Health Care in the uk the nhs in this unit you will learn



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Health Care in the UK

  • The NHS

In this unit you will learn:

  • How and why the NHS was created
  • What the original aims of the NHS were
  • Individualist and collectivist views of health care
  • New Labour’s “Third way”
  • Improvements in health
  • New health problems
  • The growth of private health care
  • The advantages and disadvantages of private health care

The Five Giants

  • The NHS was set up in 1948 as a result of the Beveridge report.
  • Beveridge had identified five problems:
  • Disease
  • Ignorance
  • Squalor
  • Idleness
  • Want

The NHS 1948

  • Nye Bevan was the Minister of Health who oversaw the creation of the NHS.
  • “Administration will be the chief headache for years to come” Aneurin (Nye) Bevan
  • The main political parties all agreed on the basic principles of the NHS: a comprehensive service, caring for all and free at the point of use.

Why was the NHS created?-Qs

  • 1) Describe the five giant evils identified by Beveridge. Page 65
  • 2) What did the government do to address each of the “five Giants”? Page 65
  • 3) Make notes on the aims/features of the NHS Page66
  • 4) Describe health conditions for the poor before the introduction of the NHS. Page 66
  • 5) Why has expenditure continued to rise in the NHS?
  • 6) What issues have affected the income of the NHS?

Individualist Vs Collectivist!

  • Ideology - part of Thatcherism
  • Responsible for own health
  • Lifestyles- smoking drinking
  • poor diet, little exercise
  • Individuals are aware of the health risks of these
  • Individuals should be allowed to opt out of paying for NHS & allowed to put this money towards Private Medical Insurance (PMI)
  • Ideology -socialism
  • Strong link between poverty & ill health.
  • Poverty related ill health is wider than scope of NHS - housing & benefits
  • Government has a responsibility to narrow inequalities of society
  • Lifestyle choices linked to poverty - stress of unemployment & lack of knowledge

The Third Way

  • Labour governments since 1997 have drawn on both individualist & collectivist ideas to come up with the Third Way idea.
  • The need to address the issue of poverty: -improving housing -improving education -get unemployed back to work
  • The need for individuals to take responsibility: -promotion of healthier diet -promote taking exercise -discourage bad habits - drinking, -prevention better than cure

Responsibility for health Qs

  • 1) What evidence is there that individuals are being asked to pay more for their health care? P14-15
  • 2) “The UK Government spent less money on health in 1997 than most comparable countries.” What evidence is there in the table on p12 to support this view?
  • 3) What evidence is there that the NHS manages a huge amount of resources? P16-17
  • 4) What evidence is there that the NHS provides jobs outside of health care? P18
  • 5) To what extent did the Conservative Governments increase spending on the NHS?P19-20
  • Life expectancy has increased:
  • 1950 2000 Men 66 years 74.4 years Women 71 years 79.6 years
  • Why?
  • Setting up of NHS
  • Better nutrition (rationing into 1950s)
  • Better Housing
  • Improvements in medical care
  • Reduced infant mortality
  • Preventative treatment of disease
  • In the future life expectancy might reach 100 years!

Vaccinations

  • TB - Tuberculosis - major killer made worse by overcrowding. Now drug resistant strain of TB becoming a problem.
  • Whooping Cough
  • Diphtheria
  • Tetanus
  • MMR controversy
  • HPV - cancer

Improved drugs & surgery

  • Better detection & treatments of cancers
  • Transplant operations
  • Heart by-passes
  • More drugs
  • Use of technology

Better Lifestyles?

  • Less people smoking
  • Greater awareness of health issues
  • Preventative programmes
  • But: will same be true in 50 years time? Elderly today had a healthier diet & more exercise than children growing up today have.
  • Problems:
  • Junk food, additives & processed meals
  • TV & PC
  • Cars
  • Mobiles???
  • Less exposure to germs!

New Health Problems

  • HIV & AIDS
  • MS & ME
  • Meningitis
  • E-Coli
  • BSE and variant CJD (mad cow disease)
  • Increase in allergies & asthma
  • High death rates from cancer & heart disease
  • Lack of exercise
  • Poor diet
  • More elderly people
  • Can you think of any others?

Challenges for the NHS Qs

  • 1) Describe the main reasons why life expectancy in the UK has improved? P21-22
  • 2) Why did the creators of the NHS believe that demands placed on the NHS would decline, rather than increase?P22-23
  • 3) Describe the new demands now made on the NHS?P23-27
  • Outcome 2 - use chapter
  • 4) “The NHS is a victim of its own success.” Discuss
  • 5) Examine the view that there was a funding crisis in the NHS in the 1980’s.

Reforms of the NHS Qs

  • 1) Why could the reforms of the Conservative Governments be seen as a challenge to the fundamental aims of the NHS? P29-30
  • 2) Why is it inaccurate to describe a NHS Trust hospital as a “private hospital”?P33-34
  • 3) What rights do patients have under the Patients’ Charter?P34-35
  • 4) Describe the main features of the internal market.P31-36
  • 5) What is meant by the Private Finance Initiative(PFI) & give examples of it in health care.P48-50

Reforms of the NHS Qs

  • Outcome 2
  • 1) Examine the arguments against competitive tendering.
  • 2) To what extent did the internal market create a “two-tier” NHS?
  • 3) Examine the arguments in favour of private medical insurance.
  • 4) “the Labour government has abolished all of the reforms recent Conservative Governments have made in the NHS.” Discuss.

Private Health Care

  • 12.7% of the population have private medical insurance (PMI).
  • More PMI companies: BUPA & AXA
  • These companies advertise - get examples.
  • People pay for one off operations or treatments.
  • Cosmetic operations have greatly increased.
  • NHS viewed as not always providing the best and most up to date treatments.
  • The NHS often has long waiting lists to see specialists & have operations.
  • Thatcher encouraged individual responsibility - tax relief for over 65s paying PMI.

Advantages of Private Health Care

  • Individual choice - how to spend your money
  • Takes some pressure off NHS - cuts waiting lists
  • Focus on individual responsibility - you smoke you pay more PMI
  • Some treatments/surgery not available on NHS - Some fertility treatments
  • Doctors can top up wages doing private work - prevents brain drain
  • Creates additional employment - medical & non-medical
  • Allows top executives & key workers to get fast treatment - preventing a slowing of the economy
  • Private health gives the patient greater comfort - choice of meals, private room, TV and phone.
  • Private patients still contribute to the NHS
  • Patients have greater choice on the timing of operations
  • Private hospitals can operate on NHS patients - further cutting waiting lists
  • Private Health care has always been available in the UK and could not now be reasonably removed.
  • The private sector shares resources and facilities with the NHS.
  • The private sector conducts a great deal of medical research

Disadvantages of Private Health Care

  • Choice only for the well-off
  • Makes NHS look second class
  • Queue jumping
  • Common reward from companies to employees for good work
  • All medical staff trained by NHS - private sector never pays for training
  • Moonlighting - working in both NHS & private - results in overworked & tired doctors
  • Lessens pressure on the government to improve NHS if “cream” using private
  • Primary Health care not private - only London has good coverage of private doctors - private patients still have to use NHS doctors
  • Some groups of people may find it hard to get PMI - elderly, disabled & terminally ill
  • Not subject to same controls - Intensive Care Units in NHS have to have ICU trained nurse on duty at all times - private hospitals don’t
  • No emergency treatment facilitates

Essay question

  • How does this private sector contribute to health care in the UK? This question requires you to look at PPP/PFI as well as private health care.
  • 15 Marks


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