JG: If you get sick in Britain, you go to the doctor or a hospital, you get treated, and pretty much never see a bill.
FW: We provide care for elderly people, for mothers-to-be, for newborn babies, for children, and we provide long-term care for certain groups of patients who have what we would describe as chronic illnesses.
JG: Fiona Wise is in charge of three London area hospitals. This one sees a million patients a year. The government sets targets for the health service, such as a maximum wait of eighteen weeks between diagnosis and an operation. Wise says patients are increasingly discerning.
FW: So, if you have high infection rates, or you're not meeting the 18-week target, or if you have a lot of things that go wrong that the public know about, then less people come to you.
MS: The cost for each service is fixed, and everyone in Britain is covered.
JG: Michael Summers works for the Patients' Association, a non-profit group that helps patients understand the National Health Service:
MS: It's relatively cheap for what you get and it's been in existence for 60 years, so it's well-established as a health service. And it works! It isn't perfect, but then, there's no country that has a perfect system.
JG: The association answers patients' questions and offers advice on how to get the best care from the national health network.
MS: It's vast, absolutely vast! It's the biggest employer in the country, said to employ more people than the Red Army, if that's a comparison. It is vast. It costs an enormous amount of money, but of course, it's funded from taxation and from the contributions made by patients.
JG: The sheer size of the system seems at the heart of many complaints: long waiting times, cancelled operations, poor nursing care. Errors by doctors who are either too pressed for time or inadequately trained are also a growing problem. Studies indicate up to 15% of all patients in Britain are diagnosed incorrectly or have ailments that are overlooked. While Britain's system means that everybody in the nation has healthcare, its critics say that some patients who need expensive or complicated treatments are left behind. Dr. Karel Sykora (phonetic) is a cancer specialist. He says the problem with the system is that there is no national standard to determine what medications or treatments are available. Local healthcare trusts decide what's covered.
KS: Each of them have a different philosophy about heart disease, about cancer, about mental illness. And so, the services you get for whatever it is you need depends critically on where you live. We call this “post-code prescribing”.
JG: Some patients have had to fight to get care when a trust rules a medicine or treatment is too expensive, even if it could prolong life.
KS: There has to be a boundary, but our boundaries are well below neighboring countries. The use of many modern cancer drugs are tenfold less here than in France, for example.
JG: A national healthcare system is an advantage at times like this, as Britain prepares for a possible swine flu pandemic. Liam Donaldson is the British government's Chief Medical Advisor:
LD: We can, if necessary, be very centralized. We can get stockpiles of antivirals, we can distribute them to people, we can put a vaccine program in place very quickly and get very high levels of coverage. And when we have shortages in one part of the country, of beds or intensive care beds, we can ensure that a network of services provides them in other parts of the country.
JG: As Britain's National Health Service enters its seventh decade, its biggest challenge is the mounting cost of new technology and drugs. While no one here thinks the service is going away, politicians may need to rethink how it will survive the next 60 years. Jennifer Glass for VOA News, London.
标题
Britain's NHS Cares for 60 million (VOA)
视频介绍
Voice of America - September 30, 2009
Analysis of the National Health Service in the United Kingdom.
