The velvet reform of the British medical services: implications for Israeli psychiatry.
Since 1990, the United Kingdom has been reforming its public medical services aiming at decentralization and more competition among the providers of services. To achieve these aims two major administrative changes are being introduced: a) increased direct cooperation between providers and consumers; b) the creation of self-government trusts (similar to the Israeli "taagidim"). Israel is also modifying the structure of its medical services in ways which have some basic similarities to the U.K.'s changes. However, the British process of change is smoother and steadier. The possible effects of the general changes on the psychiatric services in the U.K. and in this country are complex and are already raising controversies. This paper compares the processes in both countries.