The Basics of the National Health Service System - Essay Example

Contexts of Profession Roald Cabugao Order # There exists a notion that humans are basically made of two things - the body and soul. However, while the soul is said to be everlasting and nourished by an omnipotent force, the body is temporary, a mere shelter to signify our presence. It is continuously beset by ailments and conditions that ultimately lead to its termination. Nevertheless, the futility of it all should not be taken as an excuse to deny the body of health care. Although nature has given us the ability to somewhat repair ourselves, through blood-clotting for example, it is quite inadequate compared to the variety and severity of sickness ranged against us. This is where health care services come in. It is there to supplement or enhance the repair and even maintenance of the body. It is there to insure that one lives a life minimally affected by pain and discomfort. Its existence is a must if humanity is to continue its productivity and continuity. One of the places in the world where health care services have gone a long way is that of the United Kingdom. According to the 'About NHS' article (n .d.), it has invested heavily in providing health care to its populace. The World Health Organization and UNICEF (2005) estimate that greater than 90% of its 1-year-olds has been covered by immunization against DTP3 (diphtheria, tetanus, pertussis) and Hepatitis at 81%. The WHO database on Skilled Attendant delivery (2006) has also reported births attended by a skilled health personnel is 99% with 17% delivered by Caesarian. Another WHO report on antiretroviral therapy (2006 ) states that Retroviral therapy coverage for the UK is also at a high- at 75%. The statistics are one of the highest in the world. The results stated above could be attributed to the UK's National Health Service. Established in 1948, it has grown to be the largest organization in Europe. Its current strategy is focus on quality service for the patient. The Diagram below shows the structure of the NHS (About the NHS, n.d.): As can be seen from the diagram, there are different services such as the Dentist and Pharmacists section. The different governing bodies and their functions can be read from the diagram. One of the biggest challenge confronting the health service sector is that of funding although this is also true for other sectors. NHS has always considered health care as a basic human right. This is codified in one of its core principles "The NHS will provide a universal service for all based on clinical need, not ability to pay" (DOH Press Release, 2000). It has therefore tried to make its services as free as possible. Visits and consultations to the General Practitioners (GP) and any surgery under them is free of charge. The NHS fund is the product of the taxpayer's labor and toil. The NHS also realizes the fact that health service providers must also be given the proper training. This is the reason behind its scholarship program known as the NHS Contribution to Undergraduate Medical Education Budget (previously known as the Service Increment for Teaching). The program has two elements. One is that of the Medical School part which covers the tuition fee of students, salaries of lecturers, administration and other overheads. The other part is that of the Clinical which covers the internship fund for the students. The following diagram represents the total contribution of the NHS in medical education costs (Funding Guide, 2005): As was already stated, the NHS is oriented toward achieving high quality health care. One of the components of its plan of action is to encourage scholarly research on medical topics. It has established a trust fund as the source of scholarship expenses (NHS Contribution, 2005) . However, due to its public service, non-profit nature, the NHS is currently undergoing streamlining its branches due to huge deficits. It is forecasting a debt of more than 620,000 for the year 2005. Health Secretary Patricia Hewitt has resorted to cost cutting schemes which will be detailed later in the paper (Coombes, 2005). The deficit and the resulting cost cutting measure will have great repercussions in the health care industry as will be seen later. Podiatry and Funding According to the Society of Chiropodists and Podiatrists (Scope of Practice, 2006), Podiatry is defined as the study and medical treatment of disorders of the foot, ankle and the lower extremity by all systems and means including effects of cancer and diabetes. There are four fields in the profession - General Clinics, Biomechanics, High Risk Management and Surgery. The job of the Podiatrist , to name a few, includes nail cutting, corn bunions removal and injured leg treatment.Podiatry services are also made available by the NHS. The field of Podiatry has also received substantial funding under the NHS. Through research grants, many podiatrists were able to conduct studies that aimed at improving medical techniques that would ultimately be availed and enjoyed by the patient. One of these projects, as recorded by the National Research Register (2005), was entitled "RheumAFooT (Rheumatoid Arthritis Foot Trial): A clinical and cost-effectiveness evaluation of podiatry in Rheumatoid Arthritis". The research is mainly evaluating the effect of podiatry treatment of Rheumatoid Arthritis of the Foot. Through these available funds, the field of Podiatry can be furthered and improved. The NHS Fact sheet for Higher Education (2006) states that scholarship grants are also available for Podiatry students. This opportunity offered by NHS will likely increase a person's eagerness to pursue Podiatry. Nevertheless, the greater the number does not necessarily translate to the development of the field. This is where the quality part of the scholarship comes in. Combining the quantity and quality factor is without doubt, a good component to the development of the profession. However, the fact that NHS is in financial debt offers severe repercussions to the field. Research would become limited and the number of scholarship slots would surely go down. The combinatory effects of the two will likely stunt the growth of the profession. Reduce the benefits and you reduce the initiative. Professional practice as a Podiatrist is not without complaints. According to Sheffield Podiatry Summary of Complaints (2005), the following are the negative feedback: Clerical mistakes made when booking appointments Attitude of Podiatrist Proposed care plan Frequency of appointments Access to Podiatric Surgery Poorly stocked clinics that caused delay in treatment In the context of professional practice vis--vis funding, the complaint "Frequency of Appointments" and "Access to Podiatric Surgery" would be the most relevant . In the research carried out by the University College Northampton (1997) on the effect on foot health of discharging 5,500 patients from the Cambridge and South Cambridge Primary Care Trust, it was found out that due to the inadequate funding, only those with high-risk problems were entertained. This criterion includes those with diabetes and autoimmune diseases. The others were waitlisted up to 10 months. This translates to patients at low-risk foot and lower extremity problems being discharged from the NHS. They are either forced to pay for private care or use Age Concern sector or any relevant voluntary sector to provide foot health care. Furthermore, patients who are classified as 'low-risk' are no longer treated under the NHS for free. It was also found out that low-risk problems that usually come back at the clinic are diagnosed as high-risk patients. As already stated, the NHS is in deep financial debts. To balance the books, Patricia Hewitt - the Health Secretary, has resorted to instructing Primary Care Trusts to deliberately delay operations such that costs from performing services will be minimal (Coombes, 2005) . From this cost cutting method, the interplay of funding and its effects to the delivery of health services is quite evident. That is, funding has a direct relationship to the state of health care delivery. As funding decreases, so does the service. No one can ever deny the truth that the health delivery system is based mainly on the funds available for it to operate. The government prescribes at most 6 month waitlisted period for services such as surgery. A July 2006 research by Welsh Liberal Democrats revealed that 2,275 patients waited for 36 weeks just to receive podiatry treatment while 1, 787 were waiting over 72 weeks. One extreme case was a waiting time of four years (Society of Chiropodists and Podiatrists, 2006). One could just imagine the strain that funding exerts on the profession. Furthermore, Secretary Hewitt halved the number of PCTs thereby cutting the number of health authorities. According to her, the changes would save 250m. The plan calls for the number of PCTs from 300 to at least 7 and reduce the number of strategic health authorities from 28 to 9 (Coombes, 2005). Along those affected are Podiatry services, Personnel and Internship grants. A question now comes into mind -"how can the profession develop if it offers only uncertainty in job and disillusionment". One may argue that they can go to private practice but then again you are actually denying the people the opportunity to study or research. Conclusion All in all, the paper delineated the basics of the NHS system and its funding scheme. The funding scheme as applied to the patient and to the practitioners was discussed. Then it proceeded to determine the effects of funding to the Podiatry profession. From the foregoing discussion, one can see the impact of unavailability of funds in terms of health care delivery service and professional development. The situation, if it continuously deteriorates, would drastically affect not even Podiatry but the whole structure as a whole. References: NHS- Connecting for Health. (n.d.) About the NHS. Retrieved October 9, 2006 from http://www.nhs.uk/england/AboutTheNhs/Default.cmsx. WHO/UNICEF. (2005). Estimates of National Coverage for year 2004. Retrieved October 9, 2006 from http://www.who.int/immunization_monitoring/routine/immunization_coverage/en/index4.html WHO (2006). WHO Database on Skilled Attendant at Delivery. Retrieved October 9, 2006 from http://www.who.int//reproductive-health/global_monitoring/data.html WHO. (2006) . Progress on global access to HIV antiretroviral therapy. A report on "3 by 5" and beyond. Retrieved October 9, 2006 at http://www.measuredh.com UK Department of Health. (2000). NHS Plan Sets Out Radical Programme Of Reform. DOH Press releases, Issue 455. Retrieved October 10, 2006 from http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/enCONTENT_ID=4005067&chk=c3kwMf UK Department of Health (2005). Funding Guide. West Yorkshire Workforce Development Confederation Guide Releases. Retrieved October 10, 2006 from hhttp://www.westyorkswdc.nhs.uk/content.aspxobjectuuid=B6102EA6-9108-433B-BF88-870FF3582927 UK Department of Health (2005). NHS Contribution to Undergraduate Medical Education. West Yorkshire Workforce Development Confederation Guide Releases. Retrieved October 10, 2006 from hhttp://www.westyorkswdc.nhs.uk/content.aspxobjectuuid=B6102EA6-9108-433B-BF88-870FF3582927 Rebecca Coombes. (2005). Primary care trusts should delay treatment to cut deficits, minister says. BMJ Reports, Vol.331, Issue 1426. Retrieved October 9, 2006 from http://bmj bmjjournals.com. /cgi/content/full/331/7530/1426/DC1 Society of Chiropodists and Podiatrists. (2006). Scope of Practice. Retrieved October 9, 2006 form http://www.feetforlife.org/careers/scope.html. National Research Register. (2005). RheumAFooT (Rheumatoid Arthritis Foot Trial): A clinical and cost-effectiveness evaluation of podiatry in Rheumatoid Arthritis. Retrieved October 10, 2006 from http://www.nrr.nhs.uk/ViewDocument.aspID=N0436130598 NHS. (2006). Fact sheet for Higher Education of NHS and Social Work Students. Retrieved October 10, 2006 from www.dfes.gov.uk/studentsupport Sheffield Podiatry Service (2005). Podiatry Service- Complaints and Compliments. Retrieved October 10, 2006 from http://www.sheffield.nhs.uk/podiatry/2-7-1.php University College Northampton (1997). NHS Podiatry Services, Current Issues. Retrieved October 10, 2006 from http://www.feetforlife.org/cgi-bin/item.cgiap=1&id=830&d=pnd&dateformat=%25o-%25B Society of Chiropodists and Podiatrists. (2006). Podiatry Waiting Times are Totally Unacceptable. Retrieved October 9, 2006 from http://www.feetforlife.org/cgi-bin/item.cgiid=1446 Read More