503). Moreover, less than one in three NHS hospitals followed the procedure of checking the compatibility within the ambulance and it's "mounting system" prior to moving the patient (Ahmed, p. 504). All of these concerns are worth noting by U.S. healthcare professionals, lest similar situations may occur and put patients in jeopardy. Should every American healthcare provider be required to publish performance data in an online account -- information that relates to the clinical outcomes of his services as well as a record of patient satisfaction? That is a pertinent question because that is the new rule that all NHS healthcare providers are required to follow as of April, 2010 (Ali, 2009, p. 1416). This new approach to patient service that allows the patients in the future to make an "informed choice" about where and with whom they are treated (Ali, p. 1416). However, that having been said, the author of this article in the International Journal of Clinical Practice asserts that "not all patients are capable of exercising this choice" (Ali, p. 1416). Ali contends that while this "market-based NHS reform" is intended to empower patients, it "seems likely to exacerbate inequality" and "once again threaten the viability of the NHS as a collectivist service" (p. 1416).

What about the elderly lady who does now how to use the Internet, and therefore cannot access information about the best hospital available to her? And as to those less educated and not fluent in English, they too might not be able to take advantage of this reform, Ali goes on. By basically delegating the task of choice to the market -- rather than raising the minimum level "so that choice is no longer necessary" -- the NHS is offering a reform that is "neither equitable nor, indeed, necessarily effective" (Ali, p. 1417).

The NHS has experienced many problems and there have been many reforms to transition away from those issues in its 63-year history; yet it remains, according to Julian Le Grand of the London School of Economics, "…one of Britain's most revered institutions" (2002, p. 116). In particular Le Grand alludes to the Labour government's reforms (initiated by former Prime Minister Tony Blair) which, though too wordy to mention in this paper, offered more "central control" than competition (p. 123)....

In fact Le Grand asserts that sanctions for "poor performance" and "rewards" for good performance shouldn't be applied from the central control apparatus of the NHS but rather should come from the local and regional levels of administration (p. 123). U.S. healthcare professionals should note scholarly responses to NHS reforms as well.
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