The National Health Services in England - Essay Example

Prof The National Health Services (NHS) in England is a government hospital offering comprehensive healthcareservice using peoples’ tax as its support since its inception in 1948. It is allocated with more than ?100 billion for human resource salary, hospital supplies and drugs, and for infrastructure developments or maintenance. NHS (2011), nurtured by egalitarianism, is providing the public with full and free access on all form of healthcare services for all British residents in England, Northern Ireland, Scotland and Wales with fairest budget of ?1,980 per patient. It has employed more than 1.7 million experts and qualified doctors, nurses, midwives, ambulance staff and general practitioners (NHS, 2011). Statistical data showed that it is accommodating an average of 1 million patients in 36 hours or roughly translated as 463 patients per minute (NHS, 2011). Structurally, NHS is under the Department of Health (DoH) , the latter is chaired by the secretary of health. DoH also controls the ten Strategic Health Authorities of England, clothed with mandates to administer and monitor NHS operations in their respective areas. Central to its core mission are the public or patients who seek medical health service from “cradle to grave.” NHS (2011) had two sections: primary and secondary cares. Primary care is offered by NHS Direct, NHS Walk-in Centres, general practitioners, dentists, pharmacists and optometrists and is allocated with 80% of NHS budget. Secondary care, on the other hand, are services covering Care Trusts, Mental Health Trusts, Health Trusts, Ambulance Thrusts, and Emergency Care. NHS (2011) also has National Institute for Health and Clinical Excellence (NICE) which provide directions and promotion of cost-efficient and effective community-based health care. NHS (2011) is governed b y a Constitution where all its objectives, duties and responsibilities are laid. This fundamental document is the basis of all other policies that govern decision-makings within the institution and which upheld “quality health for all” as its mission. It also vested rights to patients under its care including redress to possible grievances that will be raised in case of dissatisfaction of service. Such patient right include the universal value on non-discrimination and non-refusal of medication based on unreasonable causes (NHS, 2011). As part of the fiduciary relations between patients and physicians, the former expect to be treated with dignity, confidentiality, and be informed of the nature of such illness with corresponding proposed medication procedures as well as of alternate treatment (NHS, 2011). Thus, they were accorded with informed decision-makings and such liberty to participate in rationalizing the needed health care service, especially when patient will be subjected to major operations. Patients were also allowed to access their records for their interests (NHS, 2011). NHS (2011) has five guiding principles. These are (a) provision of holistic service from birth-to-death free from all forms of prejudice and discriminations; (b) free access for clinical services unless sanctioned by the Parliament; (c) adherence to professionalism and quality standard of medical services to patients; (d) affording of medical services reflective of the needs of patients and their immediate families; (e) upholding an integrated system with core values while partnering with multi-organizations in the interest of the patients. It’s these principles that govern the behaviors and interaction of patient-physician relations. NHS has clear structure and core values. It has NICE , with research and development teams, that help strengthen the capabilities of medical experts in the delivery of their services (NHS NICE, 2011) specially on treatment, procedures and preventing illnesses and diseases. It upholds health service quality standards; provide scholarship programs for practitioners; and offer domestic and offshore scientific consultancy services for cost-efficiency. NHS (2011) has an online service where information and database relating to illnesses and its related medication are accessible or readable for customers. Part of the weaknesses of the institution is the absence of regular and systematic performance measure and of empirical appraisal of patients’ health changes. Thus, it has admitted difficulty in providing impartial information about the impact of NHS to the health of the nation, although the institutions have conducted surveys on patients’ satisfaction which gave positive feedback so far (NHS, 2011). Since it is structurally governed by a government agency, it is susceptible to political decisions and manipulations. For instance, early January 2011, UK Parliament introduced Health and Social Care Bill which seek to abolish NHS’ Primary Care Trusts and the Strategic Health Authorities. Analysts shared the purview that this proposed bill supported by think-tanks in Britain is basically patterned in western privatization scheme and is severely criticized by the public as a legislative proposal that is contrary to their welfare (Smith, 2010). It will also necessitate restructuring and management reorganization as budget allocation for NHS will likely be reduced (Elliot, 2011). The proposal is held socially unacceptable and medical practitioners have started raising potential impacts of budget reduction to operational, administrative and the very nature of NHS as an institution (Elliot, 2011). Thousands of medical practitioners will also be dismissed from their jobs. Besides, this was not set as an agenda by proponent political party at the height of election in 2010 (Elliot, 2011). As structural changes are also designed under this bill, proponents wanted the establishment of NHS Commissioning Board, organizing of new health authority and officials, and development of a new monitor as its regulator. The NHS will also be converted in to a foundation trusts (Elliot, 2011). Indeed, to manage this change, massive consultations will be required to hear the voices of all stakeholders of NHS: patients or the public, the medical practitioners, the support clients, and management of the present NHS. This will allow ventilation of stakeholders’ concerns on potential impacts and effects of proposed health reform bill which favors participation of private sector in this institution. As such, problems on the absence of safeguards from potential exploitation of private sectors in this reform agenda are raised e.g increase of prices for medical services, entry of private insurance companies with interests to benefit more from patients, and possible divestment of decision-making to private capitalists who are interested to take over NHS. Moreover, as the bill is met with massive outcry of disagreements, it’s essential for the proponents to reconsider the constitution of NHS, its values and mission, its goals and corporate intentions, as well as the medical professionals’ culture developed through decades of service. If the intention of reorganization and restructuring is for NHS to have substantive savings by 2015, the Parliament can allow NHS medical practitioners and its administration to plan how they can best effect savings without compromising its human resources and the interests of the public. Proponents must also review and reflect that while privatization has been done to water system, to power sector, and telecommunication, it must also look into the impacts and result of privatization to these industries and restudy if the same is applicable to NHS. Proponents must also address the public’s suspicion why parliaments proposed “merciless reduction of NHS budget” and where such savings is intended for. It must be reckoned that health is a fundamental right of the people and is mandatory as a basic social service. Health is not simple commodity that can be traded in a market, although its medicines are. The state is accountable to its peoples’ welfare. It’s appropriate for the liberal democrat to seek for more accountability clause in the proposed reform to add restriction to commercialization of healthcare. The possible dismissal of thousands of medical practitioners under NHS should also be put under serious labor concern. The public needs more of their services and not their dismissal. British government should not also allow its constituents to suffer poor medical services and possible inaccessibility to health due to marketization of NHS system . It must be sensitive that even before the bill becomes a law, there are already reported closure of maternity, general medicines and cardiology departments (Smith, 2010). If economists thought that public hospitals lacked beds to accommodate hundreds of patients at a time, the remedy is to provide more beds and to improve facilities that can accommodate in-patients and not to privatize the system. If there are concerns about lack of responsiveness among nurses to increasing demands of patients, the remedy is to systemize and to increase nurses’ accountability to patients and to enhance their performance management; not to dismiss or terminate them. If the problem is to how to save money for the government in 2015, the remedy is to present this to the NHS administration and DoH so that they can collaboratively plan, decide and develop a mechanism on how to reduce expenditures that is agreed at a consensual level; not to radically change its system that will run contrary to its Constitution as well as to its original intention when NHS was established. Least, proponents should view the patient, specially those needing special care, not as consumers but as human beings needing care and are paying such medical services through their taxes. Indeed, managing change is difficult. It needs serious listening and understanding of all stakeholders who would be affected thereof. It s all about opening communications, consultations, presentations of intents and evaluation how these best served the stakeholders based on contextual conditions (Osborne & Brown, 2005) . It’s all about looking at perspectives at all angles and strategically deciding at a consensual level. References NHS, About the National Health Services, http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx Accessed: June 13, 2011. NHS, NSH Structure. http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspx Accessed: June 13, 2011. NHS NICE, Putting Guidance into Practice. http://www.nice.org.uk/usingguidance/ April 29, 2010. NHS , The NHS History. http://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory1948.aspx . December 12, 2009. Accessed: July 13, 2011. NHS NICE, Do not do recommendations. http://www.nice.org.uk/usingguidance/donotdorecommendations/index.jsp . February 2, 2011. NICE, About NICE. http://www.nice.org.uk/aboutnice/ March 22, 2011. Smith, Rebecca, Cuts being made to frontline NHS services survey reveals. Health News. The Telegraph. http://www.telegraph.co.uk/health/healthnews/7610848/Cuts-being-made-to-frontline-NHS-services-survey-reveals.html April 21, 2010. Accessed: June 13, 2011. Osborne,Steven & Brown, K., Managing change and innovation in public service organizations. Routledge, Volume 84, Issue 3, 2005, 262 (783-810) Torjesen,I., NHS reforms and the search for local solutions. The Guardian. http://www.guardian.co.uk/society/2011/jul/13/nhs-reforms-local-solutions?INTCMP=SRCH , July 6, 2011. Accessed July 13, 2011. Elliot, Larry, Thinktank advocates abolition of NHS and slashing of government aids. The Guardian. http://www.guardian.co.uk/politics/2011/jul/13/thinktank-advocates-abolition-of-nhs#start-of-comments July 13, 2011. Read More