Inasmuch as the NHS has been highly touted in the ongoing discussions about the US health care system, it is worth noting that circumstances have compelled a MAJOR reorganization:
If passed, all 151 primary care trusts (PCTS) and strategic health authorities will be disbanded. The resources of the system would be allocated to consortia of primary care providers, who would in turn go to market to procure the services required by those under their care. They would control about 80% of of the NHS budget, which must shrink substantially over the next few years. This contraction of resources is occurring simultaneously with the aging of their population. Sound familiar? It is worthwhile to note that the US solution is not hugely different - pay less. In both instances, the decision making is likely to be opaque to everyone outside the decision loop, most especially the doctors and their patients. The only question is why the primary care docs, instead of the patients themselves, should control the funds. Whether this particular re-organization comes to pass or not, it is clear that the leadership of the NHS confronts a problem very similar to the US: a burgeoning population of elderly and contracting contributions to their system. Importantly, the structure they already have cannot deliver the care required.
The IT infrastructure of the NHS also continues to flounder. There are a variety of news items that have covered this, but none is more succinct than these:
Given the size and scope of the UK investment, it is hard to imagine how the paltry sums allocated by the US for similar projects have any chance of success. If there is any hope, it may be a consequence of a more free market, and the absence of 6000 page policy and procedure manuals. History will know the answer, we are left guessing as to what it might be.
The ability of CHIT to generate information overload is likely to be akin to military systems. See this recent article in the New York Times: