英国全民医疗服务(NHS)的组织管理体制探析——兼论对中国的启示

NHS in England: Structure, Reforms, and Implications for China

国家对医疗服务体系的深刻调控和医疗服务机构的高度公共化,是英国NHS体系建制之初的核心特征。近年来,NHS历经内部市场化、政府向地方和社会放权、医疗服务购买和提供机制的调整、公立医院自主性的增强和私人医院的参与等变革。但公平普惠的理念始终没有动摇,税收仍是首要筹资来源,完备的全科医疗服务及守门人制度仍是NHS之基石。NHS发展的经验和教训可为中国提供借鉴。

The profound and dominant regulatory role of the government in health care institutions and its highly public service roles were the salient features of the English NHS system when it was initially established. In recent decades, the NHS has experienced such changes as introducing the internal marketization, adjusting the mechanism of purchasing and providing healthcare, and adding components of decentralization and privatization. Despite these reforms, the value of equity and universality remain unchanged, taxes are still the primary source of funding, and excellent general practice and the system of“goalkeeper”are the cornerstone of the NHS. The experience and lessons from NHS can be used for reference in the process of developing national health care in China.