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This is a commentary on Gilbert and colleagues' (1) paper on morality and markets in the National Health Service (NHS). Morality and values are not ephemeral qualities and universal healthcare is not simply an aspiration; it has to be enshrined in law. The creation of the UK NHS in 1948 was underpinned by core legal duties which required a system of public funding and delivery to follow. The moral values of the citizens in support of social solidarity were thus transformed into a political and legal contract for citizens. The NHS still survives in Scotland, Wales and Northern Ireland but the coalition government abolished it in England in 2012, reducing the NHS to a funding stream, a logo and a set of market regulators. This paper describes and explains the Health and Social Care (HSC) Act 2012 in England and how the NHS is withering away and health services are being remodeled along US Health Maintenance Organization (HMO) lines. There was nothing moral about this extraordinary act of savagery and violence against the public in England, and against common values and widely held beliefs in public ownership funding and provision of universal healthcare. The public health consequences will be catastrophic which is why after the election on May seventh a new Bill is required to Reinstate the NHS and the Secretary of State's legal duty to provide listed health services throughout England. [ABSTRACT FROM AUTHOR]

Situation Reports (SitReps) is an internal Department of Health performance data collecting system. Although intended primarily for internal use, the data are also used to answer parliamentary questions, brief ministers and to inform national performance indicators. This paper reviews the data collection system and data-set, and shows how it can be used to evaluate delays in hospital discharge under the Community Care (Delayed Discharges etc.) Act 2003. However, limitations in the data include the fact that the data have only recently been extended to National Health Service (NHS) non-acute settings and do not include NHS patients in the private acute sector. Further, as the data-set derives from a weekly aggregate return rather than from individualized person-based records, it cannot be used to evaluate length of delay, or to link to other relevant data such as emergency readmissions. The provision of individualized data to facilitate linkage and extending coverage would increase its potential future use. Categories of delay should be further refined to facilitate monitoring of delays due to disputes about eligibility. [ABSTRACT FROM AUTHOR]

The authors describe the complexity of the financing arrangements of primary care premises. They explain how the early vision of integrating health and social services within local health centres failed to be realized, with GP-owned practice premises remaining as the dominant model. There was a switch to private finance when the government loan body (General Practice Finance Corporation) was privatized in 1989. Although capital can now be freely raised by the private sector for investment in the National Health Service (NHS), these debts have to be repaid through NHS funds or user charges. The complexity, combined with demographic factors, makes it likely that as GPs opt for the Personal Medical Services (PMS) scheme and a salaried service, the trend towards for-profit corporations owning and buying out GP premises will accelerate. [ABSTRACT FROM AUTHOR]

Focuses on independent nursing homes for the elderly in Great Britain. Examples of poor care in privatised nursing homes in the United States and Australia; Question whether the regulatory framework for nursing home in Great Britain offers adequate protection for patients; Suggestion that regulators, public bodies, and private providers must be directly accountable to the public and service users to ensure quality care.

Discusses the reasons why private finance is moving primary care into corporate ownership. Reasons for the establishment of the National Health Service (NHS) of Great Britain, to integrate primary care and health and social services in health centers; How the aim was compromised by the absence of public capital and the reluctance of the Treasury to buy out practice premises owned by general practitioners; Question about the extent to which planning, population needs and accountability are incorporated into the procurement process.

Addresses concerns in the United Kingdom of whether primary care trusts leads to United States-style health care. Ability of a National Health Service (NHS) body to charge for personal care and hotel costs; How government guidance on intermediate care restricts entitlement to NHS care to six weeks except in exceptional circumstances; Details of the incentive structure of the new system, which will force care trusts to find ways of constraining expenditure through rationing, user charges, and commercial activities.

The recent general election in Britain saw healthcare as the dominant issue amongst voters. The victorious Labour Party responded to this concern with a set of reforms designed to introduce greater private-sector involvement in the delivery of healthcare. These reforms are ill-thought-out. The standard of care in British private hospitals is below that found in public hospitals, whilst new contracting arrangements are likely to increase the administration costs within the system. Faith in private-sector management techniques is misplaced at a time when the real problem facing the NHS is that of capacity. The Labour Party is also committed to redefining some aspects of healthcare as a personal responsibility and not a right, moving Britain towards a more market-based healthcare system. [ABSTRACT FROM AUTHOR]

The World Trade Organisation (WTO) is drawing up regulatory proposals which could force governments to open up their public services to foreign investors and markets. As part of the General Agreement on Trade in Services (GATS) negotiations, the WTO working party on reform of domestic regulation is developing a regulatory reform agenda which could mark a new era of compulsion in international trade law. Article VI.4 of the GATS is being strengthened with the aim of requiring member states to show that they are employing least trade-restrictive policies. The legal tests under consideration would outlaw the use of non-market mechanisms such as cross-subsidisation, universal risk pooling, solidarity, and public accountability in the design, funding, and delivery of public services as being anti-competitive and restrictive to trade. The domestic policies of national governments will be subject to WTO rules, and if declared illegal, could lead to trade sanctions under the WTO disputes panel process. The USA and European Union, with the backing of their own multinational corporations, believe that these new powers will advantage their own economies. Health-care professionals and public-health activists must ensure that this secretive regulatory reform process is opened up for public debate. [ABSTRACT FROM AUTHOR]

Discusses issues on Britain's private finance initiative and the National Health Service (NHS). Arguments on the private finance initiative; Cost of the third wave of private finance initiative hospital schemes on planned private sector investment in the health service; Condition of creating alternative sources of funding with the NHS. INSET: Summary points.

Assesses the challenges of devolution on public health Wales and Scotland. Structure of the assemblies and their powers; Inequalities in health and wealth in both countries; Overview of public health in both countries; Party policies on health services.

The authors explain how the Private Finance Initiative (PFI) has raised the costs of infrastructure development in the health service. They demonstrate that the assumption that higher capital costs would be offset by savings resulting from the involvement of the private sector is wrong rather, NHS trusts and health authorities have been obliged to make savings on other budgets in order to make the high costs of investment affordable. There is no reason to believe that these problems will disappear as the volume of PFI investment increases. [ABSTRACT FROM AUTHOR]

Presents several letters on medical care in Great Britain. Impact of local managerial target setting in achieving improvements in health; Specification of the cut off point used in quoting years of life lost; Efficacy of using fluoxetine in suicidal patients .

The article discusses developments in the health care sector in Great Britain as of January 2014, particularly the role of special administrators in the reduction of National Health Service (NHS) hospital services. It focuses on the amendment for the Health and Social Care Act of 2012 that is being tackled by the British Parliament. The amendment aims to restore a partial planning function of the government in the health services sector.

The authors discuss the impact of the Health and Social Care Bill of 2011 on the National Health Service (NHS) in England. They note the bill's movement toward eliminating the NHS through the British Parliament, and facilitating the introduction of a U.S.-style health system. Moreover, the authors cite significant legal consequences of Bill which include weakening the accountability of the Secretary of State to Parliament for the provision of services to patients in the NHS.

Discusses a decision by the United Kingdom's Competition Commission that could make all contracting out and commissioning of health care by N.H.S. and social services subject to European Union competition law, rather than a matter for national public health policy. Tensions between the European Union's economic constitution and national control over healthcare policy because of healthcare reforms; Judgment by the United Kingdom tribunal that shows how the courts are moving the dividing line between economic and social activities; Implications of the judgment.

Discusses the choice extended to patients to choose among public and private health providers in Great Britain. Effort of Great Britain's National Health Service to engage more constructively with private sector; Implications for national control over health policy; Role of Great Britain's National Agreement on Trade in Services; Failure of Great Britain to protect its health policy.

Focuses on significance of public opinion to the people running the National Health Service (NHS) in Great Britain. Opinion of National Association of Health Authorities and Trusts on public consultation; Implications of threats to health services on NHS; Processes affecting the central tenets of NHS.

The article discusses three reports on the future of medical care in Great Britain namely, "Future Direction of Health Care," from the National Association of Health Authorities and Trusts, "Future Health Care Options," released by the Institute of Health Services Management and the survey of health policy makers. The first paper focused on how the National Health Service (NHS) deliver health care in the nation. The second report gave out suggestions for medical care such as social insurance and local taxation.

This article presents a letter to the editor in response to the article "Evidence not ideology," by Godlee that appeared in the October 8, 2005 issue of the "British Medical Journal."

Reports on the holding of the 1994 International Conference on Strategic Issues in Health Care Management in Scotland. Theme of the conference; Disappointment of the British orientation of the meeting; Narrow range of participants; Obstacles to the patient advocate role; Role of the internal market in priority setting.