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The National Health Service was established in the United Kingdom in 1948 as a universal, comprehensive service free at the point of delivery, which is publicly provided, funded, and accountable. Market incrementalism in England has eroded this system over three decades. The recently enacted Health and Care Act will erode it further. This article first explains briefly how legislation and policy initiatives in 1990, 2003, and 2012 furthered development of the market and private provision of health services, and then describes the main structural changes in the new Act and their implications. England is now moving decisively toward a marketized, two-tier, mixed-funding system with several similarities to the United States. [ABSTRACT FROM AUTHOR]

Objectives: To examine the impact of NHS-funded private provision on NHS provision, access and inequalities.Design: Ecological study using routinely collected NHS inpatient data.Setting: England.Participants: All individuals undergoing an NHS-funded elective hip arthroplasty in England from 2003/2004 to 2012/2013.Main Outcome Measures: Annual crude and standardised rates of hip arthroplasties per 100,000 population performed by NHS and private providers between 2004/2005 and 2012/2013.Results: Age standardised rates of hip arthroplasty increased from 116.4 (95% CI 115.4-117.4) to 148.7 (147.6-149.8) per 100,000 between 2004/2005 and 2012/2013. Provision shifted from NHS providers to private providers from 2007/2008; NHS provision decreased 8.6% and private provision increased 188% between 2007/2008 and 2012/2013. There is evidence of risk selection; private sector hip arthroplasties on NHS patients from the most affluent areas increased 228% from 10.8 (10.2-11.5) to 35.4 (34.3-36.5) per 100,000 compared to an increase of 186% from 8.8 (8.1-9.4) to 25.2 (24.1-26.4) per 100,000 among patients from the least affluent areas between 2007/2008 and 2012/2013. There was no statistically significant (p > 0.05) widening in any measure of inequality (absolute, relative difference and slope and relative slope of index inequality) in hip arthroplasty rates between 2004/2005 and 2012/2013.Conclusion: Private provision substituted for NHS provision and did not add to overall provision favouring patients living in the most affluent area. Continuing the trend towards private provision and reducing NHS provision is likely to result in risk selection and widening inequalities in provision of elective hip arthroplasty in England. [ABSTRACT FROM AUTHOR]

Under what circumstances can healthcare professionals issue a private prescription? This article explores the various options. [ABSTRACT FROM AUTHOR]

The authors describe the incremental approach to the marketisation of the English National Health Service (NHS) since the introduction of an 'internal market' in 1990 until the 2010 White Paper, 'Equity and Excellence: Liberating the NHS', and the subsequent Health and Social Care Bill published in January 2011. The introduction of a competitive market for a universal, tax-financed health system requires fundamental changes in regulation in order that market bureaucracy can be substituted for direct management. The components of reform are insufficiently captured by the framework of hierarchies and networks in new public management theories of decentralisation. [ABSTRACT FROM AUTHOR]

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 article reports that the U.S. Health and Social Care Act 2012 will replace the administrative structure of the NHS in England and its implications on existing routine data systems and the production of routine statistics. As stated, under the Act, unlike primary care trusts (PCTs), commissioning groups will no longer have responsibility for geographical areas and their practices will be able to recruit patients living anywhere in England. It also states that some health services for which PCTs are responsible will be out of the health service entirely or may be provided under the new public health system.

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.

Biomedical health services and health systems research require timely, complete, accurate and accessible data relating to geographical populations in order to facilitate needs assessment and planning of medical care, new medicines and technology. The international trend towards competition and privatisation has largely proceeded as if data generation were immune to market fragmentation and loss of universal coverage. By examining recent reforms to the English National Health Service, the authors show that this is not the case. Routine and population data are products of administrative systems and the nature, completeness and quality of data available to clinical and public health researchers are substantially impaired by market reforms. [ABSTRACT FROM AUTHOR]

The article presents the authors' view on the fate of the government agency the National Health Services (NHS). Topics discussed include the authors' opinion on the 2012 Health and Social Care Act and its impact in the government's healthcare services, the similarity of the care organizations created by the U.S. Affordable Care Act of 2010 to the clinical commissioning groups of Great Britain and the authors' call for the creation of a legislative bill to restore the NHS in Great Britain.

The article discusses the Francis inquiry into substandard care at Mid Staffordshire should make the government rethink its staffing policy. It mentions that Francis had strongly recommended training and regulation of staffing levels to improve the delivery of services. However, the Quality, Innovation, Productivity, and Prevention Programme (QIPP) is driving controversial service reconfigurations - cutting staff and closing emergency services and hospitals throughout England.

A letter is presented in response to the article "Dismantling the signposts to public health? NHS data under the Health and Social Care Act 2012" by Allyson M. Pollock, Alison Macfarlane and Sylvia Godden in the April 2012 issue; a response by Pollock and colleagues to this letter is also included.

The article offers information on Health and Social Care Bill. It mentions the significance of writing a letter to the House of Lords in the Great Britain to protect National Health Service (NHS) as the bill did not deliver quality and fairness. It mentions that the healthcare needs of the entire population has been evaluated by public health professionals. It also discusses several problems related to the bill which includes the abolishment of direct accountability.