Healthcare and Health Policy in the UK - Essay Example

1. Discuss at least four main factors responsible for the current pressures on the United Kingdom National Health Service. The UK medical service is expanding as a result of increase in the demands of the growing population and the innovations in the treatment field as well. These health care reforms have been established in most hospitals. All healthcare organizations like hospitals, clinics, nursing homes, doctor’s offices etc are to be sanitized and well cleaned. Therefore, cleaning service is one of the main factors that put pressure on the current United Kingdom National Health Service. The spreading of infection is a high possibility in all work places even if they have been fumigated. Though it is a factor important to all sectors, it is more essential in the health care industry. The prevention and control of the Healthcare Associated Infections (HAI) is the main concern of the UK National Health Service. When compared to other European countries, UK has the highest rate of Methicillin resistant Staphylococcus Aureus (MRSA) infection. The government of UK finds it difficult to bring down this rate as there is lack of investment from the government and people’s part. It has also been found that effects of HAI are more prevalent in UK since it is easily spread in this country as compared to others. Apart from this, there are many people in UK who are the carries of MRSA infection. “A further difference between the UK and the rest of Europe is that the UK has comparatively higher bed occupancies, which lead to greater opportunities for patient to patient transmission” (Arm yourself with cleaning in the battle against infection, 2011). The way in which other European countries tried to tackle this MRSA infection was by sending patients to their own homes for about four months and treating them there with antibiotics. If the infection spread to the wards of the hospital, they were closed and those areas were later cleaned and disinfected. There are up-coming new technologies for disinfection, but they need long term planning as the whole ward has to be emptied. This is the current pressure that the NHS in UK is facing and they are likely to achieve it by the end of the year 2011. Another major problem the UK government faces is that they are not able to tackle and help the BME groups to overcome their health related challenges. These Black and Minority Ethnic groups have worse health compared to the whole UK population. They experience a high rate of poverty than the white Britons. A number of policies have been implemented to alleviate the pain and suffering of these poverty-stricken helpless people. “Sir Donald Acheson’s Independent Inquiry into Inequalities in Health (1998) was a key initiative which put health inequalities onto the policy agenda” (Ethnicity and Health, 2007, P.2). Even though these policies were aimed at reducing poverty of the ethnic groups, implications have been made that these groups did not benefited from these policies. Therefore, the welfare of these BME groups remains like an unfulfilled target of the UK government and this is another factor that pressurizes the UK NHS. Another element is that the causality departments of the Hospitals in UK are struggling to grow up and meet the expectations and demands of emergency care because they possess neither enough staffs nor enough beds. John Heyworth, president of the College of Emergency Medicine says, “The emergency care system is struggling to cope at the moment” (Campbell & Ball, 2011). He points out to the NHS figures that there is an increase in the rate of patients who have to wait for more than four hours in order to get the emergency treatment. Due to the pressure on funding systems, the organizers cut short the number of staff in the hospital. This has become the reason of many problems in the emergency care departments. According to Carl Emmerson, Christine Frayne and Alissa Goodman, healthcare costs and ageing are other factors that become a heavier burden for the NHS in UK. Healthcare cost varies according to age. It is very expensive for the elderly people as compared to younger people, that is, the cost associated with treatment for newborns and children is relatively low in comparison with that of the adult life. The cost steeply rises as a person grows older. However, the elderly visit NHS more often and they attend more hospital consultations. Therefore, the expense of the inpatient and outpatient hospital use is considerably of high rate. (Emmerson, et al, 2000). “Delayed hospital discharge was an issue which first came onto the UK legislative agenda in 2001” (Meyers, 2010). 2. How true is the argument that charging users of healthcare services at the point of use exacerbates inequalities in health outcomes? Discuss in relation to a named developing country. “User charges can be defined as ‘contributions to costs by individual users in the form of a charge per unit of service consumed, typically in the form of cash” (Reddy and vandermoortele 1996). (User charges in India’s health sector: An assessment, 2001). The policy of user charges was adopted by third world countries following the advice of the World Bank. This was done with aim of improving the economic conditions prevalent in the poor countries. User fees for government healthcare services have been put into practice by some developing countries since the 1980s. By the mid 1990s, most of the countries had adopted this policy. The user fee in developing countries has both positive as well as negative effects. The benefit from user charges for medical services includes generation of extra income, efficient use of services and increase in the quality of services. On the other hand, negative effects are the inefficiencies created by the charges, increase in inequality and high costs of administration. Various studies have revealed that user fee had a negative impact. Studies by Waddinton and Enymayew (1990) and Mwabu et al. (1995) have found that user charges in health sector have led to a decrease in the demand for medical services in a range of 15-45% in most of the developing countries. An example of a developing country, which had introduced user cost for health services is China. User charges were introduced in China during the 1980s. The experience of China underlines the argument that introducing user fees for healthcare reduces the use of healthcare services. A study by Liu and Mills (2002) uncovered as well as emphasized that there is a negative impact of user cost. It was observed that the gap between rural and urban people widened in the area of healthcare. A reduction in preventive services was accompanied with improvement in public sector productivity. “The increased reliance on user fees worsened allocative efficiency, with over-provision of unnecessary services and under-provision of socially desirable services” (James, et al, 2005). Studies showed the increasing negative effects of user cost in China. “For elderly people in China, medical cost (user fees) is the main reason for 40% of those not visiting a doctor and 75% of those not gaining admission to hospitals. Another argument against user fees is that it worsens health inequities. The human costs of prolonged illness at old age and the increase in long term health costs from delayed treatment are further disadvantages” (Jayasinghe, 2006). Inequalities in the field of health sector increased after the implementation of user cost. The inequalities between the people were in terms of both economy and society. The imposition of user cost made poor people poorer and, therefore, the access to better health facilities for poor people became expensive. “According to the World Health Organization estimates in 2000, China ranked 188th among 191 member states in terms of “fairness of financial contribution to health systems” (Cai, 2009). Subsequently, a survey based on 10,000 Chinese households indicated that healthcare is the leading concern among the Chinese (See Hu et al., 2008).” (Li & Wei, 2010). In the past, prior to healthcare reforms, the health services were provided at low and reasonable costs by the government. However, after the reforms were introduced, there was a drastic reduction in health insurance coverage as well as a rise in the user cost. Imposition of user cost was accompanied by an increased economic disparity, which further entailed in regional disparities. These reforms increased the burden on local systems. When these systems became incapable of fully covering healthcare expenditure, they increased the user fees, which made healthcare more expensive for people. Healthcare is one of the important factors, which determines the pace of development of a country. In one of the significant economic indicators, HDI, human health is given prime importance. Therefore, healthcare should be provided at the least possible cost. The disparities in providing healthcare facilities to all people in the same country add to the inequalities in health outcomes. This will lead to regional disparities within the country. The importance of abolition of user charge is clear from what countries like Uganda and Zambia have experienced. When Uganda made its public health services free of charge in 2001, against the advice of the World Bank, the use of outpatient care facilities increased up to 90% across the country after a period of adjustment. (Key Facts: User Fees for Health Services, 2011). The Chinese experience adds to the result of the abolition of user charge in Uganda. From the evaluation of accounts that occurred in China, it can be concluded that the government of the poorer countries must provide healthcare free of cost to its citizens. If the complete abolition of user charge is not possible at least the regional disparities should be avoided somehow so that everyone can leave peacefully and harmoniously. Reference List Arm yourself with cleaning in the battle against infection, 2011. [Online] Health Business. Available at: http://www.healthbusinessuk.net/content/view/2431/11/ [Accessed 19 May 2011]. Campbell, D. & Ball, J., 2011. NHS funding pressures hitting frontline, says A&E chief. [Online] guardian. Available at: http://www.guardian.co.uk/society/2011/apr/12/nhs-funding-pressures-hitting-frontline [Accessed 19 May 2011]. Ethnicity and Health, 2007. [Online] Parliamentary Office of Science and Technology, P.2 Available at: http://www.parliament.uk/documents/post/postpn276.pdf [Accessed 19 May 2011]. Emmerson, C. et al., 2000. Pressures in UK Healthcare: Challenges for the NHS. [Online] Institute for Fiscal Studies. Available at: http://www.ifs.org.uk/comms/nhsspending.pdf [Accessed 19 May 2011]. Available at: [Accessed 19 May 2011]. Jayasinghe, SA., 2006. Where next for China? User fees increase China's health challenges. [Online] BMJ. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557948/ [Accessed 19 May 2011]. James, C. et al., 2005. To retain or remove user fees? Reflections on the current debate. [Online] ungei. Available at: http://www.ungei.org/SFAIdocs/resources/To_Remove_or_Retain_User_Fees.pdf [Accessed 19 May 2011]. Key Facts: User Fees for Health Services, 2011. [Online] Health Poverty Action. Available at: http://www.healthpovertyaction.org/policy/health-systems/user-fees-for-health-services/key-facts-user-fees-for-health-services/ [Accessed 19 May 2011]. Li, Y. & Wei, Y. H.D., 2010. A Spatial-Temporal Analysis of Health Care and Mortality Inequalities in China. [Online] Bellwether Publishing, Ltd. Available at: http://www.geog.utah.edu/~weiy/PDF/LiWei10EGE.pdf [Accessed 19 May 2011]. Meyers, RA., 2010. Complex Systems in Finance and Econometrics. [Online] Springer Available at: http://books.google.com/books?id=0scA5J9sfVIC&pg=PA502&dq=main+factors+responsible+for+the+current+pressures+on+the+United+Kingdom+National+Health+Service&hl=en&ei=h4TTTfusKMyHrAfl2MCpCQ&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEQQ6AEwBA#v=onepage&q&f=false [Accessed 19 May 2011]. User charges in India’s health sector: An assessment, 2001. [Online] Financing and Delivery of Health Care Services in India. Available at: http://www.whoindia.org/LinkFiles/Commision_on_Macroeconomic_and_Health_User_charges_in_India_health_sector.pdf [Accessed 19 May 2011]. Read More