TIME: Almanac 1990/1990 Time Magazine Compact Almanac, The (1991)(Time).iso/time/021389/02138900.024

Text File | 1990-09-17 | 4KB | 71 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.