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NHS Reforms Threaten Best Aspects of U.K. Patient Care

Changes to the U.K. National Health Service may fatally undermine patient-doctor relationship

FRIDAY, June 6 (HealthDay News) -- Changes under way in the U.K. National Health Service (NHS) threaten to destroy patient-led personal care that is at the heart of the organization's ethos and success, according to an article published in the June 7 issue of BMJ.

John Howie, M.D., of the University of Edinburgh in the United Kingdom, and colleagues describe their grave concern that government policy, which inevitably sees health on a population-wide basis, subjugates patients' needs, as does the concept of 'team care' whereby the traditional doctor-patient relationship is lost as aspects of care are contracted out to other health professionals.

Perverse incentives put measuring processes ahead of measuring outcomes, and all of these changes conspire to reduce learning opportunities for undergraduates and general practice registrars, the authors note. Added together, the reforms now under way undermine the best of the past with no proof of benefit, they add.

"Allowing these trends to continue unchallenged will result in the dismemberment of a primary care system that has been the envy of other countries. Patients will lose holistic care, doctors will lose job satisfaction, and the NHS will lose effectiveness and efficiency. As medicine changes, and the society it serves changes, evolution is inevitable and desirable. But in a complex organization such as the NHS, simplistic and unpiloted measures are likely to have unintended consequences," the authors write.

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