联合政府医改对医院方面影响_医改形势下医院发展

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NHS trusts（信托机构）bid to attract more private patients Hospitals bid to lure(吸引)paying patients after Andrew Lansley abolishes cap on revenues。在兰斯利取消对医院的经费照顾之后，医院将通过竞标吸引更多付费病人。Critics say he is encouraging private care.有批评者说他在鼓励私人医疗。

Elite NHS foundation trusts(不知道怎么翻译)are gearing up to lure private patients from home and abroad as health budgets are squeezed--a decision made poible after health secretary Andrew Lansley said he would abolish the cap limiting the proportion of total income hospitals can earn from the paying sick, research by the Guardian has shown.由于健康预算被压缩，医院准备吸引国内外的付费病人。

With a £20bn black hole opening up in NHS budgets, a group of top performing trusts are seeking to profit from paying patients and use the money to fund public healthcare in Britain.The Guardian contacted the top 10 NHS trusts in terms of private income after the health secretary proposed new freedoms and discovered proposals to build new wings and wards to cater for private patients, set up hospitals abroad and entice（怂恿，诱惑）medical tourists with airport-to-hospital bed services.因为有200亿英镑的预算赤字，一些顶尖的公费医院将探索从付费病人身上获利，然后将这些钱运用到公共医疗开支上。卫报就private income问题联系了顶尖的十个医院托拉斯，在卫生大臣兰斯利建议这些医院发挥自主性并且建立新的服务模式去迎合付费病人，建立海外医院和从机场到医院的病床服务。

Critics say that because Lansley has abolished targets to reduce waiting times and is encouraging private care, patients will be back to a system where those with cash can jump ahead of those in need.The chief executive of one of the largest NHS hospitals, speaking anonymously, said chasing new markets might also see management spread “too thinly and lose clinical oversight”.“Look at Great Ormond Street.They expanded up the road to Haringey Council and the Baby Peter tragedy happened on their watch,” said the chief executive.The hospital in London provided paediatric staff（儿科医生）to hospitals where Baby Peter was taken with fatal（致命的）injuries that are now known to have been deliberately inflicted（强加）.批评者说由于兰斯利取消了减少就医等待时间的目标，患者将回到那种有钱人可以比有需要的人先得到服务的状态中。最大的公费医院之一的一个匿名的负责人说追逐市场目标“不好”（下面举了一个婴儿peter死亡的例子）。

Labour says the policies give “a green light to let market forces run riot through the NHS”.Andrew Burnham, the shadow health secretary, said there was “a dangerous combination of lifting the cap on treating private patients and scrapping national waiting time standards,” adding: “With no limit on the amount hospitals can earn from seeing private patients, NHS patients can be made to wait.And as waits grow, people will be forced to consider paying for their care.It's the same old Tory NHS choice – wait longer or pay to go private.”

工党批评说为这一政策是为市场力量管理NHS开放绿灯，但这样做会导致全民医疗保健系统的混乱。影子卫生大臣安迪·博涵（Andy Burham）表示改革将会是一个“巨大的赌博”，因为没有限制医院从付费病人获利的标准，公费医疗病人将被迫等待。随着等待时间的增加，人们可能会被强制考虑付费医疗。这是保守党一贯的医改作风——要不就等着，要不就付费。

But despite concerns that the NHS will wither as private medicine booms, Caroline Shaw, of Manchester's Christie hospital, Europe's largest cancer centre, said it would treble（三倍的）its private income from £10m to £30m within a decade after making a deal last month with the biggest private hospital group in the world, HCA.The deal will see the US-based HCA – which owns six private hospitals in London – pay £14m for a new private cancer centre at Christie.Shaw said staff voiced doubts until they realised half the income went back into the NHS.“We are full of top academics and researchers, so we had to explain we are not losing our values or morals.But we are getting new facilities and it's a 50:50 split of income.I am only half joking when I say we are the new Robin Hoods（罗宾汉）, taking from the rich to pay for the poor.” 尽管随着私人医疗的繁荣公费医疗将衰落，但Caroline Shaw说这将使医院的private income在十年内变为原来的三倍，从一千万英镑增加到三千万英镑。他认为这一措施是劫富济贫。

Others have gone shopping acro the world for rich patients.The Royal Brompton and Harefield, the UK's largest cardio-respiratory centre, devotes an entire section on its website to marketing its “personalised, world-cla service” offering patients a city guide and suggesting trips to the “high-end shopping facilities” of nearby Sloane Street and Harrods.It has emerged that removing the limit on private patients, put in place by Labour, is central to Lansley's reforms.Last week the department of health put out a consultation paper calling for the lifting of the “arbitrary, ill-thought-through cap on [hospitals'] private income...[to let] the NHS to take proper advantage, for the benefit of this country, of the power of its brand abroad”.Many have taken the health secretary at his word and are targeting the rich in Ruia and the Middle East.It is now planning another hospital in oil-rich Abu Dhabi.Moorfields, the eye hospital, opened for busine in Dubai and in three years has seen patient numbers jump five-fold to 9,700.Moorfields' total income from private patients tops £13m, with around £4m of that generated in Dubai.John Pelly, Moorfields's chief executive, said: “Without profits [from our commercial busine] our ability to invest in our clinical services would be seriously constrained...Particularly at a time when the financial constraints facing the NHS are going to be as severe as they are in the next three or four years, it's going to be really important to the NHS that we can take advantage of the abolishing of the cap.” 没有商业模式的盈利将无法实现对全科医生服务的投资，尤其是在这样一个时候，英国的NHS面临严重的资金限制（预算赤字），这种赤字在接下来的三四年将会更严重。因此现在对NHS来说利用取消大医院经费优惠的优势很重要。Labour's cap had meant most hospitals were unable to generate more than 2% from private income.（工党限制大部分医院的private income不能超过2%）The exception is the Royal Marsden, a leading cancer hospital which, thanks to history, has a cap of 31% – and a private income of more than £40m a year.The Marsden, Lansley says, is the “model” in his new-look NHS.The policy shift has led to smaller trusts thinking big.Papworth Hospital, home to the first succeful heart transplant in the UK, will soon be submerged into the new 135-acre Cambridge Biomedical Campus.Some of its operations are so complex – with costs running into £25,000 for 10 hours of surgery – that the NHS can only afford to pay for 80 a year.“I think Andrew Lansley has really thrown down the gauntlet to us.In the next five years we aim to triple private income from 5% today to 15%.There are plans for a completely new private hospital on the campus,” said Stephen Bridges, the hospital's chief executive, who has been advised by private healthcare company Spire.这一政策转变导致小医院考虑扩大规模。用了一个例子来说明。

However, academics caution that the rush to the market could lead not to NHS trusts profiting, but to them being undercut by ruthle foreign competitors or losing patients abroad.“What's to stop US healthcare companies coming over here to poach patients.Or GPs sending patients to India for cheap operations? Or English hospitals raiding Scotland for sick people?” said Alan Maynard, profeor of health economics at the University of York.“It could be a real me.” 有学者提醒这种急于向市场的转变带来的可能不是公费医院盈利，而是在激烈的国际竞争对手面前被迫降低医疗费用或者失去海外病人。

Some are concerned that despite the push the NHS has “mied the boat” when it comes to competing in global private healthcare.Jane Collins, chief executive of Great Ormond Street, which raises £23m from private patients and has just signed a contract in Kuwait to bring seriously ill children to London for treatment, warned: “In terms of UK plc, we are way behind the US, the Germans, Indian companies and Malaysian hospitals.”