The UK National Health Service - Assignment Example

Discuss critically the concept of public patient involvement with reference to the key themes of citizenship and consumerism The main focus of the essay is how public patient involvements came about in the National Health Service (NHS) and how this relates to consumerism and citizenship in health care. This paper seeks to create an all-round understanding of the different factors that revolve around public patient involvement with regards to consumerism and citizenship as the key factors that shape the access to public health. There are various perspectives that have been discussed in this paper and these perspectives are drawn from the different policies and policy makers in the UK health sector. The first important element of analysis would be the definition of patient involvement within the NHS platform. Public patient involvement has been described as a growing need to initiate a system that makes the healthcare services more person-centered. When talking about patient involvement, it is often important to create a difference between the involvements of individuals as both patient and care-givers or as individuals or involving the same individuals as groups of patients/citizens. A further distinction that stands out as necessary is whether the approach to Public Patient Involvement (PPI) is either proactive or reactive in such a way that affects the activities of involvement that are preferred above the others as well the purpose for the involvement. (Christine, 2006) When dealing with patient involvement, the stakeholders involved should be furnished with the essential understanding of who, why and how the involvement will be implemented because the understanding of these relevant pieces of information. This paper will be performing the function of the disseminating the information in regards to the level of patient involvement as being more than just the sharing of information, but a connection to direct user control anduser participation with clear descriptions of the types of involvement being user and public involvement within service quality amongst others that will be made clear in the paper. (Ralph, 1989) The other relevant definitions that feature in the general discussion and outlook of this paper are citizenship and consumerism. Citizenship can be defined as an institution whereby norms and practices that are responsible for the regulation of relations between the society, the state and the individual get determined. (Ralph, 1989) Under the citizenship, there are the discussions of social citizenship that refers to the social dimension in regards to social rights of an individual to be protected from the practices that produce inequality in the health sector. When talking about citizenship, the citizens are equipped with the rights that allow them fulfill citizenship responsibilities in their actions as full citizens under the law. This means that social rights can be described as the conditions registered to allow an individual to enjoy the inclusion in community services such as access to healthcare. (Ralph, 1989) Consumerism has been defined asa commitment to the organization of services around a section of the public that is considered as the consumers to health care services. The factors that have been connected to consumerism in this paper will be creating a deeper understanding of the specific factors that are important in the analysis of consumerism for the services provided through the health care system as well as through the policies stipulated by the National Healthcare System. (Susan, 1998) This paper will, therefore, be comprehensively covering the important elements of healthcare provision in the United Kingdom with the understanding of different platforms such as citizenship, consumerism, patient involvement and many more for the purposes of reviewing the National Healthcare System’s responsibility in the inclusion of these basic structures in their reforms and public policies that have been backed by the governance structure for a long time now. The main body of this paper will be discussing the different timelines and the specific landmark occurrences and commissions that have shaped the whole platform of access to healthcare, consumerism, citizenship and the general view of patient involvement. All the timelines in this part of the paper are relevant because they connect to the thesis statement and the title of the paper with regards to National Healthcare System’s guidelines, mission and expectations. (Ralph, 1989) TheBeveridge Report was based around the understanding of personalisation with regards to the transformations that were deemed as necessary for self support in the healthcare system. (Jon et al, 2011)The methods that were documented in a report made it clear that social care should be used to initiate a transformation from the period of passive receivership of health services to a more stable situation whereby the citizens are empowered enough to be able to decide the kind of support that they require for their well-being even if it meant having to shape their individual support. Direct payments and personal budgets have been described adequately in the report and there is an emphasis on adult social care and its provision in the report. As the years went by, the services started getting piloted to include the provision of the same services to children. (Jon et al, 2011) Self-support and personalization as approaches to the welfare platform have had the impact of reordering more than just the social care but also criminal justice system, children services, health as well as the tax and benefits within the system of healthcare provision. The potential transferability of these services onto other services provided by the state has created a base for a radical reshaping of welfare states according to the expectations of the 1942 Beveridge Report whose ambition was one of the greatest in the healthcare system, in the United Kingdom. (Jon et al, 2011)The reception of the recommendations from this report has, however, received mixed reactions from the public because the agenda of personalization has been seen with clear features of ambiguity as some people view the elements of personalisation to be insufficient in the process of articulating issues involving the rights of the marginalized or disadvantaged groups. Critics claim that the recommendations of the report to embrace self-directed support have brought with them risks of broader social contract that would raise the personal responsibilities of individuals offering new patterns of engagement and behavior. (Jon et al, 2011) When talking about the social needs for healthcare, one has to critically review the whole idea of catering for the people’s needs that are living long-term conditions that affect their social lives. These kinds of services would help initiate the ability for the people with these conditions to live independently through the improvement of the status of their health. Social care should be personalized and person-centralized just as healthcare so as to involve the people as much as possible in the systems of healthcare provision that involves them and their families. The maintenance of patient independence should be encouraged by the NHS that should also help facilitate the process of communication between the different services that are interconnected with the process of increasing the state of health to the individuals affected as well as to the close family members. (Rosemary, 2002)At this section of the discussion, citizenship is very important because this may be considered as a basis for drawing the lines between the provisions of social health services from one individual to the next. The levels of consumerism also determine the level of access to the social health care services within the same platform as the same individuals with similar cases in the same environment. (Rosemary, 2002) When putting consumerism to practice, particular conceptions have to be considered with regards to the requirements of the consumers of the services provided in the healthcare platform. Consumerism has been documented in some cases in the form of consumer oriented or generic discourses especially with regards to the different providers of public service namely the health care, policing, and social care. Each of these sectors involves a unique form of relationship as seen between the public, the providers and the individual users within their specific spaces with the differences documenting critical embodiment of health care choice. When talking about policing in consumerism then one has to consider the distinctive authority in the relationship seen between the public and the health care service to be provided with clear regard to the rule of law and what is either acceptable or not and vice versa.(Cliff, M.)Policy for the provision of health care and social services in the access to health care services also falls under the discussion of the different ways through which social needs for provision of health care can be related to consumerism. The same platform of health care provision and discussion is derived from the elements of citizenship whereby equality has to be established with regards to the provision of health care services. This means that the children should be assured of equality before the health system as the older individuals within the society. The National Health System has to critically consider the importance of the elements documented in this paper because they create a reflection on the literature review with regards to the references that address the same issues as the ones presented in this case to directly affect the public patient involvement. (Rosemary, 2002) The most important element of discussion about the possible operations of NHS should be started at the bottom and that is the period of inception within the platform of medical health provision. The National Healthcare System was established on the 5th of July 1948. The year marked the climax to a very ambitious plan that was aimed at bringing quality healthcare to all the people who need it. The plan got underway as soon as the health secretary at the point in time, Aneurin Bevan, officially opened the Park Hospital in the city of Manchester when public utterances were made to that effect.(Carole, 2011) The main agenda of the NHS at that point was to bring together nurses, doctors, opticians, pharmacists, hospitals and dentists under an umbrella body that could provide free-for-all services at the point of delivery. The NHS union made it apparent that the medical health care services were to be availed to the individuals who required it and was to be financed entirely from the funds derived from taxes thereby creating an understanding that people were to pay for these services within their means. The other important development made at the inception of NHS was seen in the year 1952 when charges were introduced for prescription drugs that were charged at one shilling at this point. The charges for prescription drugs were abolished in the year 1965 after which the prescription drugs remained free to the public until 1968 June when the prescription charges were reintroduced in the healthcare system. The other important timelines that saw landmark developments in the provision of healthcare include: 1953 when DNA structures were revealed; 1954 when a direct link was made between cancer and smoking; in the same year, 1954, a system that allowed children to visit hospitals daily was introduced and in 1958, vaccination programs were launched to curb polio, diphtheria and other diseases. (Carole, 2011) The power of responsibility is examined through the powers devolved to the NHS so as to create an understanding on the elements of citizens’ involvement in the different sectors of service provision and access to healthcare. There were further developments connected to the NHS service delivery which were established the moment the Thatcher government came in to power. There were landmark decisions that were made to change the implemented structures within the sector. Internal markets provided an insight on the acquisition of drugs to the point that the prescription drugs were now accessible albeit temporarily because there were shortages experienced. (Michael, 2002) These kinds of shortages are what inspired the elements of governance to start charging fees for the prescription drugs. Privatization came as a result of the need to create a difference between the different social classes whereby the rich people in the society sought to have privatized health care while the ones that provided the government with small taxes were offered the public platform whereby they could access the services that were concurrent with their remittances to the government. As soon as it was time for Tony Blair to take over the mantle of leadership, there were major changes that were implemented brought about differences in the NHS whereby the structure was to encompass personal health services for all the individual patients to curb the occurrences of such illnesses either old or new ones starting to appear during the time such as obesity. The Blair governance at this time advocated for the provision of healthcare in regards to the needs of the people and not in regards to thecapacity to deposit payments for these services. (Michael, C) The government implemented reforms that were to reconstitute the NHS into a platform that was to include dedicated and passionate staff. There were reforms that were connected to the NHS patient care platform and one of the most outstandingreforms in this case was the one whereby the government was pledging to increase funds for the NHS. This was initiated so that the service can reach all the people who were deserving of the subsidized service delivery. The reforms are aimed at bringing modernization that would make it easier for the governance structures to deliver their main objective which is equality in health care delivery through such designs as public patient involvement. (Gillian, 2006) The current reforms have shown elements that encompass both the citizenship and consumerist approach whereby the latter makes use of familiar market tools. The consumerist approach has been applied for a long time so as to improve efficiency, but the consumerism approach has often been criticized with the claims that the design does not place the patients’ interest as the core principles of operation. The citizenship approach has, however, received positive reviews as a reform platform initiated by the NHS within the 21st century time frame with the aim of changing the general attitude towards the health issues as well as to encourage responsibility for the benefit of personal health. (Gillian, 2006) Patient-led consensus appears as a platform for the creation of unique types of service providers whereby independent providers seek to compete with other primary care providers within the market. Patient-led consensus documents the idea that healthcare provision and access should be based on the choice of the provider to provide the care as well as the concept of choice in regards to the treatment design that they deem fit for their beliefs. The commissioners who seek to initiate the patient-led systems of treatment and healthcare services have often advocated for plurality or a range of providers for the patients to choose from including the healthcare providers from the private sector. (Andrea L et al) Consumerism approach is in the forefront in featuring the qualities of patient choice through the provision ofthe market that enables them to select their provider of choice paid for by NHS. The main function of reforms is the initiation of improvement in different sectors such as the service provision, improvement in the value for money and efficiency. The reforms have to practice the qualities of difference in the quality and conditions for job satisfaction as expected by the individuals delivering services to the public. Features of reform in the NHS should seek to drive success and efficiency in service delivery as well as embracing public patient involvement when delivering health care services to the member of the public. (Gillian, 2006) The structures regarding PPI that were put in place after David Cameron took over power changed the ways through which the elements of patient involvement were to be viewed by the healthcare providers with the example being observed in the White Paper that changed an understanding regarding the involvement of the patients in their health care access. Some of the suggested ways to involve the patients include the review and response to the patient complaints and queries efficiently, performing an interview with the purpose of discovering patient preferences, creating a patient panel that debates the different levels of patient involvement scenarios and through the commission of the recorded challenges as well as asking individual patients to write a diary that documents their experiences and how they rate the service delivery in the sector. The coalition constituted the LINks commission responsible for the investigations around the quality of proposed and existing health service provision whereby the commission performed other duties in collaboration with HOSCs. There were further actions by the coalition after the abolition of LINks and the formation of Local Health Watch as stipulated in the Health and Social Care Act 2012 whose main aim was to ensure adequate provision of better choices to patients as well as to study the performances of other service delivery departments in the provision of healthcare. (http://www.bad.org.uk/healthcare-professionals/clinical-services/patient-and-public-involvement) In conclusion, public patient involvement is very important when initiating reforms that involve the different elements of healthcare access and provision of the same. If the health sector is intended to improve the well-being and health of the people, then this service delivery sector has to be designed so as tomeet the objectives of improvement as stated in the reforms section of this paper. This is what makes it important to view these elements of change and reforms from the perspective of the NHS, which is an old system that has been existent for over 60 years, with respected and established principles and values, comprising of hundreds of trusts, practices and agencies with buildings worth millions of shillings so as to serve the function and purpose to the society.Self-support and personalization as approaches to the welfare platform have had the impact of reordering more than just the social care but also criminal justice system, children services, health as well as the tax and benefits within the system of healthcare provision. The thesis question has been answered in the course of this paper but the difficult section that still creates an element of confusion is the reforms that have been initiated since 2000 because the principles still remain unclear. The platform of health care provision and discussion is derived from the elements of citizenship whereby equality has to be established with regards to the provision of health care services.In addressing social needs for healthcare, one has to critically review the whole idea of catering for the people’s needs that are living long-term conditions that affect their social lives. The future of healthcare service delivery may seem secure due to the fact that the government is willing to provide the funds needed for the operations of the system, but the clarity of the reforms should still be established to make them have conclusive principles.Therefore, the maintenance of patient independence should be encouraged by the NHS that should also help facilitate the process of communication between the different services that are interconnected with the process of increasing the state of health to the individuals affected as well as to the close family members. 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Strengthening Accountability Involving Patients and the Public Practice guidance Section 11 of the Health and Social Care Act. 2001 Susan P. 1998 Citizenship and Consumerism in Health Care: A Critique of Citizens’ Juries The NHS Improvement Plan Putting People at the Heart of Public Services Presented to Parliament bythe Secretary of State for Healthby Command of Her Majesty June 2004 http://www.bad.org.uk/healthcare-professionals/clinical-services/patient-and-public-involvement Read More