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  3. Few would dispute that the Lansley reforms of the National Health Service in England, embodied in the Health and Social Care Act

Few would dispute that the Lansley reforms of the National Health Service in England, embodied in the Health and Social Care Act

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问题     Few would dispute that the Lansley reforms of the National Health Service in England, embodied in the Health and Social Care Act 2012, failed. More than 500 pages long, and often opaquely expressed, the legislation stripped control of the NHS from national and local government, and thus from the public, creating a large new bureaucracy to manage healthcare, drive competition and build a regulated internal market. Coming amid fierce spending austerity, the reforms were often seen as the enabler of a program of cuts and privatization. "I could and should have stepped in earlier," David Cameron admitted in his autobiography.
    Disastrous though the reforms have been, and clear though the case is for replacing them, a new attempt at reorganization would be destabilizing without strong support within the NHS that it can be implemented sympathetically. Matt Hancock embarked on such an attempt on Thursday, in his Integration and Innovation white paper. His proposals are unquestionably aligned with the goal that NHS England has been advocating to improve integrated care in the past two years. But Mr. Hancock will have to make a strong case over the coming weeks if the public is to be persuaded that this reorganization is the right priority in health policy.
    That’s because the context is at least as tough today as it was in 2010-11. The NHS is in the middle of the biggest public health crisis it has ever faced. Staff are exhausted
    and there are large numbers of vacancies. Waiting lists for essential interventions are alarmingly lengthening—nearly quarter of a million people are now waiting more than 12 months for treatment. The care crisis is getting worse and there is no clear plan for reform and financing. The economy is on life support, with public money likely to be very tight for years.
    Exactly why this is the right or necessary time to launch a structural reorganization of the NHS is not obvious. Higher spending seems a much more immediate and practical response. Mr. Hancock says that lessons from the pandemic point towards the need for new approach. That may well be true. Covid has cruelly exposed some of the multiple fragmentations in the health service—not just between health and care, but between proactive and reactive health services, between hospitals and general practitioners, and between physical and mental health.
    It is true that the Covid-19 crisis shows the need for better integration. This is something for which NHS England has been pressing, in the form of what it calls integrated care systems. But the largest single example of the current fragmentation—the relative neglect of care homes in relation to hospitals—will remain unaddressed until there is a proper spending programme, which forms no part of the white paper.
Why were the Lansley reforms generally considered a failure?
选项 A、The 2012 Act was wordy and repetitive with no clear aim.
B、The reforms contradicted the government’s commitment.
C、The reforms rendered the NHS out of due supervision.
D、The reforms were a driving force of higher spending.
答案 C
解析 根据Lansley reforms和failure定位到第一段第一句，该句描写了没有人质疑改革是失败的。由此可知相关的原因分析在第二句，该句写道“这项法案的条款长达500多页，而且往往含糊其辞，剥夺了国家和地方政府以及公众对国民医疗服务体系的控制权，从而建立了一个大型的新官僚机构来管理医疗保健，推动竞争，建立一个受管制的内部市场。”因此改革被视为失败的原因是失去了对NHS应有的监管，所以正确答案为选项[C]。
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