Accountability of public health service - Essay Example

Introduction This paper provides an insightful study of the accountability issues involved in the British National Health Service organisation. TheNational Health Service is basically the most renowned government backed health care system. It is the free provision of complete health care from the UK government to the general public that provides funding for its operations. The organisation is run by the Department of Health under the supervision of Secretary of State for Health. As it is a government funded and publicly run health service organisation, the accountability and answerability concerns are of utmost importance in the organisation. Hence, this paper investigates into the accountability requirements in the British National Health System and the types of accountability involved therein. Accountability Of Public Health Service Accountability has been defined several times with several meanings and perspectives such as Ijiri (1983), Robinson (2002), Sinclair (1995) etc. According to Mulgan (2000, p555), "complex and chameleon-like term", which calls for the usage of term as ever changing and available in various forms and ranges. In much simpler words, we can define accountability as the notion of being accountable and answerable for the deeds and doings. Accountability is involved in many forms in various aspects of human lives. For instance, an organisation is accountable to its shareholders, and a minister is accountable to parliament etc (Mosley 2000). Accountability is essential in the sense that it creates a sense of responsibility and sets a value framework for the actions to be performed. Accountability in public health service is of enhanced importance because of the nature of operations it conducts. If the funds provided by the government are to be allocated completely to the desired beneficiaries and if the prescribed operations are to be performed in the best manner, some necessary accountability measures need to be taken. Such strategies need to be undertaken so as to combat misuse of resources, ensure abidance to defined rules, and enhance efficiency in the health care system. Schedler (1999) says that answerability is the vital component of accountability, which refers to the notion of being answerable for the deeds and decisions. Accountability is pre-eminently important in public health service, because it the utmost responsibility of any government in the world to make the provision of best medical and health care facilities to its people. Any lack of accountability can lead to the corruption, mal-practice and misuse of the resources on the part of the government personnel. Brinkerhoff (2001) refers to the following types of accountability that should be enforced in public health care system: Financial Accountability It makes the public officials accountable for their use of financial resources of the organisation with the help of various tools such as accounting, auditing, and budgeting etc. As public health care system is funded by ministries, the government needs to enforce control measure using predetermined budget for specific facilities and setting limit standards for spending power granted to different levels of authority. This type of accountability is needed to reduce the corruption among public officials in the health sector. The Audit Commission and National Audit Office can take National Health Service bodies under investigation but not much of the information is disclosed outside the organisation. However, the recent reforms introduced by the government require the NHS bodies to publish and disseminate the organisation's annual reports plus their business plans. This counts for an enhanced accountability in financial aspect because the uses and outcomes of financial resources can easily be analysed through the financial statements. Managerial Accountability Managerial accountability lies in measuring the performance of the organisation in terms of the results achieved out of its various operations. The personnel can be made accountable through the imposition of specific standards at each level of performance. Furthermore, performance accountability can also be gauged in terms of financial resources expended and results achieved thereon. In the context of UK NHS bodies there seem to no specific predetermined performance standards to measure the performance of individuals, Trusts and hospital at an public level. Political Accountability Political accountability refers to the fact that governments should consider themselves accountable for their responsibility and position in health care system. The power exercised by the government should be consistent with the confidence and faith put into it by the government. The government should fulfill the promises that it makes in election campaigns for a fair provision of health care facilities to public through proper implementation of policies and strategies. According to the National Health Service structure, the Boards of Health Authotities and Trusts are held accountable to the Secretary of the State. However, there is a little extent of accountability exercised by locally elected governments in the decision making within NHS bodies and the decision making relies too much on the centralisation. Skelcher, Weir and Wilson (2000) illuminate that there were no such provisions to make the NHS bodies accountable in the political sense, however the reforms conducted in the year 2001 provided powers to Local Authorities to investigate on matters concerning malpractice on the part of NHS bodies. Legal Accountability Legal Accountability can be obtained through the implementation of policies that are in consistency with the legal rules and regulations while making a strong point to observe legal considerations in all the aspect of the health service's operations. Consumer Accountability Consumer accountability can be achieved by having a robust consideration for the benefits of the customers of health service. The customers in the sense of a public health service such as NHS are the general public to whom the government is responsible for the provision of efficient health care facilities. That makes the importance of customer orientation a vital part of accountability. The government has taken measures to enforce a customer oriented touch to the activities of NHS bodies. The personnel of the organisations can be taken to task by the Health authorities as an action taken on a patient's complaints. However, the procedure is so long and tedious that these complaints might even take years to be processed. Therefore, the focus on consumer interest is weak in UK health system. Conclusion Based on the above discussion, it can be said that despite the continuous implementation of reforms in the sector, the British National Health System or the public health service lacks proper measures of accountability. The current practices undergoing in the system do not efficiently fulfil the five major aspects of accountability in the health care system. Therefore it is of utmost importance to the government to introduce effective measures to enhance accountability, which will in turn bear fruits in the form of efficiency of the system. Read More