英国国民卫生服务制度(NHS)的结构性改革与治理模式

基于英国NHS在管理体制与机制上所实施的结构性改革措施,从完善法律、建立问责机制、完善财务管理和经营模式4个维度,系统阐述了NHS的结构性改革与治理模式的特点;作为一种"公共利益公司",NHS所属公立医院基于公私伙伴关系的原则,在坚持公益性的前提下,引入企业经营行为组建了信托基金医疗联合体,并根据NHS的核心原则,免费医疗、需求导向、可负担性等,基于购买合同向辖区患者或居民提供医疗保健服务。随着相关改革措施的逐步实施,NHS信托基金医疗联合体的法人地位和自主决策权得到明显提升,能真正做到对自身的发展负责;同时,随着对提供者行为的规范,以及医疗服务市场竞争与规制机制的完善,也极大的促进了医疗机构之间的有序竞争和医疗服务供给的多元化发展。

Study on structural reform and governance models of National Health Service in UK

Based on the structural reform approaches of management system and mechanism implemented by the British NHS, this paper systematically introduced governance models and characteristics of NHS Foundation Trusts (FTs) from the four dimensions:perfecting the laws, establishing accountability framework, improving financial management, and operational governance business model. As a public benefit corporation, on the basis of the principle of public-private partnerships (Public-Private-Partnership, PPP), NHS foundation trusts currently introduces a number of entrepreneurial practices under the premise of public welfare attribute, and provide goods and services according to entrustment contract and core NHS principles-free medical care, demand-oriented, affordability and so on. With these reform measures being implemented, the legal status and independent decision-making power of NHS Trust Fund Medical Consortium will be remarkably improved, so as the Foundation Trusts will be much more "on their own" and take complete responsibility for ensuring that they are successful. At the same time, with the norms of the provider''s behavior and medical services, and the improvement of competition and regulation mechanism has also greatly promoted a much more diversified and orderly competitive market for medical service providers.