Reforms to the UK's National Health Service announced Monday would shift decision-making to general practitioners, let some hospitals become not-for-profits and give patients more control over their health care, but could also cost tens of thousands of jobs, according to reports.

A white paper presented to the British Parliament, "Equity and Excellence: Liberating the NHS," outlined a streamlined future for the NHS, with a greatly reduced bureaucracy, giving patients more hands-on control of their health care in what are seen by some as "pro-market" reforms.

"With this White Paper we are shifting power decisively towards patients and clinicians," Secretary of State for Health Andrew Lansley told Parliament.

The change also calls for the abolition of doctor-managing organizations, which could result in as many as 30,000 managers and administrators getting sacked, the British paper Guardian writes. The plans call for abolishing 10 health authorities by 2012 and 150 primary care trusts by 2013, the paper said.

Through the reforms, the NHS would reduce its management budget by 45 percent, with the savings reinvested in patient care, Langley said.

"The dismantling of this bureaucracy will help the NHS realize up to 20 billion pounds of efficiency savings by 2014," he said.

SHIFT TO FAMILY DOCTORS

At the heart of the reforms is shifting decision-making on patient treatment from primary care trusts to general practitioners, who would be forced to join one of around 500 consortia by 2013. These consortia would handle around 80 billion pounds of NHS money, with the doctors helping patients shop around for treatment at hospitals.

"Doctors are ideally placed to help determine the health needs of their local population," Dr. Hamish Meldrum, chairman of the British Medical Association's council, said in a statement. "They will wish to see how the proposed changes allow them to work collaboratively, and in partnership with their patients, to facilitate improvements in the care pathway and to see unnecessary barriers and bureaucracy removed."

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