当前位置:黑龙江地方站首页 > 龙江新闻 > 正文

襄阳第四医院专家预约大河资讯襄樊铁路医院泌尿系统在线咨询

2020年01月25日 04:22:26    日报  参与评论()人

襄阳市第三人民医院治疗睾丸炎怎么样襄阳白癜风体检医院襄阳第四医院阳痿早泄价格 The world this week-Politics本周政治要闻Tributes were paid to Antonin Scalia, one of the justices on Americas Supreme Court, who unexpectedly died while holidaying in Texas.前美国最高法院大法官安东宁·斯卡利亚(Antonin Scalia)在德克萨斯度假时意外身亡。The political bickering over replacing him was less dignified.葬礼上,他受到很多人的追悼,但关于其继任者的政治争吵却没有那么体面。Barack Obama said he would nominate a successor to the conservative Mr Scalia.巴拉克·奥巴马表示将选出保守派斯卡利亚的继任者,该人选需要获得参议院的认可。That person would need to be confirmed by the Senate.共和党人却主张把此任命推迟至新总统上任即十一个月后再进行。Republicans argued for a delay until the next president takes office in 11 months time, undoubtedly in the hope that he will be one of their own.毫无疑问,共和党此举意在希望能有一名共和党人出任该职位。A federal judge in California ordered Apple to help unlock the iPhone used by one of the Islamists who attacked an office party in San Bernardino last December, killing 14 people.加利福尼亚的一名联邦法官要求苹果公司破解一名伊斯兰教徒的手机。该教徒于去年十二月袭击了圣贝纳迪诺(San Bernardino)的一个办公室聚会,致使14人丧生。The FBI wants Apple to disable the password feature.联邦调查局希望苹果能够破坏密码系统,但该公司并未从。But the company is not complying, arguing that building the software to unlock the phone “would undeniably create a backdoor” to its encryption protocols and give the government “power to reach into anyones device to capture their data”.苹果认为编译解锁手机的软件“将无疑给加密协议开了后门”,同时还将给政府“进入个人设备获取数据的权力”。Trucks carrying aid entered several besieged towns in Syria, including the rebel-held town of Muadhamiya, near the Syrian capital, Damascus.载有救援物资的车辆驶入数个被围困的叙利亚小镇,其中包括叙利亚首都大马士革(Damascus)附近被反对派控制的穆阿达米亚(Muadhamiya)镇。This came ahead of a planned “cessation of hostilities” in Syrias war, thrashed out by America and Russia in Munich.此次救援发生在叙利亚内战的“休战”之前,这场有计划的休战由美国和俄罗斯在慕尼黑举行的会议上经研究后共同提出。No one expects the ceasefire to take hold.无人料到此次停火的出现。Members of opposition parties in the Democratic Republic of Congo went on strike to protest against efforts by Joseph Kabila, the president, to run for a third term in office.刚果民主共和国(Democratic Republic of Congo )的反对党通过罢工来抗议总统约瑟夫·卡比拉(Joseph Kabila)竞选第三任期。Britain was on the brink of agreeing on new terms for its membership of the EU at a summit on February 18th and 19th, clearing the way for a referendum in June.在二月十八日和十九日举行的峰会上,英国即将同意有关其在欧盟的成员地位的新条款,这为将在六月份举行的全民公投扫清了道路。David Cameron, the prime minister, was confident of securing a deal in Brussels, but Eurosceptics back home were poised to criticise whatever emerged from the talks.英国首相戴维·卡梅伦对于在布鲁塞尔达成协议十分自信,但国内的疑欧派却随时准备对会谈中发生的任何事情都进行批评。The European summit would also tackle the refugee crisis.欧盟峰会还将对难民危机进行处理。Austria set a daily cap of 3,200 migrants whom it will allow to cross its borders.奥地利把过境的难民人数上限设定在每天3200人,It also tightened border controls with countries in the Balkans that migrants cross to reach Austria.同时还加紧了对与巴尔干国家接壤的边境的控制。Many then travel on to Germany and Sweden.难民通过巴尔干国家进入奥地利后,很多人继续去往德国和瑞典。Turkeys prime minister, Ahmet Davutoglu, cancelled a visit to Brussels after a bomb in Ankara, the Turkish capital, killed at least 28 people.土耳其首都安卡拉(Ankara)发生爆炸,造成至少28人死亡,总理艾哈迈德·达武特奥卢(Ahmet Davutoglu)取消对布鲁塞尔的访问。The device was detonated close to the defence ministry as an army bus was passing by.一辆军车驶过时,爆炸装置在国防部附近被引爆。Turkey blamed Kurdish rebels.土耳其对库尔德武装分子提出谴责。Russia filed a lawsuit in a court in London to try to get Ukraine to repay a billion bond.俄罗斯在伦敦的一个法院对乌克兰提起诉讼,要求偿还价值30亿美元的债券。Ukraine says that Russia has refused to take part in negotiations over restructuring the debt.乌克兰表示俄罗斯此前拒绝了参与重组债务的和谈。Meanwhile Ukraines prime minister, Arseniy Yatsenyuk, survived a vote of no confidence in parliament after the countrys president, Petro Poroshenko, called on him to step down, ostensibly over the slow pace of reforms.与此同时,乌克兰总理阿尔塞·雅琴尼克(Arseniy Yatsenyuk)在一场议会不信任投票中险险保住职位,此前该国总统佩特罗·波罗申科(Petro Poroshenko)表面上以改革进程缓慢为由要求他辞职。The economy minister recently resigned and blamed Mr Poroshenko for hindering reform.最近,经济部长辞职并谴责波罗申科阻碍了改革的进行。 译文属译生译世201602/428463Lexington莱克星顿Hillary Clintons bad book希拉里·克林顿新书欠精Her stodgy memoir is best understood as a briefing book for surrogates and “influencers”对这本枯燥乏味回忆录的最好诠释是为代理人和有影响力者写就的简明手册HILLARY CLINTON is a big fan of briefing books. As Barack Obamas envoy to the world she devoured great, thick binders on every subject imaginable, she writes in “Hard Choices”, a new memoir published on June 10th. As she worked tirelessly to prepare for summits and official trips to 112 countries, she admired the expertise of her diplomats. Only one thing bothered her. A few months into the job she asked the State Department to be more creative with graphics, after envying the flashier briefings carried by Pentagon brass. Soon, she beams: “there were plenty of coloured maps and charts to go around.”希拉里·克林顿是这种简明手册的忠实粉丝。她在她6月10日出版的新回忆录《艰难抉择》中写道,作为奥巴马总统的代表出使全世界,她见多识广。在她不知疲倦地为她112国的峰会和出访做准备时,她还不忘对她的外交官表达钦佩。只有一件事让她烦心。入职几个月后,眼红五角大楼浮夸的简明手册,她要求国务院在制图上也能够更有创意一些。不久后,她终于能够笑得出来:“总算有足够多的色地图和图标了。”Mrs Clintons 600-page doorstopper is full of this stuff: micro-revelations which are earnest, dull and self-serving, all at the same time. “Hard Choices” is a frustrating . The memoir has the cautious, polished, poll-tested feel of a campaign speech. A million copies have been printed. A multi-city speaking tour has begun. A first-day book-signing in Manhattan drew lines around the block and hundreds of reporters. A large campaign-style bus idled outside. It was sent by “Ready for Hillary”, a ginger group that wants the former secretary of state, first lady, senator and presidential contender to run again for the White House in 2016.克林顿夫人这本让人望而却步的600页自传中充满了这样的小故事—急切、无聊、自娱自乐却又无足轻重的爆料。《艰难抉择》会是一次让人挫败的阅读经历。这本回忆录就像一本小心翼翼、千锤万凿、经得住选民考研的竞选演讲。100万本印刷完毕,计划在多个城市的巡讲蓄势待发。第一天在曼哈顿的签售会吸引了长长的队和数百名记者。一辆庞大的竞选风格的巴士停在外面。它是由激进团体“为希拉里准备”(Ready for Hillary)赠送的,该团体持入主白宫。A press strategy was even crafted to handle a single chapter of the book, addressing the low point of Mrs Clintons time as secretary: the 2012 killings of four Americans by militants in the Libyan city of Benghazi, including Americas ambassador. The chapter was leaked early and Democratic officials and “surrogates” (campaign jargon for folk who can speak for a candidate) briefed on Benghazi talking-points by a former Obama spokesman, Tommy Vietor, and Mrs Clintons press guru Philippe Reines.公关策略占据了《艰难抉择》中的整整一章,描述了克林顿夫人在担任国务卿时的低谷。那是2012年4名美国人在利比亚城市班加西收到激进分子袭击的时候,这4名美国人中,其中就有美国的大使。这一章在书籍出版之前泄露了出来,里面写道,当时,前奥巴马发言人汤米·费艾托和希拉里手下的媒体专家菲利普·莱因斯曾就针对班加西时间的要点对民主党内官员和“代理人”(竞选术语,指候选人发言人)进行简要说明。Still Mrs Clinton says she has not yet decided whether to run. She did not write the book for followers of Washingtons political soap opera, she says severely. Rather, it is for Americans keen to learn more about diplomacy in the Obama era, and the exercise of American power in the 21st century, she insists. Such pieties are not wholly convincing. For starters, much of the book smells of raw politics, rather than diplomatic history. Mrs Clinton stepped down as chief diplomat in 2013 with high public approval ratings (in part because her job lofted her above the partisan mire for four years), but a list of vulnerabilities too. “Hard Choices” doggedly works its way down that list.但至今为止,希拉里称她还未决定是否参加选举。她严肃地说,她这本书不是写给华盛顿政治肥皂剧的剧迷看的,她坚持把这本书送给那些希望了解奥巴马时代的外交和21世纪美国的权利运作的人。这般虔诚并不是非常有说力。因为首先,这本书更像在写政治,而非外交历史。2013年,希拉里在公众持率一片大好的形势(部分原因是她的工作让她在四年时间里,暂离党派混战泥潭)下从第一外交官的职位上卸任,但即使那时,她也有长串弱点。而《艰难抉择》则固执地一项项弱化这些弱点的影响。In the Benghazi chapter Mrs Clinton accuses conservative critics of mounting a “political slugfest on the backs of dead Americans”. She has a point. But in turn she constructs a political straw man, accusing critics of suggesting that diplomats stage an un-American “retreat” from the world. She leaves unanswered the more relevant question of whether the Wests intervention in Libya, which she championed, left the country better off.在班加西那一章里,希拉里谴责保守派的批评家们让“踩在死去美国人的背上进行的政治斗争”愈演愈烈。这话不无道理。但另一方面,她在谴责批评家暗示美国外交使得美国从国际舞台上以一个不怎么美国派的方式落荒撤退时,她实际上把这当做了挡箭牌,因为她避开了更需要揭露的问题,比如西方是否真的在干涉利比亚,而这项政策一直因为她认为对国家有利而得到她的持。After Ukraine lost Crimea to Russia, many Republicans accused Barack Obama and Mrs Clinton of having emboldened Russia with their bid to “reset” relations. Mrs Clinton retorts that Russia rolled into Georgia when George W. Bush was still in office, calls the “reset” a worthy attempt to work on areas of agreement while setting tough issues to one side, and blames its failure on Vladimir Putin, one of the worlds “hard men”.克里米亚从乌克兰沦陷俄罗斯之手后,许多共和党派人士谴责奥巴马和希拉里在年“重启”双方关系的提议成了俄罗斯的“雄心豹子胆”。但希拉里反击道,早在乔治·沃克·布什在任期间,俄罗斯也曾吞并格鲁吉亚,“重启”美俄关系是值得的,能够让双方求同存异,专心双方存在共识的领域,暂时搁置难题,而这次错在这位世界上的风云人物弗拉基米尔·普京。Strikingly, other chapters involve veiled swipes at Mr Obama and his team. Mrs Clinton revisits painful disputes from the 2008 Democratic primary, when she felt subjected to sexist attack by Obama allies. She confirms a much-reported dispute from 2012, when she (in alliance with the then CIA chief, David Petraeus, and the then defence secretary, Leon Panetta) wanted to train and arm non-extremist Syrian rebels. Mr Obama decided the risks outweighed possible gains—a scepticism shared by White House aides. In the book she links this to a remarkably reductive account of Mr Obamas 2008 victory, writing: “After all, the President had been elected in large part because of his opposition to the war in Iraq and his promise to bring the troops home.”值得注意地是,该书其他章节含沙射影地抨击了奥巴马总统及其团队。希拉里在书中重温了2008年民主党总统候选人预选时令人痛苦的争论,当时的希拉里深感自己受到奥巴马团队的性别攻击。她确认了2012年一次多见曝光的争论,那时她(和时任中情局主管大卫·霍威尔·彼得雷乌斯和时任国防部长莱昂·帕内塔)主张训练和武装叙利亚的非极端叛军。然而奥巴马总统则认为风险大于受益,而白宫助理也同样有此怀疑。在书中,她把这段往事与奥巴马2008年获胜演说中的一段叙述联系在了一起,评价道:“毕竟,总统得以当选的绝大部分原因,是因为他反对伊拉克战争,以及承诺把驻扎海外的美国军队带回家。”Hawkishly, Mrs Clinton questions Mr Obamas decision to announce a fixed exit date for American troops in Afghanistan. She suggests that callow young Obama aides were wrong to urge a swift end to Hosni Mubaraks rule in Egypt. Finally, she addresses those who say she accomplished little. This is a popular attack: a recent conservative shows young Hillary fans struggling to name her greatest accomplishment. She retorts with a long list of mid-sized successes, from democracy promotion in Burma to a 2012 ceasefire in Gaza, or projects to advance womens rights.希拉里还强硬地质问奥巴马总统宣布从阿富汗撤军日期的决定。她暗示,奥巴马少不经事的助理团队不该操之过急地结束侯赛因 穆巴拉克在埃及的统治。最后,她赠言那些在她眼中成就甚少的人。这是时下流行的攻击方式——近期一个保守党派视频中,年轻的希拉里持者正在为找出希拉里最大的成就而左右为难。她选择用一长串不大不小的胜利来反驳,从在缅甸推进民主,到2012年加沙地带的停火,到推进女性权利的项目。If some chapters are too nakedly political for a work of foreign-policy analysis, then others are too worthy for many general ers. At times it feels as if none of those 112 countries is going to be missed out. Mrs Clinton offers accounts of African trade flows, a coup in Honduras, climate talks in Denmark, the fine work that Barbados has done with solar water heaters and her opinion of Canada (“our northern neighbour is an indispensable partner”). Those hoping for gossip will be disappointed. Few insiderish nuggets leaven the mix—though Mrs Clinton does explain why the secret service dislikes VIPs visiting Buddhist temples (they feel uny for emergencies without their shoes).如果说,书中一些章节从外交政策分析来说,显得有些过于裸地政治化的话,那么对于许多一般读者,其他章节还是值得一读的。希拉里在书中叙述了非洲的贸易往来,洪都拉斯的停火和她对加拿大的观点(我们的北部邻邦是我们不可或缺的伙伴)。那些想要八卦的人怕要失望了。书中鲜有内部猛料为本书添色,不过希拉里的确解释了为什么特勤部不喜欢重要任务访问佛教寺庙(因为不穿鞋子,他们会觉得不能时刻准备着)。Coming soon to a book group near you去你身边的书会吧To solve the mystery of what “Hard Choices” is for, think back to those Democratic surrogates being schooled on Benghazi talking-points. This is a briefing book for surrogates, and—beyond them—for the legions of “influencers” so prized by modern political campaigns: the amateur opinion-formers whose friends, colleagues and relatives listen to their political views, or follow them online. Understood as a briefing book, the memoirs oddities make more sense. It exists to offer talking points to each possible element of a future Clinton coalition—from folk worried about climate change to women who voted for Mitt Romney, who could imagine voting for Hillary, but whose husbands are obsessed with Benghazi. It never needed to be a good .要弄清楚“艰难抉择”目的为何,只要想一想班加西事件中给“代理人”提供的要点教育就明白了。这是对代理人的一份简明手册,不仅如此,这同样是针对众多在现代政治竞选中饱受褒奖的“有影响力的人”,他们是熟练的舆论导向者,引导他们的同事亲友听取他们的政治见解,或在网络上关注他们。作为一份“简明手册”来理解,这本书就不再让人困惑了。它的存在,是为了向每一个潜在的希拉里自己人提供话术,这其中,可能有担心气候变化的人,有为米特·罗姆尼(Mitt Romney)投票的女人们,她们也许想过投票给希拉里,但无奈自家丈夫痴迷班加西事件。从这个角度来看,这本书不需要是一本好书。 译者:杨雪 译文属译生译世 /201507/387597南漳县妇幼保健中医院妇科疾病多少钱

枣阳市康复医院子宫肌瘤怎么样Germany’s obstinate chancellor固执的德国总理Angela Merkel, swimming instructor“游泳教练”安吉拉·默克尔When it comes to the euro, the German chancellor prefers self-help to help—but she can be more flexible than she seems德国总理在欧元问题上嘉勉自救胜过人救,不过她这个表面上的立场仍可通融。WHEN warnings sound that the end of the euro is nigh, all eyes turn to Angela Merkel, the German chancellor. Germany must “assume its part” in saving the currency, says Spain’s economy minister, Luis de Guindos. If there is rescuing to be done, Germany is the obvious rescuer. Yet rather than toss out the lifebelt, Mrs Merkel offers swimming lessons.欧元瓦解的警报就将拉响,所有人的目光都聚焦在德国总理安吉拉.默克尔的身上。西班牙财政部长金多斯(Luis de Guindos)说,德国必须在拯救欧元的行动中“承担相应的责任”。若真有国家亟待救援,德国显然是拯救者。然而,默克尔女士却选择站在岸边教游泳,而非抛出救生圈。She would find this characterisation unfair. Time and again she has taken stands against bail-outs only to relent. She balked at bailing out Greece and at a permanent rescue fund, and she vetoed the use of bail-out money to buy government bonds in the secondary market. In each case she gave in (too late,say critics).默克尔女士也许会认为此般描述有失公正。她一次又一次地反对纾困, 到头来却总是松口让步。她在救助希腊和永久性救援基金上踌躇不决,还否决了利用纾困资金在二级市场上购买国库券。以上事件她都做出了妥协(可惜为时已晚,批评家如是说)。By July she will push through parliament the European Stability Mechanism(ESM), the permanent fund she once opposed, and Europe’s fiscal compact.Germany’s capital contribution to the ESM will push its budget deficit from 26 billion( billion) to 35 billion. Germany’s potential liability, if all the money is lent and everyone defaults, could be 280 billion. But her partners want more: Eurobonds backed by all countries,more time for weak economies to meet deficit-reduction targets, direct lending to Spanish banks and a “banking union”, with Europe-wide deposit insurance.Will Mrs Merkel yield on these, too? Do not count on it.7月前,默克尔将推动议会通过欧洲“财政契约”,以及她曾经反对的永久性援助基金——欧洲稳定机制(ESM)。德国向ESM的注资会将联邦政府的财政赤字从原来的260亿欧元(320亿美元)扩大至350亿欧元。如果德国投入的资金全部借出,且统统遭到违约,德国将会面临2800亿欧元的潜在负债风险。 然而,默克尔的同僚们想要的不止这些,他们希望发行所有成员国持的“欧洲债券”,给疲软经济体更多时间,用以完成赤字削减目标,直接向西班牙贷款,以及成立带有欧洲通用的储蓄保险的“联盟”。默克尔女士是否也会此一一退让?别抱太大希望。Despite her retreats, she sees herself as a defender of principle.Everything to which Germany has assented has been part of a bargain:peripheral countries get help, but only in exchange for reform. Aid from the European Financial Stability Facility (EFSF), the ESM’s precursor, is conditional. Greek bail-outs came with crushing demands (which Greece may reject after its election on June 17th). The ideas urged by Francois Hollande, France’s new president, and Mario Monti, Italy’s primeminister, would break her principle, say the Germans. To introduce Eurobonds as a crisis-fighting measure would only encourage less creditworthy countries in their spendthrift ways. Similarly for centralised deposit insurance, which would enlist German banks (and ultimately the state) as guarantors of other countries’ savings.尽管默克尔有所让步,她仍视自己为原则的卫道士。但凡德国赞成的,都是议价的一部分:国家获得救助的前提是,他们要进行改革。ESM的前身,欧洲金融稳定基金(EFSF)的救助款也有附加条件。纾困希腊伴随着一系列严酷的要求,而在6月17日大选后,希腊也有可能予以拒绝。德国方面称,法国新总统奥朗德(Francois Hollande)和意大利总理马里奥(Mario Monti)极力推崇的观点有违默克尔的原则。以欧洲债券作为抗危机措施,只会助长信誉度较低的成员国挥霍无度的气焰。设立中央储蓄保险的目的也亦如此。该储蓄保险会令德国的(继而整个德国)成为其他国家储蓄的担保人。Such proposals “bear on the core issue: do debt and responsibility remain linked to each other?” asks Norbert Barthle, a member of the Bundestag from MrsMerkel’s Christian Democratic Union. Any instrument that severs the link wil lperpetuate the crisis. Besides, such measures are forbidden by Germany’sconstitution. That is not to say they can never happen. But they are imaginable only if the EU becomes more of a federal state, with a common fiscal policy anda parliament that reflects Germany’s share of the population. Mrs Merkel wants “more Europe”.But that requires “treaty changes, and we are not there yet today”.此番提议“涉及的核心问题是:债务和责任间是否依旧存有联系?”,联邦议院议员,默克尔所属基民党的成员巴斯勒(Norbert Barthle)问到。任何隔断此种关联的工具都会使危机继续蔓延。此外,德国宪法明令禁止采取此类措施。这并不意味着该措施永无实现之日。只有欧盟成为一个联邦式的国家,具有统一的财政政策,并配有依据德国人口数分配席位的议会的情况下,才有实现可能。默克尔女士要的是“大欧洲”。但这需要“修改条约,而今我们还没走到那一步”。译文属译生译世 /201606/451810中航工业三六四医院处女膜修复手术多少钱 襄阳脂溢性皮炎脱发的治疗

襄阳市中医院无痛人流手术多少钱 The NHS国民健康保险制度Health reform in a cold climate遇冷的医改The governments reforms to the NHS are viewed as its biggest failure. They are better than that政府医改被指其最大败笔。“盛名”之下其实难副“WITH the Conservatives there will be no more of the tiresome, meddlesome, top-down restructures that have dominated the last decade of the NHS.” So said David Cameron in , and many were convinced. Voters made Mr Cameron prime minister in2010 inpart because the Conservative Party cut into Labours lead on health care, which it had enjoyed almost since it founded the NHS in 1948. The Tories quickly squandered their advantage. But their legacy will be better than they seem to believe.“有了保守党,NHS(National Health Service 英国国民健康保险制度)近十年主要的恼人、好事、专制的医疗结构会一扫而光”,这是英国首相卡梅伦在年说过的话,且广受信。2010年,选民把戴维·卡梅伦选为首相,有部分原因是因为保守党插手了工党主导的医疗保健项目,这个项目几乎自从1948年设立了NHS就赞誉颇多。然而保守党很快就把优势糟蹋一空。但“遗产”比他们大部分人认为的要丰厚。In spite of his promise, Mr Camerons Conservative-Liberal Democrat coalition government embarked on reforms that would reshape the NHS from the top down. The immense Health and Social Care Act of 2012 increased competition, gave the service greater autonomy and put more decisions about the purchase of care in the hands of local doctors, known inBritainas general practitioners, or GPs. The changes were so big that they could be seen from space, quipped Sir David Nicholson, the departing head of the NHS.即便是承诺在前,卡梅伦领导的保守党和自由民主党联合政府着意的改革仍将自上而下的改造NHS。2012年,声势浩大的医疗社会保障法案使竞争更加激烈,给医疗务业更大的自主权,以及把决定医疗开销的权利交由本地医生掌握,这类医生在英国被称为全科医生,简称全医。NHS前主管戴维·尼克尔森爵士曾调侃,这么大的变革,在太空都能看到。The government soon came to wish they would disappear. The reforms were never popular with a bemused public. Doctors groups argued they would lead to a more fragmented and privatised system. Others worried that GPs would be incapable of commissioning care. Ed Miliband, Labours leader, dubbed the reforms Mr Camerons “poll tax”, a reference to the policy that helped fell Margaret Thatcher. In this case it was Andrew Lansley, the health secretary, who fell. Less than six months after his reforms were passed, Mr Lansley was replaced by Jeremy Hunt, who talks about them as little as possible.很快,政府就希望这些变革能尽快消失。迷惑的民众并不欢迎这些改革。医生群体称,这个权利会让他们最终导致一个更加零碎化、私有化的医疗系统。还有人担心,全科医生并没有能力被委任护理。工党领袖埃德·米利班德把这些改革戏称为卡梅伦的“人头税”,一个曾经让撒切尔夫人下台的参考政策。而现在,下台的是卫生部长安德鲁·兰斯。兰斯的改革通过不到六个月内,他就被杰里米·亨特代替了,而后者几乎对改革只字不谈。The health reforms were supposed to make the NHS more independent. Yet Mr Hunt now styles himself a patients champion—he is known to ring hospitals to ask about waiting times. This is a concession to reality: politicians will always be held accountable for the performance of the NHS. Still, the frantic smothering of the reforms conceals something useful. A policy that has caused the government so much embarrassment is quietly bearing fruit.医疗改革旨在让NHS更加独立。然而杰里米·亨特现在自比为病人的胜利,因为大家都知道他常常打电话给医院询问等待时间。这是承认现实:政客永远要为NHS的表现负责。但是,改革密不透风的大动干戈掩盖了一些有用的东西。一个让政府非常窘迫的政策正静悄悄地开花结果。Let 211 flowers bloom让211之花盛开The biggest change was the creation of 211 Clinical Commissioning Groups (CCGs), which placed about 60% of the NHS budget in the hands of local doctors and health workers. They became responsible for procuring hospital care, mental-health services and the like. Navigating a muddled system, the cannier ones have figured out ways to realign the incentives of hospitals, which are often paid per procedure, with those of GPs, who aim to keep people healthy and at home.最大的改变是211临床调试组(CCGs)这一创举,收纳了本地医生和医务人员手中60%的NHS预算。调试组负责采购医院护理、心理健康护理之类的物品。游走在混乱的医疗系统中,头脑灵活的人已经想出办法调整对医院的刺激,这些在每次采购中都会被全科医生偿付,他们旨在使病人保持健康,觉得自在。The commissioning group in Bedfordshire, for example, has bundled some 20 contracts for musculoskeletal care (treatment for things like weak knees and cracked hips) into one five-year contract that was won by Circle, a commercial health group. Far from fragmenting the system, as critics had feared, this has made Circle responsible for integrating the services of local providers. Patients will be told which are doing best. Circle and its partners must achieve an agreed set of outcomes to receive some of their pay. Paolo Pieri, Circles chief financial officer, expects the deal will not only improve care but save Bedfordshire some £30m(m).例如英格兰南部贝德福德郡的调试组,已把20余份关于肌肉骨骼保健(面向脆弱的髌骨和股骨骨折之类的治疗)的合同与一份五年期的合同相捆绑,这份合同被商业医疗集团Circle中标。批评家们曾经担心的医疗系统会分崩离析的问题使Circle必须负责,这能使Circle为本地供应商的集成务负责。病人将会被告知哪个做的最好。Circle及其合伙人必须就后果及分利达成共识。Circle的CFO(首席财政官)保罗·皮耶里希望,这笔交易不仅仅能够改善卫生保健,还能为贝德福德郡留下约3000万英镑(约合5000万美元)的结余。Not all commissioning groups are as bold. But perhaps a quarter are considering contracts like the one in Bedfordshire, reckons Mr Pieri. Diane Bell, a doctor there, says more than 40 CCGs have contacted her group. “Every CCG I look at is doing brave and innovative work,” says Shane Gordon, who heads one inEssex.并非所有调试组都能这般大胆无畏。皮耶里推测,约有四分之一的调试组正考虑像贝德福德郡那个一样签订合同。贝德福德郡的一位医生戴安娜·贝尔说,有超过40家临床调试组与她的团队签订了合同。肖恩·戈登在埃塞克斯郡领导一个调试组,他说“每个临床调试组在我看来都在从事勇敢无谓、富于创新的工作”。The Labour Party—which launched a series of NHS reforms during its 13 years in power—says this sort of innovation was on the way anyway, and may have been delayed. Thanks to the giant restructuring of the NHS “we lost two or three years”, says Andy Burnham, the shadow health secretary. He also criticises a regulatory regime that leaves many providers confused. Fair enough. But the reforms replaced bureaucrats with clinicians, which seems to have encouraged creative thinking. Dr Bell was warned by an old hand that outcomes-based contracting would stir up a fight in her group. When she suggested it, though, the other GPs quickly bought in.工党在其执政的13年间,曾颁布了一系列NHS改革,它称这类改革创新不管怎么说都已经在半路上了,还有可能推迟。影子卫生部长安迪·翰讽刺,幸亏这次NHS巨大的改革让我们“浪费两三年”。他还批评监管制度让许多供应商迷惑不解。虽有道理,但是改革用临床医生代替了官僚分子,似乎还鼓励了创造性思维。贝尔医生曾被这行老手告诫这个以结果为基础的契约签订可能引起团队内讧。尽管当她提到了这个,全科医生还是被迅速引入了。If Labour wins the next election, Mr Miliband might ground CCGs just as they are taking flight. Although he has no plans to restructure the NHS yet again, his laudable aim of integrating health and social care, which currently falls outside the NHSs remit, would probably shift responsibility to a different local body. Mr Burnham would also clip the wings of reformers by giving NHS providers a built-in advantage in the competition for contracts.下届大选如果工党获胜,米利班德可能搁置临床调试组,正如现在他们才刚刚起航。即使他没有再次重组NHS的计划,他值得赞赏的集成医疗社会保障计划目前还处于NHS的推迟项目,很可能把责任转移到一个不同的地方机构。翰也会通过给予NHS供应商先天优势的方式,限制改革者在签订合同方面的竞争。But the biggest threat to CCGs and what some of them are doing to improve services is not politics but whether they can move fast enough to keep in front of a funding squeeze, says Thomas Cawston of Reform, a think-tank. Though the NHS has been protected from the worst of austerity, it could fall short by £30 billion by 2020—the result of rising demand from a growing elderly population. Sir David warns that without more cash, the service could tip into the red next year.智囊团Thomas Cawston of Reform称,对于临床实验组最大的威胁,以及其中部分改善务所作的努力不是来自政治方面,而是他们是否可以发展的足够快是实验组一直保持在资金压力前面。尽管NHS被最糟糕的财政紧缩保护,但其资金到2020年还不到300亿英镑,这是不断增长的老龄人口日益增长的需求带来的结果。戴维·尼克尔森爵士警告道,没有更多的钱,这项务明年就会陷入危机。As money runs short, the real test will arrive. It could be an opportunity for health reformers. Or bureaucrats could panic and revert to old ways. Whatever happens, the next government will not be able to duck the issue.随着资金短缺,真正的考验即将来临。这对医改人士而言是一次机遇。那些官僚却可能会陷入恐慌,且想要回归老路。无论发生什么,下届政府都无法回避这一问题。译者 周雨晴 校对 邵夏沁译文属译生译世 /201509/401375襄樊中心医院做割包皮的费用枣阳市一医院是公立的吗

襄阳南漳县人民医院泌尿外科
襄樊市襄阳区人民医院哪个好
老河口市人民医院妇科中医频道
襄阳妇幼保健院中医院治疗前列腺炎怎么样
问医分享襄阳市中心医院北区人流医院排名
襄阳第四医院妇科疾病多少钱
襄樊男性前列腺炎治疗医院哪好
襄阳市四院体检多少钱39口碑襄樊铁路医院私密整形
88对话襄阳包皮手术在哪里做大河热点
(责任编辑:图王)
 
五大发展理念

龙江会客厅

宜城妇幼保健院割痔疮怎么样
襄樊市红十字医院治疗睾丸炎多少钱 宜城市中医院妇科医院排名养心优惠 [详细]
襄阳市治青春痘的办法
襄阳市第一人民医院男科咨询 襄阳前列腺炎祛痘医院 [详细]
襄阳四医院男科挂号
襄阳四院医院是正规医院吗 养心频道襄阳中医院看前列腺炎好吗医护知识 [详细]
襄樊市妇幼保健中医院有做阴道松弛?
安心健康老河口市第一医院医院电话 襄阳四院收费好不好华晚报鱼梁洲开发区妇幼保健中医院男科怎么样 [详细]