Should the NHS treat patients with smoking related cancers - Essay Example

By the late 1980s when the idea was first come under consideration, the NHS was suffering from a severe lack of resources. This was the result of three factors. Firstly, because of the policies of the government, which was cutting back on public expenditure. Secondly, because of the increasing numbers of elderly with their demands on the health services and thirdly, the increasing demand for higher standards of health. The situation was so bad that districts were not paying their bills, and operations were being cancelled.

Waiting lists were increasing rapidly. As a result, a review of the NHS was announced. The Government Review produced a list of the strengths and weaknesses of the NHS, and suggested that one of the main problems lay in the lack of incentives for employees of the NHS to make savings and be more efficient. The government was strongly influenced by an economist, Enthoven, who argued that by introducing an internal market to the NHS, managers would be encouraged to become more efficient and without extra spending many of the NHS could be solved.

He claimed, " there is nothing like a competitive market to motivate quality and economy of service "(Carrier, 1998, p.145). What Enthoven meant by the internal market, was that each hospital or community care unit would compete against others to win contracts to care for specified numbers of patients. This is similar to the situation faced by companies in the private sector of the economy, which compete against each other to win commercial contracts.For the treatment of smoking related cancers patients the idea of competition between hospitals and community care units was the basis for the NHS and Community Care Act of 1990.

The NHS reforms, which came into effect in 1991, aimed to give patients, wherever they lived in Britain, better health care and greater choice of service. (Collee 1996, 1-7)Therefore the concept of the internal market was introduced, according to which, the 'providers' of healthcare were to be separated from the ' purchasers ' of healthcare. The idea was that by giving the purchasers the freedom to choose where to buy the best care, including the private sector, the system would place competitive pressure on the providers to offer greater quality, efficiency and value for money.

Fundamental changes had to be made to the traditional relationship between the various parts of the NHS to make the new system work. Health authorities ceased to run the service directly and become purchasers of healthcare from a range of providers (hospitals, community services, ambulance services) who, in turn, were given the opportunity of becoming NHS Trusts. They were to be self- governing bodies with the freedom to decide things like staff numbers, rates of pay and what to charge for their services.

Though independent of local health authority control, trusts remained part of the NHS. They had to provide a range of care accident and emergency services, but can choose which other services to concentrated on.A central role in the new system was reserved for family doctors who, for the first time, were offered budgets to buy a range of services for their own patients, such as non- emergency surgery,