TIME: Almanac 1993/TIME Almanac 1993.iso/time/021389/02138900.024

Text File | 1992-09-23 | 3.8 KB | 79 lines

                                                                                WORLD, Page 53

BRITAIN

Hard Cases, Strong Cure


Lawyers and doctors face of sweeping new reforms


    Never let it be said that Margaret Thatcher lacks courage.
After confidently taking on the miners, the press and the
teachers, the Prime Minister has announced plans to reform two
of the country's most prestigious professions, medicine and
law. Her proposals, the most sweeping in decades, prove that
Thatcher has lost none of her zeal for leading Britain toward
a more open, free-market economy.

    The most controversial changes involve the National Health
Service, the state-financed system that employs about 1 million
workers and treats 30 million patients a year. Thatcher's plan,
which must still be approved by Parliament, allows the
best-managed of the nation's 2,000 state-run hospitals to form
self-governing trusts that can hire outside staff, pay higher
wages to doctors and negotiate salaries for nursing personnel.
The plan encourage doctors to shop around for the best prices on
hospital services, and permits them to refer patients to
hospitals outside their district.

    Neil Kinnock, the Labor Party leader, pounced on the
government, accusing the Tories of "putting cash before care"
and "profits before patients." Labor health spokesman Robin
Cook said the proposal would "put bureaucrats in the driving
seat at the expense of doctors and patients," and denounced it
as a "prescription for a health service run by accountants."

    Those charges struck a chord among middle-and lower-income
Britons, who fear a future of progressively better services for
an increasingly wealthy few. The issue goes to the heart of
Britain's free-health-care system and moves the country toward
medical treatment based largely on the patient's ability to
pay. Says Paul Swain, a London hospital consultant: "A majority
of people really like the NHS no matter how much they grumble
about it."

    While the British Medical Association and the Royal College
of Nursing opposed the plan, other health professionals
reserved final judgment. Otto Chan, a junior doctor at St.
Thomas's Hospital, is concerned that the emphasis on efficiency
will hurt the elderly and the poor most, since they often
require expensive drugs or repeated office visits. Says Chan:
"The profit-making system is biased in favor of young patients."

    The Conservatives are finding it much easier to rally
popular vocal support for deregulation of the legal profession.
Thatcher's plan calls for abolishing the traditional division
between solicitors, who deal directly with the public, and
barristers, who must be "instructed" by solicitors before
taking on a case and who have a virtual monopoly on presenting
cases in high court. Under the government's proposal, any lawyer
would be free to present cases in court after obtaining a
"certificate of competence." Many consumer-interest groups and
solicitors cheered the plan, while barristers promised to fight
it.

    In an effort to further broaden access to legal advice, the
government also proposed allowing lawyers to accept civil cases
on a no-win, no-fee contingency basis, taking their payment out
of their client's award. To prevent an explosion of litigation,
the government wants to strictly limit the maximum lawyers can
collect on contingency.

    The Thatcher government, showing its determination to push
ahead with the medical-service reforms, will issue eight working
papers in the next two weeks. The resulting legislation will be
submitted to Parliament, where its chances of passing are
considered good. As for the legal reforms, a bill is expected
to be ready by this fall. Despite the barristers' all-out
campaign to block the changes, there is a widespread feeling
that their monopoly is nearing its end.