The National Health Service of the United Kingdom - Essay Example

HEALTH POLICY by of the of the of the School 18 March Introduction The National Health Service (NHS) was established on July 5, 1948, as part of a purposeful plan to provide healthcare to all (NHS, 2011). All services were free, covering all citizens of the United Kingdom and financed by the public taxation. The new service was adopted by Aneurin Bevan, who was then the health secretary (NHS, 2011). According to Webster, he “adopted the most ambitious remit for his creation, which he was apt to call ‘the most civilised achievement of modern government’” (2002, p.1). Over the past years, the National Health Service has experienced a lot of restructuring and developments. Despite the fact that the National Health Service was initially designed to be entirely financed through public taxation, changes began taking place in 1952 when prescription charges of £ 1 for ordinary dental treatment were introduced (NHS, 2011). The charges were however abolished in 1965, only to be reintroduced in 1968. The first restructuring took place in 1974 when fourteen Regional Health Authorities, and nineteen new Area Health Authorities were established (Mercier, 1997). Mercier points out that “community health care services which had previously been managed by local government were also transferred to the responsibility of the NHS by the 1974 reforms” (1997, pp. 22-23). Further restructuring took place in 1982, when heath costs hugely escalated prompting the Conservative government to change the culture of the National Health Service management, by encouraging the use of nursing homes and private hospitals to patients. For the first time since the introduction of the National Health System, tenders for different tasks were issued to private firms in order to support the health authorities in managing some departments of the health service. However, there was a lot of dissatisfaction with the management style, and this led to the appointment of general managers at all levels of the health service system. An advisory board was also established and various other officials appointed to oversee the affairs of the NHS. Other substantial restructurings and developments have taken place leading to the passing of the Health and Social Care Act in 2012. NHS Changes in the Health and Social Care Act 2012 In 2004, the first NHS foundation trusts were established as autonomous National Health Service providers (Great Britain National Audit Office 2011). A re-launch of the foundation trusts process was announced by the United Kingdom government in July 2010 in a white paper named Equity and Excellence: Liberating the NHS. After the publication of the Equity and Excellence: Liberating the NHS white paper, the Health and Social Care bill was brought up into the House of Commons in 2011. The Local Government Association points out that “the bill was the largest piece of health legislation since the creation of the NHS” (2012, p. 3). Debate on it took fifty days on the floor of both houses and in the committee, and it underwent over two thousand amendments. According to the Department of Health, “the Health and Social Care Act 2012 puts clinicians at the centre of commissioning, frees up providers to innovate, empowers patients and gives a new focus to public health” (2012a, n.p.). The provisions of the Health and Social Care Act 2012 are intended to meet a number of challenges, these are: 1. Escalating treatment costs and rising demand for health care. The costs of treatment have been growing each year placing pressure on the National Health System that is required to keep up with other health systems around the globe. Demand for health care has also been growing rapidly as long-term medical conditions become common and as the population continues to age. According to the Department of Health, there is a rising need for more complex treatment options as the costs of medicines increase to over hundreds of millions of pounds each year (2012a). 2. Demands for improvement in the National Health System. Despite being a world leading health care system, there are significant sectors of the NHS that need improvement since they trail behind those of other major European nations. There is need for better access to facilities such as scanners X-rays, and operating rooms (Department of Health, 2012b). 3. Condition of the public budget. Funding for the National Health System is very tight despite being protected by the government. This has placed a lot of strain in the health care system given the fact that the population has been increasing and aging, and long-term medical conditions are on the rise. 4. Unfair disparity in the quality of health care across the United Kingdom. Depending on where a patient is treated in the United Kingdom, chances of examination and survival vary. This has been noted in cases of heart attacks, breast cancer, major operations and dementia (Department of Health, 2012b). 5. Fragmentation of health care. There is fragmentation in health care between social care and the National Health System, and among different sectors of the health service. This does not mean that integration of health services does not exist, but there is need for more integration to ensure provision of quality health services to patients. 6. Need for more response to patients. For a long time, patients have had to fit around services provided by the NHS. This has only served to degrade the quality of health care. Therefore, there is need for more attention to matters relating to patients and provision of care at its best. 7. Lack of accountability within the system. For a long time, the NHS has not held bodies involved in the provision of health care, such as the trusts and PCTs responsible for anything. Despite the fact that such bodies have existed, the Secretary of State has been held accountable for all matters (Department of Health, 2012b). Main Features of the Current National Health Service National Health Services continue to be provided to patients not on the ability to pay, but on the need for health care. However, reforms have been made on the organisations that function, coordinate, and support health care services. The responsibility of health promotion for the local population now lies with the local authorities. In order to ensure that an integrated way to improve well-being and local health is found, new Health and Well-being boards have been established. Clinical commissioning groups are in-charge of the current National Health Service care, while General Practitioners and other clinicians are tasked with the obligation of utilising resources in order to provide high quality medical services (Department of Health, 2012c). A new body called the NHS Commissioning Board supports all NHS commissioners, authorises specific services, and allocates resources. Strategic Health Authorities no longer manage the NHS providers. This is because a dependable system of regulation known as the Care Quality Commission has been established and has the responsibility of supporting service continuity, setting prices, and ensuring that despite the existence of competition in the health care sector, the interests of patients are safeguarded (Department of Health, 2012c). Through the help of the NHS Trust Development Authority, existing NHS trusts are able to attain foundation status. Management and control for specialist training and education is provided by the Health Education England. Health and social care information will be made available by the Information Centre, while autonomous advice and guidance is provided to the National Health System by the National Institute for Health and Care Excellence, as it also continues its role to social care (Department of Health, 2012c). Objectives for the NHS are now set by Department of Health Ministers through authority to the NHS Commissioning Board. Overall, the Public Health England, which is a new public health service, is responsible for safeguarding and boosting the health of UK citizens. The requirements in the Health and Social Care Act 2012 are intended to handle the discussed challenges by making the National health system accountable, more responsive, and efficient. The changes made derive from experience and evidence of reforms in the NHS over the years. With the new structure of the NHS, there will be greater accountability, integration o relevant bodies and services, improvement in public health, greater attention to the interests of patients, more effective use of resources, and freedom to introduce and provide quality services for health and care providers including the National Health System foundation trusts. April 2013 Changes in the National Health System From the beginning of April 2013, ten strategic health authorities in England will be consolidated into four groups of strategic health authorities (NHS South of England, 2012). Local Clinical Commissioning Groups comprising of General practitioners, doctors, nurses, as well as other specialists will replace Primary Care Trusts and Strategic Health Authorities in authorising medical services for the local citizens. The Clinical Health Commissioning Groups will take orders from an independent NHS Commissioning Board. The independent NHS Commissioning Board will in turn be responsible for the national NHS outcomes and managing the new commissioning system. Conclusion Since its introduction in 1948, the National Health System has undergone a lot of reforms and developments. The health service system has also faced numerous challenges arising from the increasing demand for health care in the United Kingdom and escalating costs of treatment around the globe among others. Consequently, changes continue to be made in order to tackle these challenges, with the recent ones being the passing of the Health and Social Care Act 2012. Reference List Department of Health, 2012a. The Health and Social Care Act 2012. [pdf] Available at: < http://www.dh.gov.uk/health/files/2012/06/A1.-Factsheet-Overview-240412.pdf> [Accessed 19 March 2013]. Department of Health, 2012b. The Case for Change-The Health and Social Care Act 2012. [pdf] Available at: < http://www.dh.gov.uk/health/files/2012/06/A2.-Factsheet-Case-for-change-240412.pdf> [Accessed 19 March 2013]. Department of Health, 2012c. Overview of Health and Care Structures-The Health and Social Care Act 2012. [pdf] Available at: < http://www.dh.gov.uk/health/files/2012/06/A3.-Factsheet-Overview-of-health-and-care-structures-240412.pdf> [Accessed 19 March 2013]. Great Britain National Audit Office, 2011. Achievement of Foundation Trust Status by NHS Hospital Trusts: Department of Health. Greater London: Great Britain National Audit Office. Local Government Association, 2012. Get in on the Act Health and Social Care Act 2012 [pdf] Available at: < http://www.local.gov.uk/c/document_library/get_file?uuid=81914af4-5de6-4ccb-93e2-3764523dd8b0&groupId=10171> [Accesses 19 March 2013]. NHS, 2011. NHS history 1948- 1959. [online]Available at: < http://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory1948.aspx> [Accessed 18 March 2013]. NHS South of England, 2012. Changes to the NHS. [online] Available at: [Accessed 19 March 2013]. Mercier, C., 1997. Infection Control: Hospital and Community. Cheltenham: Stanley Thornes (Publishers) Ltd. Webster, C., ed., 2002. The National Health Service: A Political History. Oxford: Oxford University Press.   Read More