will be
achieved by:
• Doing things differently. Giving people more
control over their own health and the care they
receive, encourage more collaboration between
GPs, their teams and community services, as
primary care network, to increase the services
they can provide jointly. Increasing the focus on
NHS organisations working with their local
partners, as integrated care systems, to plan and
deliver services, which meet the needs of their
communities.
• Preventing illness and tackling health
inequalities. The NHS will increase its
contribution to tackling some of the most
significant causes of ill health, acting to help
people stop smoking, overcome drinking
problems and avoid Type 2 diabetes, with
a particular focus on the communities and
groups of people most affected by these
problems.
• Workforce. Increasing the NHS workforce,
training and recruiting more professionals
– including more clinical placements for
undergraduate nurses, more medical school
places, and more routes into the NHS such as
apprenticeships.
THE NETHERLANDS
Total current health expenditure as % of Gross Domestic Product (GDP)
General government/compulsory current health expenditure as % of total current health expenditure
Hospital current health expenditure, as % of total current health expenditure
Household out-of-pocket health expenditure as % of total current health expenditure
All hospital beds per 100,000 inhabitants
Acute care hospital beds per 100,000 inhabitants
Acute care admissions/discharges per 100 inhabitants
Average length of stay for acute care hospitals (bed-days)
Practising physicians per 100,000 inhabitants
Practising nurses per 100,000 inhabitants
24
HHE 2019 | hospitalhealthcare.com
2002
8.0%
65.5%
38.5%
8.4%
457.0
297.0
9.4
8.4
n.a.
783.0
2008 2016
9.5%
10.4%
81.7%
81.0%
32.1%
34.5%
10.7%
11.5%
470.0
363.0
310.0
320.0
11.0
9.7
6.0
5.0
n.a.
350.0
840.0
1,058.0