Effects of the 1989 White Paper Working For Patients on NHS Reforms - Essay Example

Running head: EFFECTS OF THE 1989 WHITE PAPER WORKING FOR PATIENTS ON NHS REFORMS Effects of the 1989 White Paper Working For Patients on NHS Reforms Insert Name Insert Grade Course Insert Tutor’s Name 3 December 2010 Effects of the 1989 White Paper Working For Patients on NHS Reforms Introduction The NHS operations since its inception was deemed to have had some pronounced shortcomings in the period before the 1980’s until when the government proceedings provided a white paper in the 1989 entitled “working for patients”. The paper was provided with an intention of taking control of the NHS system operations to improve health care in the medical centers. The NHS (National Health Service) is a system of healthcare that was initiated in the United Kingdom in 1948. It is mainly responsible for provision of health care services to the patients in the country, whose operations are facilitated through public funding processes. The white paper had a collection of proposed objectives, as well as of proposals, which the government deemed as essential change tools. Nevertheless, the white paper’s contents have had very great impacts in the NHS, both positive and negative. A vast number of reforms have been realized over the years as a result of the changes imposed by the inception of the white paper. The body’s operations have taken a new direction over the years, a factor marked by success in the change implementation processes (New Scientist magazine 24). Objectives and contents of the 1989 white paper The white paper by the government whose logo was “working for patients” entailed a set of objectives and proposals, which were considered by the health department as a programme that was dreadful for NHS reformation. The main emphasis was the need for research as well as a better system of research result translation to meet the intended goals. The government looked forward to see a translation of medical research results into effective health care practices. Alongside other proposed NHS amendments by the 1989 government’s white paper, there were two main objectives. First, the government sought to improve its capacity in the control of the NHS cost and output in all its operations. The main intention of this was to formulate the health care providers into reliable beings to the government as well as the patients. This objective was raised out of the realization that administration and control had posed many problems since the inception of the organ. Additionally, the government had realized that there existed a lot of autonomy in the clinics by the car providers; where no other person would have been allowed to have control over the operations of the NHS (Klein 64). On the other hand, The NHS needed to operate on a ground that would offer efficiency; hence, the government intended to spearhead the kind of improvement. The key areas that needed efficiency were in terms of productivity and allocation. The efficiency in productivity would be made possible by provision of maximum health care out of the resources that they would be allocated. This would call for advancements in the services provided to the patients, as well as ensuring the utilization of the available and arising opportunities for advancement. The efficiency in allocation would ensure that NHS provided treatments, medicine, as well as operations as per the consumer requirements. Additionally, the allocation was meant to ensure that the patients are attended to in the right manner, as well as giving them the quantities that were helpful to them. In order to meet the objectives, these proposals were found to be necessary; to facilitate a fresh funding configuration, to give room that would promote the independent sector, to clearly define the responsibilities of the agency, to develop a management system that would have the responsibility of assessing the needs as well as the community care requirements and development of care that is practically carried out to enhance the community’s welfare (Monthly current affairs magazine 27). Factors contributing to success in implementation of NHS reforms A number of factors are responsible for the success already realized in the NHS system reforms. Commitment is a key factor to change implementation. The enthusiasm developed by the government to get involved in the facilitation of services to the community was very crucial for the reforms to take place. The individuals like Griffith’s contributions on research spearheaded the action taken by the government to take control of the NHS activities. Additionally, the health care providers were ready to embrace the proposed move by the white paper, thus their outgoing commitment has yielded positively on the system (Porter 197). More over, duration is a factor that is important to a successful implementation of change. The reforms in the NHS could not be implemented over a short duration, this called for patience of the care providers, the government as well as the community. It has taken a couple of years since the white paper was established for the ultimate realization of the proposed goals outcomes. Today, there are still goals that have not been fully realized, but with the continued enthusiasm and commitment, there is room for more changes (Trinder and Reynolds 4). Impacts of the white paper on NHS The white paper has caused many impacts, to the government, the large community, as well as the NHS. The initial release of the paper caused many controversies to people, who complained that the government wanted to establish a system of self-gain by wanting to take control of the NHS activities. However, great are the impacts that have been so far realized. Great reforms in the NHS management have facilitated the welfare of the community by providing efficient services to the clientele. Additionally, the shift of the management from the RHA has enabled the creation of other sectors, though offering healthcare, operate in the distinct lines to provide efficient services. For instance, the WHO, UNICEF and other bodies have found room to provide their services. The reforms in the sector have facilitated public funding continuity, leading to the systems continuity. Customer satisfaction has been realized as a result of the efficient services provided by the NHS under the government funding control programmes. The separation between the providers and the purchasers has led to increased specialization, leading to major advancements in the medical grounds. Generally, the NHS operations have been modernized to meet the requirements of the community at large (Porter 197). Reasons for the NHS reforms The need for reforms in NHS was driven by a number of reasons, which not only the government seemed to address, but also other individuals. Earlier on, The Griffith report had been presented which manly addressed on the issue of inadequacy in the health care that was being offered to the community at the period between the inception of the NHS and the 1980’s. The community care paper that he produced in the 1988 was taken with a lot of concern, leading the government to provide the white paper, which called for reforms. Mainly, from the Griffith report and the white, the issue of management was the main reason as to why the government found it necessary to make the health care system accountable. The management was being exercised by the health care providers independently to an extent of not giving room for anybody else not in the health profession room for contributing (Sheard, 2). Another reason why the reforms were found necessary was that the practitioners could not provide the health services in order to satisfy the needy patients, but to satisfy their own interests, thus calling for government involvement in control for NHS. More so, though the NHS system had been funded by the public, it could not offer efficient services as per the expectations, and they could run out of fund at rampant times, an indication of poor management of funds. On the other hand, the NHS had a programme that enabled the practitioners interested in research to carry out their activities as well as academicians, but there emerged an overwhelming realization that the results of the medical research had been taken for granted and had not been put into practice, thus there needed the government involvement to facilitate this. The government was also interested in taking control of the private clinics, whose operations sometimes acted as a bias to the requirements of the government and the general public (Trinder and Reynolds 65). Nevertheless, the powers that had been given to the medical consultants had posed a threat in the health systems since they are said to have been competing for clientele, a phenomenon that should not occur in the medical cases at normal grounds. The sum total of the above reasons spearheaded the government intention to take control of the NHS, fund it, and ensure the services provided are in line with the community needs. More over, there was the need to set boundaries between health and social care since it seemed that NHS had not implemented such agendas. There was more concentration by the NHS on the health care forgetting that special care was needed for different ages and status. Thus, the old people needed to be provided with facilities like home nursing as well as the disabled. Thus, the white paper aimed to meet the needs for the community at large (Malek and Malek 247). NHS reforms Radical changes have been realized since the introduction of the white paper in 1989, in terms of structure, culture, and management. The reforms have occurred in all health departments, where all operations are now based on the propositions of the working paper. The internal and the external structures have been reformed tremendously. Initially, there was the control of NHS by the regional health authority, which was considered to have some great shortcomings. The great reforms have caused a shift to a fund holding General practitioner system, from a control of purchasing by the Regional health authority. The major reform has been a success due to the change of control powers, which were initially exercised by the consultants, to the government control system. Additionally, a great revolution has occurred in the management strategies and hospital trusts, rather than the former system that was controlled by the RHA since it rendered it hard to efficiently run the health system Leathard 247). The earlier proceeding and the 1989 white paper passed into the regulations as an act of the NHS and the community care move, which occurred in the 1990. The government’s aim was considered conformist in their effort to address the challenges at hand. The white paper passed the idea of the internal markets to counteract the challenges like the increasing waiting lists, having arisen as a result of inadequate funds in 1980. The NHS reformed according to the proposals into amplified response to customer services. In addition, the intended reforms would give room for innovation of new facilities and management systems, with an aim of overcoming the idea of monopoly control in the hospitals. The challenge of competition has been addressed over the years by the reforms, which had earlier dominated the NHS operations (Concannon 138). More important, the establishment of the internal markets led to drastic shift from a bureaucracy that was monolithic to a split of provider-purchase system, which indicated that one had either to be a family doctor or a health authority’s doctor, thus enabling specialization. The providers would be allowed to become NHS trusts under their own managements while the purchasers would operate on the opposite side. Additionally, there was the introduction of General practitioners fund holding practices, where family doctors could purchase health care facilities from the trusts from the NHS. Over the years, the leading government continued to introduce new ruling systems to enhance the activities of the NHS system New Scientist magazine, 37). The initiation of the National Institute for Clinical Excellence was a move to ensure that implementation of new technologies and purchasing of drugs was well facilitated, to enhance cost-effectiveness in management. Great emphasis over the years has been given to provision of quality services, adequate governance. Furthermore, they focus on how the trusts conduct the management of finances to ensure equity and accountability, all under the commission of health care that was later established. Effectiveness in the management and running of the NHS has always been considered as an important element to the accomplishment of overall objectives. The system has witnessed a lot of modernization aspects especially with the modern technological advancements Also, there have been mixes for changing skills among the trusts, which has always been geared towards the establishment of pathways that are effective in the clinics, with an aim of compressing waiting lists and at the same time boost competence (David 350). Conclusion Change should be considered as an instrument for advancements in all aspects of health care. The proposed changes in the government’s white paper in the 1989, though seemed hard to implement have had great impacts in the NHS system. As a result, the healthcare sector has improved and great reforms have been realized since the 1980’s. The success to the proposed reforms has occurred as a result of the government commitment, medical care provider’s acceptance to move in the proposed direction as well as the fact that the public embraces the change. The strategic position of NHS today is able to inform its operations, since change was implemented and at the same time managed properly by the responsible parties. On the other hand, though major reforms have been realized over the years, there is need for more advancement in the healthcare systems. The health care system providers should carry out their activities with the patients in mind, and aim to provide the best to them. As the government’s proposals, the health cares main objective should be to work for the patients needs by implementing appropriate strategies that have the potential to inform business appropriately Finally, the objectives of the 1989 white paper; working for patients have so far seen great achievements (Leathard 216). Work Cited Concannon, Liam. 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