Public Health Policy and Practice in the United Kingdom - Essay Example

?Review and Appraise Public Health Policy and Practice in the United Kingdom Table of Contents Introduction 3 Historical Progression of Public HealthPolicy and Practice in the UK 3 Review and Appraisal of the Current Practice and Policy of Public Health Care in the UK 7 Impact of Health Policy on General Population 11 Conclusion 12 References 13 Introduction Public health is related to the aspect of assisting people to remain fit and preventing the occurrences of diseases or illness. Thus, public health includes performance in relation to the series of policies pertaining to vaccination, nourishment, tobacco, alcohol and drugs among other aspects. Apart from the mentioned factors, public health policy is also known to encompass pregnancy, children health and medical recovery. In the United Kingdom (UK), public health policy poses significant influence on the overall lifestyle and environment which affects the health of the people (Department of Health, 2012). Health services are characterised to be quite unequal in the UK and is extremely structured in relation to the social class. In the UK, ‘National Health Services’ (NHS) formulates policies in order to develop the facet of healthcare for the population. The report will describe the past and current policies on public healthcare. The objective of the report is to review and appraise the health policies and practices in the UK. Historical Progression of Public Health Policy and Practice in the UK The concept of public health defines the phenomenon which can be realised by mutual activities. Public health policy in the UK has great significance for the population in terms of inhibiting diseases, protecting lives and encouraging healthy activities through planned practices and up-to-date selections of culture, organisations and entities (Baggott, 2011). During the 19th century, the notion of public health was mainly related with the quality of food, water and air. With respect to diseases, public health was mostly concerned with transferable, deadly and painful reasons of death which was a result of complete poverty. However, in the 20th century, public health policy was adjusted to meet the challenges of new kinds of sicknesses associated with longevity, industrial development, disparities in health and ecological damage. The change in the public health policy was accompanied by the increasing conviction of people that several fundamental aspects could be cooperative towards the prevention of diseases through social, ecological or developmental changes. Nowadays, the apparent link between health care and disease has transformed over time. The traditional view of healthcare was observed in terms of exerting attempts to cure existing diseases or treatments of the outcomes of any diseases. However, modern view of healthcare is observed in the form of dealing with the aspects or reasons which results to any particular disease. Within the new structure of disease, new treatment leads to increased demands for public health policy (Exworthy & et. al., 2003). Social deprivation is a major determinant of weak health in traditional times. It had been evident in the UK with regard to the health care problems. Social status, whether dignified by educational level, income level or type of job, is supposed to be a strong analyst of health outcomes. These disparities in health occur because of poor lifestyle, poor control on work situation and weak social provisions. Public health can gradually reflect on the facets of emerging knowledge regarding inborn susceptibility to disease and the significance of connections between inborn endowment and the surroundings. Several concepts have been evaluated to conceptualise the present views on the association between individual, their surroundings and their illnesses. Over time, such concepts have started to be reflected on public health policy by admitting the impact of broader elements of health, such as poverty, education and occupation (Exworthy & et. al., 2003). Throughout the era of 1970s, failure of England to improve the health was observed and its association with disparities turned out to be apparent. During that period, the objective of public health policy was to develop the living standards of poorest individuals in the UK. There were two major strategies in relation to the public health, one encouraging an overall approach towards the improvement of health and the other one supporting a fundamental renovation in the balance of activity and allocation of resources within the health and associated services. ‘Black Report’ had developed 37 recommendations encompassing the enhancement of information and providing more focus on inhibition, primary medical care, free health services and development of situations for the underprivileged people specially children, mothers and disable people (HM Treasury, n.d). The importance of public health policy in the UK has gradually transformed over the period of 1970 and 2000 through the publication of several reports. During that time ‘World Health Organisation’ (WHO) was acknowledged as the principal supporter of public health. In the year 1978, WHO had expressed the requirement for undertaking grave measures in every nation, to defend and encourage the health of individuals in the global context. The idea of setting targets for healthcare also developed in this period. In the year 1979, the ‘Black Report’ of UK recommended that targets must be used in healthcare as well. WHO also identified the requirement of setting target in healthcare, but was only implemented after 1984 (Irvine & et. al., 2006). In 2000, WHO defined targets regarding the aspect of health improvement for every region internationally with particular consideration towards the minimisation of new-born mortality rate, maternal mortality rate, illness death rate and rate of death from accidents. WHO had developed health promotion policy by taking into deliberation the several areas of public health. The UK government was found to successfully endorse the policies of WHO. However, UK had not progressed much on the problems of healthcare and was also perceived as resilient towards setting proper health targets (HM Treasury, n.d). On the basis of the target set by WHO through ‘Health for All by the year 2000’, for addressing the increasing requirements of health care system, the UK government was found to issue the policy namely ‘The Health of The Nation’. This policy set outs the targets for minimisations in the death rate of people due to heart illness, sexually spread viruses, cancer, suicide and accidents. The policy also aimed at reducing the occurrences of unhealthy activities such as smoking, drinking alcohol and obesity. However, the policy was mostly ignored on the aspects of poverty and disparities of health care for public (HM Treasury, n.d). The independent examination report on the problem of disparity of public health in the UK made several sanctions for the development of future public health policy entailing issues of poverty, income, welfares, schooling, occupation, accommodation, environment, transportation, pollution and nourishment for mothers, children, families, youths, adults and older people. The inquiry recognised three major measures for decreasing disparities in health. It denotes that every public health policy must be assessed with respect to the influence on health disparities. Secondly, the assessment signified that high importance must be provided to the health of children and families. Finally, the assessment also recommended that additional actions must be taken in order to minimise income disparities and enhance the lifestyle of poor families (Novick & Moore, 2012). Since 1998, the report on independent examination of health was learnt to have played a vital part in influencing the public health policy of UK. This report provided direction on the needed developments with regard to the health policies in the UK. The government of UK directly reacted with the recommendations and presented strategies for preventing child poverty, improving the food structure, promoting physical improvement of babies and children specially those who are poor and initiating healthy programs for minimising obesity and diabetes such as ‘Five – A – Day programme’ and ‘National School Fruit Scheme’ (HM Treasury, n.d). Review and Appraisal of the Current Practice and Policy of Public Health Care in the UK Recently, the explanation of public health has been found to change for the reason of explaining a phenomenon which entails the possibility of being impacted by the mutual action and engages implication for the overall population. Public health is considered to be the blend of science, real-world abilities and principles which are directed towards the maintenance and development of the health of every individual (WHO, 2012). The key theme of current practice in public health policy is quality. The introduction of medical governance provides every health establishments a legislative responsibility to seek quality enhancements. Quality in health care is a term which denotes efficiency. The present focus of public health policy of UK intends to encourage efficiency and thereby improvement of health care services quality. However, it can only be accomplished if appropriate evaluation outcomes and valid policy recommendations are properly merged into healthcare practices. Often it requires healthcare experts to bring in alterations in their respective behaviour and practices (The University of York, 1999). The arrival of 21st century marked the upcoming phase of public health in the UK. The renewed version of ‘Health for All’ focused on one continuous objective of WHO i.e. every individual must accomplish their complete health potential. Currently, public health is regarded as a priority for the UK government. Therefore, the objective of WHO was found to be accepted by the UK as the outwitting objective of its public health policy. The challenges that UK presently witnesses in promoting healthcare are inequalities, obesity and unhealthy activities such as substance abuse, smoking and drinking. Thus, improvement of public health necessitates policies which can effectively deal with the economic, social and environmental factors of health (Irvine & et. al., 2006). Present public health policy practices in the UK are based on the aspects of inequality, smoking, obesity, mental health and alcohol among other factors. Inequality: Current public health policy with regard to the aspect of inequality concentrates on improving the health of poor people as their health condition is supposed to be related to discrimination. In order to improve the health of poor people, the policy emphasises on downstream activities which includes performing directly with poor people and the society they belong to in order to deal with the instantaneous health issues. However, in future, more focus on inequality can prove to be inadequate for enhancing the health of the people because it involves dealing with the root reasons of inequality only on the basis of social and economic plan (Hunter & Killoran, 2004). Smoking: Smoking is considered to be one of the major reasons for death of people in the UK. Smoking causes majority of cancers which ultimately leads to death. Thus, current public health policy in the UK involves partial prohibition on smoking in the public locations. In line with the public health policy of the government, several hospitality organisations have already proscribed smoking in their locations. The prohibition of smoking can result in saving millions of pounds on health. However, it can also pose an adverse impact on the revenue of the government because taxes on tobacco products contribute significantly towards the annual income. In the year 2004, the government of UK almost lost ?2.5 million due to low taxes on tobacco. Furthermore, high taxes on tobacco can result in increasing smuggling activities (Morris & Dawson, 2006). One of the most efficient methods to minimise the activity of smoking is to make it ‘less socially acceptable’ and less attractive which can be accomplished by ‘smoke free’ policies. As majority of young individuals relate smoking activities with maturity, the laws in the UK also prohibit selling cigarettes to the minors in order to discourage smoking. Stronger implementation of the law is measured to be an efficient method for minimising smoking incidences among young people (Morris & Dawson, 2006). Obesity: Obesity is the other significant health issue which is majorly witnessed by the people of UK. The reason for obesity among people mainly relates to the behavioural aspects. Besides, genetic aspects are also supposed to be associated with the rising increase of obesity among people. Current public health policy intends to address the decline in the degree of physical workout because of improvement of transportation (such as escalators), development in communication and changing activities of children (such as greater use of car and lesser outdoor games) among others factors. Several evidences suggest that in order to deal with the issue of obesity, diet as well as physical exercise both are considered to be essential. Thus, the public health policy concentrates on enhancing the physical activities of people in leisure times (Mackett & Brown, 2011). Alcoholism: Similar to smoking, the government of UK also witnesses problem with respect to obligations on alcohol. In the year 2002, the government of UK encountered a loss of ?600 million because of alcohol tax avoidance. In the UK, the Licensing Act was passed in the year 2003 with the purpose of trimming down the act of drinking. However, it was criticised by the people on the ground that this act actually entailed the likelihood to provide more time to the people for indulging in alcoholism (Morris & Dawson, 2006). Mental health: In the UK, the practice of public health policy on improving the mental health is not considered to be appropriate. A strong focus is provided on mental illness rather than the welfare of people, development of healthcare service facility and satisfaction as well as minimisation of social disparity. The growth of healthcare services is regarded as beneficial with respect to the estimated growths of people suffering from mental illness in future. Several possible mechanisms were addressed in numerous areas of the public health policy, but those lacked connections in real life practices. The public health policies are believed to be quite constricted in nature which results in lost opportunity for obtaining wider health advantages. As there is significant association between mental and physical health, increased focus needs to be provided on the wellness of people in the future public health policy (Morris & Dawson, 2006). In numerous instances, it was observed that a major gap existed between the actual policy and its practice in the UK. In the year 1992, WHO declared that the public health policy was witnessing a severe individuality crisis as along with difficulties in terms of accomplishment in reality. In the UK, little focus was provided on practice. There always prevailed a tension between public health discipline and public health policy activities which hindered the effective form of practices greatly. One of the major weaknesses towards the implementation of health policy is compartmentalisation of policies and organisational structures. The government of UK approached the development of public health policy and its application from a reductionist viewpoint, i.e. splitting the health related issues into several elements and trying to resolve them through rectilinear activities. Above all, ‘performance and innovation’ has been regarded as vital for public health policy delivery as it is believed to control the thinking of central government. In the UK, a requirement for horizontal leadership across different divisions was evidently identified. Through strong leadership, organisations would be capable of assessing the entire scenario and develop a common vision in relation to the other healthcare institutions effectively (Orme & et. al., 2007). Impact of Health Policy on General Population Strong public health policy can significantly improve the health of the overall population. Health policy can prove to intervene with regard to the healthy activities of people in several ways. The interventions of government through policy can impact a large population with the help of implementation of laws. For instance, increasing the tax rate of cigarettes can reduce smoking based diseases. Similarly, interventions such as worksite oriented schemes which can enhance the access to physical exercise facilities of the workers can effectively result in improving the health (Raphael & Bryan, 2006). With respect to obesity, the major reasons identified are human behavioural as well as genetic aspects. Through the interference or involvement of health policy, these aspects can be controlled. Health policy can influence the aspect of food selection made by the people and physical exercise. Generally, the cost structure of food products inspires people to purchase or order food which are harmful for health. Therefore, limitations on unhealthy food through implementation of policy can check the occurrence of obesity within people. In order to make changes in public health, the policy must be developed and implemented carefully so that it restricts the population from unhealthy activities (Brownson & et. al., 2010). Decentralisation of the UK, particularly the formation of designated assemblies can exert a fresh form of emphasis on the public health services. The relation between decentralisation and public health policy is extensively supported by those functioning in the field of public health. Presently, the regional public health activities includes undertaking measures for the root reasons of poor health of people and inequalities prevailing in the health care services by implementing policies on transportation, environment and metropolitan redevelopment (Baldock & et. al., 2007). Conclusion The public health policy in the UK has developed from prevention of transmissible diseases to inhibition of chronic diseases. With the progression of public health policy, significant alteration of focus related to healthcare towards the influence of individual activities and lifestyle has been observed. In the UK, health inequalities always remained to be an important issue with regard to the overall public health, particularly since past and present public health methods greatly contributed towards such inequalities through the socio economic context. The evolutionary notion of public health policy was learnt to create an impact on the population of UK. However, government involvements are known to lack proper articulation in the UK and must be strengthened in order to accomplish its complete potential. A need for developing evidence oriented health policy and practice for achieving the healthcare objectives effectively has been apparently observed. References Brownson, R. C. & et. al., 2010. Measuring the Impact of Public Health Policy. Preventing Chronic Disease, Vol. 7, Iss. 4, pp. 1-7. Baldock, J. & et. al., 2007. Social Policy. Oxford University Press. Baggott, R., 2011. Public Health: Policy and Politics. Palgrave Macmillan Limited. Department of Health, 2012. Public Health. Policy Areas. [Online] Available at: http://www.dh.gov.uk/health/category/policy-areas/public-health/ [Accessed August 16, 2012]. Exworthy, M. & et. al., 2003. Tackling Health Inequalities in the United Kingdom: The Progress and Pitfalls of Policy. Health Services Research, Vol. 38, Iss. 6, pp. 1905-1922. HM Treasury, No Date. Public Health Policy in England: Lessons to Be Learnt. Securing Good Health for the Whole Population. [Online] Available at: http://www.hm-treasury.gov.uk/d/Wanless04_ch2.pdf [Accessed August 16, 2012]. Hunter, D. J. & Killoran, A., 2004. Tackling Health Inequalities: Turning Policy into Practice? Health Development Agency. [Online] Available at: http://www.nice.org.uk/nicemedia/documents/tacklinghealthinequalities.pdf [Accessed August 16, 2012]. Irvine, L. & et. al., 2006. A Review of Major Influences on Current Public Health Policy in Developed Countries in the Second Half of the 20th Century. Perspectives in Public Health, Vol. 126, Iss. 2, pp. 73-78. Morris, Z. S. & Dawson, S., 2006. Policy Futures for UK Health. University of Cambridge. [Online] Available at: http://www.health.jbs.cam.ac.uk/research/cuhresearch/downloads/policy_current.pdf [Accessed August 16, 2012]. Mackett, R. L. & Brown, B., 2011. Transport, Physical Activity and Health: Present Knowledge and the Way Ahead. 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