2011年6月19日 星期日

U.K. Weighs Privatizing Administrative Services

U.K. Weighs Privatizing Administrative Services


The U.K. is preparing a major push to increase the use of the private sector in operating government back offices as part of its attempts to cut public spending, people familiar with the matter said.

Francis Maude, the minister charged with squeezing efficiencies out of the public sector, is examining back-office areas that can be privatized, such as administration of the state pension and National Health Service prescriptions. The private sector's involvement in the wider NHS back office is also expected to increase.

The drive to privatize such functions could hit tough opposition, however.

The government has already encountered difficulties in its efforts to bring private competition into front-office functions, like the NHS. Attempts to bring the private sector even further into the back office will likely kick off union reaction at a time when the U.K. faces the prospect of a round of public-sector strikes over issues such as job losses and rights.

"Privatization of back office is something we expect and will oppose," said Richard Simcox, a spokesman for the Public and Commercial Services Union.

On Friday, the government got an early taste of that opposition when civil servants who administer the state pension went on strike over proposals to mutualize their department, which will allow holders of pensions to take a stake—but which unions call privatization by the back door.

Earlier this month thousands of civil servants voted to strike as a protest against pension changes.

The government hopes to release a major consultation document on public-sector reform before August. That will include what the government sees as radical ideas, such as people being given individual budgets to pay for public services, like care for the elderly, rather than having civil servants decide how all the budget is spent.

In the new push, government officials have asked private-sector companies to pitch ideas on how they can help run state-run back offices, one person familiar with the matter said. Officials believe that, given their steady cash flows, back-office functions could be marketed to companies seeking dependable returns.

As part of attempts to reduce spending, government departments have had their budgets slashed, some by as much as a third, and some believe outsourcing back-office functions may save money over time, another person said.

A spokeswoman for Mr. Maude didn't return phone calls.

With a budget deficit of over 8%, the government wants private-sector companies to compete with public-sector services in a bid to increase efficiencies, drive down costs and offer greater choice.

Rolling back the state is also a longtime ideological aim of Prime Minister David Cameron's Conservative Party. Last week, though, Mr. Cameron had to water down a banner attempt to bring greater competition into the NHS, after doctors and the public accused the government of trying to privatize the health service.

Despite Mr. Cameron's stalled NHS reform, the health service is one area in which the government has already experimented with allowing the private sector to run back offices. NHS Shared Business Services is jointly owned by the NHS and business-services company Steria. It handles finance, accounting, and other human-resource functions, as well as some procurement for the health-care provider.

John Neilson, its chief executive, says the venture will increase its share of the NHS back-office work. "Over time, it will widen," he said.

NHS SBS currently works for 40% of NHS Trusts, the operational units that deliver NHS care. By the end of the year, Mr. Neilson says, he believes he will work for over half of them, and that this work will be brought across to the bodies that will succeed the Trusts under the government's current reforms to the health service. Mr. Neilson estimates his unit saved the Treasury some £70 million ($113 million) from 2005 to the start of 2010.

Mr. Neilson said he also expects his company to move into other back-office functions like data management.

He says this sort of private-sector involvement in the back office is almost unique to the U.K., though more recently several other European countries have discussed with NHS SBS the possibility of setting up similar models in their countries.

Britain's last government took an even more radical look at privatizing back-office work, and explored bundling government activities such as human resources and information-technology management into commercial companies and selling or listing them.

The British public sector manages an asset base valued at well over £800 billion, according to the Treasury.

2011年6月10日 星期五

肺結核又現 倫敦如臨大敵

說起肺結核,總讓人覺得那是古代的事,不會發生在現代,但事實不然。英國倫敦感染肺結核人數大幅增加,英國公共衛生單 位開始設立移動X光車,檢驗病患,並考慮對給所有新生兒施打肺結核疫苗。曾在19世紀被稱為白色瘟疫的肺結核,一度消聲匿跡,現在竟在歐洲捲土重來,倫敦 是西歐國家中最多肺結核案例的地區,過去10年來,倫敦肺結核患者增加了50%,倫敦遊民罹患的比例尤其高,英國公共衛生部因此派出X光攝影巡迴車,加強 篩檢。

英國公共衛生部門已擬定對付肺結核的初步計劃,其中包括所有倫敦的新生兒都必須強制施打肺結核疫苗,此外也要制定標準化的篩檢流程。

X光攝影巡迴車自2005年上路以來,已有5萬多人做過肺部攝影,為了及早找出可能的患者,有的遊民之家甚至提供相當於台幣230元的優惠券,鼓勵他們前來照片子,但更大的挑戰在於治療,必須說服病患接受連續6個月的密集治療,中斷治療的人,身上的肺結核菌很容易產生抗藥性。(民視新聞黃彗澤綜合報導)