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英国医疗体系效率低下(Public service productivity)
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这是一个星期五下午，在西约克郡哈德斯菲尔德皇家医院2号手术室，手术团队正在向本文记者展示他们的设备。 
双语精读
Public-service productivity
公共服务效率
"What would you like to see?" asks the scrub nurse as a surgeon beside her feeds a wire through a patient's urethra. It is a Friday afternoon in Theatre 2 at Huddersfield Royal Infirmary in West Yorkshire, and the surgical team is showing your correspondent their equipment.
"你想看什么？"手术室护士问道，旁边的外科医生正在将一根导线穿过患者的尿道。这是一个星期五下午，在西约克郡哈德斯菲尔德皇家医院2号手术室，手术团队正在向本文记者展示他们的设备。
That patient--call him Mr Jones--can count himself comparatively lucky to live where he does. Calderdale and Huddersfield Trust has climbed the ladder for hospital waiting lists in recent years: 72% of patients are seen within the target time of 18 weeks compared with 59% in England overall.
那位病人----叫他琼斯先生吧----可以认为自己住在哈德斯菲尔德是相对幸运的。近年来，科尔德代尔和哈德斯菲尔德信托基金会在医院候诊名单上的名次不断攀升：72%的患者在18周的目标时间内就诊，而英格兰的整体比例为59%。
Mr Jones's path through the system shows how the National Health Service (NHS) could use its resources better. Wonks and politicians alike agree that productivity--the ratio of treatment the NHS provides to its inputs, such as labour, equipment and drugs--is a pressing problem.
琼斯先生在医疗系统中的经历表明，国家医疗服务体系（NHS）对资源的使用还有改进空间。专家和政客都一致认为，效率----NHS提供的治疗与其投入（如劳动力、设备和药物）的比率----是一个紧迫的问题。
Hospitals have more staff than ever, yet they are doing less than they were before the pandemic. Between 2019 and 2023, the amount of surgery carried out by each surgeon decreased by 12%; the numbers are almost as bad for outpatient appointments and significantly worse for emergency care.
医院的员工比以往任何时候都多，但他们做的事情却比疫情前更少。2019年至2023年期间，每位外科医生进行的手术量减少了12%；门诊预约的数据几乎一样糟糕，急诊的数据则糟得多。
A paper published for an NHS England board meeting in May identified some reasons for this. Chief among them was industrial action, which since late 2022 has led to the cancellation of more than 1.4m appointments and operations.
5月份在NHS英格兰董事会会议上发表的一篇论文指出了其中的一些原因。最主要的原因是罢工，自2022年底以来，罢工已导致超过140万次预约和手术被取消。
Other factors included an increased use of agency staff, longer hospital stays, maintenance backlogs and rising prices of new branded medicines and technology. That still left a mysterious productivity gap whose likely cause, the authors concluded, was a lack of "discretionary effort" from staff.
其他因素包括代理员工的使用增加、住院时间延长、设备维护积压以及新药和新技术价格上涨。这仍然留下了一个神秘的效率缺口，论文作者推论其可能原因是员工缺乏"自由决定权"。
Some of this may be temporary: the new Labour government has settled pay disputes with some NHS workers, for example. But many problems predate the pandemic. To understand more, rewind to before Mr Jones reaches the operating table.
其中一些问题可能是暂时的：例如，新工党政府已经与一些NHS工作人员解决了薪酬纠纷。但许多问题在疫情之前就存在了。要了解更多信息，请回到琼斯先生走上手术台之前的时候。
His first interaction with a doctor would have been when he went to his general practitioner (GP), complaining of weight loss and bleeding from his rectum. It may well have taken Mr Jones a while to get an appointment: Britain has almost 16% fewer fully qualified GPs per person than other rich countries.
他第一次看医生应该是去看全科医生，描述自己有体重减轻和直肠出血的症状。琼斯先生可能等了很长一段时间才预约到：英国的人均合格全科医生数量比其他富裕国家少近16%。
词汇预习
industrial [高考]
美[ɪnˈdʌstriəl] | 英[ɪnˈdʌstriəl]
adj. 工业的；产业的 n. 工业公司
interaction [高考]
美[ˌɪntəˈrækʃən] | 英[ˌɪntərˈækʃən]
n. 相互作用；相互影响；互动交流
overall [高考]
美[ˌoʊvərˈɔːl , ˈoʊvərɔːl] | 英[ˌəʊvərˈɔːl , ˈəʊvərɔːl]
adj. 全部的；总体的；全面考虑的 adv. 总的来说；总共 n. 罩衫；工作服
significantly [高考]
美[sɪɡˈnɪfɪkəntli] | 英[sɪɡˈnɪfɪkəntli]
adv. 意味深长地；意义深远地；重要地；较大地
productivity [高考]
美[ˌprɑːdʌkˈtɪvəti] | 英[ˌprɒdʌkˈtɪvəti]
n. 生产率；生产力
surgery [高考]
美[ˈsɜːrdʒəri] | 英[ˈsɜːdʒəri]
n. 外科手术；外科；诊所；手术室；应诊时间
cancellation [高考]
美[ˌkænsəˈleʃən] | 英[ˌkænsəˈleɪʃn]
n. 取消；撤销；废除
ratio [高考]
美[ˈreɪʃioʊ] | 英[ˈreɪʃiəʊ]
n. 比率；比例
maintenance [高考]
美[ˈmeɪntənəns] | 英[ˈmeɪntənəns]
n. 维修；维护；保持；生活费用；抚养费
within [高考]
美[wɪˈðɪn] | 英[wɪˈðɪn]
prep. 在(某段时间、距离或范围)内；在…里面 adv. 在…里面 n. 内部
lack [高考]
美[læk] | 英[læk]
n. 缺乏；无 v. 缺乏；不足
per [高考]
美[pər] | 英[pə(r)]
prep. 每；每一；经过；按照
loss [高考]
美[lɔːs] | 英[lɒs]
n. 遗失；丧失；损失；失败；失落；死亡
agency [高考]
美[ˈeɪdʒənsi] | 英[ˈeɪdʒənsi]
n. 代理；代理处；政府机构
target [高考]
美[ˈtɑːrɡɪt] | 英[ˈtɑːɡɪt]
n. 目标；对象；靶 vt. 把 ... 作为目标；瞄准
emergency [高考]
美[iˈmɜːrdʒənsi] | 英[iˈmɜːdʒənsi]
n. 突发事件；紧急状态 adj. 应急的；紧急的；备用的
temporary [高考]
美[ˈtempəreri] | 英[ˈtemprəri]
adj. 暂时的；临时的 n. 临时工
wire [高考]
美[ˈwaɪər] | 英[ˈwaɪə(r)]
n. 金属丝；电线；电报 vt. 发电报；装电线；(通过电线)接通；用金属丝把...连一起；电汇
alike [高考]
美[əˈlaɪk] | 英[əˈlaɪk]
adj. 相似的；同样的 adv. 一样；以同样的方式
labour [高考]
美[ˈleɪbər] | 英[ˈleɪbə(r)]
n. 劳动；劳工；分娩 v. 努力；干苦力活；困难吃力地行进；反复说明 n. (英国)工党
surgeon [高考]
美[ˈsɜːrdʒən] | 英[ˈsɜːdʒən]
n. 外科医生
rewind [高考]
美[ˌriːˈwaɪnd] | 英[ˌriːˈwaɪnd]
v. 倒带；转回；重绕 n. 倒带装置；重绕
lack of [高考]
美[læk ʌv] | 英[læk ɔv]
缺乏
gap [高考]
美[ɡæp] | 英[ɡæp]
n. 缺口；裂缝；差距；空白
outpatient [高考]
美[ˈaʊtpeɪʃnt] | 英[ˈaʊtpeɪʃnt]
n. 门诊病人
practitioner [高考]
美[prækˈtɪʃənər] | 英[prækˈtɪʃənə(r)]
n. 从业者；实践者
where [高考]
美[wer] | 英[weə(r)]
adv. 在哪里；在那个地方 conj. 在 ... 地方
would [高考]
美[wʊd , wəd] | 英[wʊd , wəd]
aux. 将；可能；大概；总会；愿意；will的过去式
correspondent [四级]
美[ˌkɔːrəˈspɑːndənt] | 英[ˌkɒrəˈspɒndənt]
n. 通讯记者；通信者 adj. 与 ... 一致的；相应的
comparatively [四级]
美[kəmˈpærətɪvlɪ] | 英[kəmˈpærətɪvli]
adv. 比较地；相对地
surgical [四级]
美[ˈsɜrdʒɪkl] | 英[ˈsɜ:dʒɪkl]
adj. 外科的；外科医生的；手术上的
pressing [四级]
美[ˈpresɪŋ] | 英[ˈpresɪŋ]
adj. 紧迫的；紧急的
fully [六级]
美[ˈfʊli] | 英[ˈfʊli]
adv. 十分地；完全地；全部；足足
scrub [六级]
美[skrʌb] | 英[skrʌb]
n. 用力擦洗；矮树；渺小之物 v. 用力擦洗
predate [托福]
美[priˈdet] | 英['pri:'deɪt]
v. 在日期上早于
less than [雅思]
美[les ðən] | 英[les ðən]
不到； 少于
重点讲解
Public-service productivity
公共服务效率
surgical adj. 外科手术的；如手术般精确的
【例】surgical procedures 手术程序
a surgical insight 敏锐的洞察力
surgical precision 如手术般精准
【拓展】surgery n. 外科；外科手术
"What would you like to see?" asks the scrub nurse as a surgeon beside her feeds a wire through a patient's urethra. It is a Friday afternoon in Theatre 2 at Huddersfield Royal Infirmary in West Yorkshire, and the surgical team is showing your correspondent their equipment.
"你想看什么？"手术室护士问道，旁边的外科医生正在将一根导线穿过患者的尿道。这是一个星期五下午，在西约克郡哈德斯菲尔德皇家医院2号手术室，手术团队正在向本文记者展示他们的设备。
surgical adj. 外科手术的；如手术般精确的
【例】surgical procedures 手术程序
a surgical insight 敏锐的洞察力
surgical precision 如手术般精准
【拓展】surgery n. 外科；外科手术
That patient--call him Mr Jones--can count himself comparatively lucky to live where he does. Calderdale and Huddersfield Trust has climbed the ladder for hospital waiting lists in recent years: 72% of patients are seen within the target time of 18 weeks compared with 59% in England overall.
那位病人----叫他琼斯先生吧----可以认为自己住在哈德斯菲尔德是相对幸运的。近年来，科尔德代尔和哈德斯菲尔德信托基金会在医院候诊名单上的名次不断攀升：72%的患者在18周的目标时间内就诊，而英格兰的整体比例为59%。
count v. 看作；算作
【例】I count her (as) my best friend.
我把她视为最好的朋友。
【近义词】consider sth (as) 把某物看作
Mr Jones's path through the system shows how the National Health Service (NHS) could use its resources better. Wonks and politicians alike agree that productivity--the ratio of treatment the NHS provides to its inputs, such as labour, equipment and drugs--is a pressing problem.
琼斯先生在医疗系统中的经历表明，国家医疗服务体系（NHS）对资源的使用还有改进空间。专家和政客都一致认为，效率----NHS提供的治疗与其投入（如劳动力、设备和药物）的比率----是一个紧迫的问题。
ratio of A to B A和B的比率
【例】The ratio of pupils to teachers was 30 to 1.
学生和教师的比率是30比1。
【近义词】rate n. 率；比率
pressing adj. 紧迫的；紧急的
【例】pressing business 急事
pressing need 迫切的需要
Time is pressing. 时间很紧。
【近义词】urgent adj. 紧迫的；紧急的
【拓展】be pressed for sth （时间、资金等）紧缺
Hospitals have more staff than ever, yet they are doing less than they were before the pandemic. Between 2019 and 2023, the amount of surgery carried out by each surgeon decreased by 12%; the numbers are almost as bad for outpatient appointments and significantly worse for emergency care.
医院的员工比以往任何时候都多，但他们做的事情却比疫情前更少。2019年至2023年期间，每位外科医生进行的手术量减少了12%；门诊预约的数据几乎一样糟糕，急诊的数据则糟得多。
appointment n. 预约；会面约定；约会
【例】I have an appointment with the doctor this afternoon.
今天下午我预约了去看医生。
All visitors to the National Museum of China must make online appointments.
参观国博的所有游客必须在网上预约。
Do you have an appointment?
您有预约吗？
【近义词】engagement n. 预约；提前安排要做的事
【辨析】reservation n. 预订（餐馆座位）
booking n. 预订（票、酒店等）
date n. （情侣）约会
【反义词】drop-in/walk-in adj. 不需预约的；随时来的
A paper published for an NHS England board meeting in May identified some reasons for this. Chief among them was industrial action, which since late 2022 has led to the cancellation of more than 1.4m appointments and operations.
5月份在NHS英格兰董事会会议上发表的一篇论文指出了其中的一些原因。最主要的原因是罢工，自2022年底以来，罢工已导致超过140万次预约和手术被取消。
industrial adj. 产业工人的
【例】an industrial accident/injury 工伤事故
the industrial class 工人阶级
an industrial tribunal 劳资法庭
backlog n. 积压的工作
【例】a backlog of legal cases
积压的法律案件
I have a huge backlog of work to do.
我积压了很多工作没做。
【辨析】waterlogged adj. 浸满水的；泡水的
discretionary adj. 自行决定的；酌情行事的
【例】discretionary power 便宜行事的权力
【拓展】discretion n. 自行决定权
【例】Some tests are left to the discretion of the doctor.
有些检查要不要做，由医生酌情确定/有些检查可做可不做。
Other factors included an increased use of agency staff, longer hospital stays, maintenance backlogs and rising prices of new branded medicines and technology. That still left a mysterious productivity gap whose likely cause, the authors concluded, was a lack of "discretionary effort" from staff.
其他因素包括代理员工的使用增加、住院时间延长、设备维护积压以及新药和新技术价格上涨。这仍然留下了一个神秘的效率缺口，论文作者推论其可能原因是员工缺乏"自由决定权"。
industrial adj. 产业工人的
【例】an industrial accident/injury 工伤事故
the industrial class 工人阶级
an industrial tribunal 劳资法庭
backlog n. 积压的工作
【例】a backlog of legal cases
积压的法律案件
I have a huge backlog of work to do.
我积压了很多工作没做。
【辨析】waterlogged adj. 浸满水的；泡水的
discretionary adj. 自行决定的；酌情行事的
【例】discretionary power 便宜行事的权力
【拓展】discretion n. 自行决定权
【例】Some tests are left to the discretion of the doctor.
有些检查要不要做，由医生酌情确定/有些检查可做可不做。
Some of this may be temporary: the new Labour government has settled pay disputes with some NHS workers, for example. But many problems predate the pandemic. To understand more, rewind to before Mr Jones reaches the operating table.
其中一些问题可能是暂时的：例如，新工党政府已经与一些NHS工作人员解决了薪酬纠纷。但许多问题在疫情之前就存在了。要了解更多信息，请回到琼斯先生走上手术台之前的时候。
predate v. 早于……（发生）
【例】The car predates the plane.
汽车的发明时间在飞机之前。
【反义词】postdate v. 晚于……（发生）
rewind v. 倒带；倒回
【例】The story rewound to 1900.
故事倒回1900年/故事从1900年开始倒叙。
【反义词】fast forward v. 快进
【拓展】wind v. 缠绕；倒（磁带等）
【例】to wind the tape back/forward 把磁带向后倒/向前倒
His first interaction with a doctor would have been when he went to his general practitioner (GP), complaining of weight loss and bleeding from his rectum. It may well have taken Mr Jones a while to get an appointment: Britain has almost 16% fewer fully qualified GPs per person than other rich countries.
他第一次看医生应该是去看全科医生，描述自己有体重减轻和直肠出血的症状。琼斯先生可能等了很长一段时间才预约到：英国的人均合格全科医生数量比其他富裕国家少近16%。
qualified adj. 合格的；有资历的
【例】She is qualified for the job.
她符合这份工作的资格要求/她能胜任这份工作。
【拓展】qualify v. 取得资格；使合格
qualification n. 资格；必要素养
课后练习
Why should Mr. Jones consider himself lucky?
A. Because the hospital has advanced equipment.
B. Because the surgical team is highly experienced.
C. Because he is receiving treatment on a Friday afternoon.
D. Because he has a greater chance to receive timely treatment.
What is highlighted as a urgent problem regarding the National Health Service?
A. Lack of necessary medical resources.
B. Decrease in the number of staff in hospitals.
C. Decrease in the productivity of the NHS.
D. Increase in outpatient workload.
What does the author think about the causes of decreasing productivity in the NHS?
A. The author finds the reasons easily solvable.
B. The author considers the causes mysterious.
C. The author believes the factors are temporary.
D. The author regards some issues as longstanding.
What does Mr. Jones's interaction with the GP show?
A. Mr. Jones had a serious medical condition.
B. The diagnostic capacity of GPs is insufficient.
C. Mr. Jones was not proactive about his health.
D. The GPs in Britain are not qualified for their jobs.
