NHS in the United Kingdom
The United Kingdom's Health Policy Today
Beland and Waddan Reading:
The Margret Thatcher Years...
Overview
The story of the NHS since the late 1970s is complex as the institution has undergone several re-organisations.
The Conservative: Brian Mulroney Years
- Health care as a commodity
- The NHS is funded through general taxation
- Public support for universal access
- Public Financing + Competition ~ Increased quality & reduced expenditure
- Divisions between England, Northen Ireland, Scotland and Wales
- A universal system
- Universality in healthcare remained relatively protected
- Canada witnessed comparatively limited, path-dependent changes in healthcare policy
- True within the traditional hospital and physician sectors. Significant change has taken place in areas such as prescription drugs, which are located outside the original Medicare framework
- In 1984, to prevent the development of user fees and to improve its electoral standing, Trudeau’s Liberal government introduced the Canada Health Act (CHA)
- Theories of health policy development
- Health care policies in the United Kingdom
- The scope of health policy
- Tools of health policy
- New and upcoming developments
Beland and Waddan Reading:
Citations:
The Conservative Cuts: Harper years...
Continued...
Theories of health policy development
- Béland, D., & Waddan, A. (2014). Conservatives, partisan dynamics and the politics of universality: Reforming universal social programmes in the UK and Canada. Journal of Poverty and Social Justice, 22(2), 83-97.
- Tenbensel, T., Eagle, S., & Ashton, T. (2012). Comparing health policy agendas across eleven high income ountries: Islands of difference in a sea of similarity. Health Policy, 106(1), 29-36.
- Anneliese Dodds (2013). Comparative Public Policy. Palgrave Macmillan
- McCarthy, N. (2015, Oct., 1). The Countries With The Most Foreign Trained Doctors. Forbes. Retrieved from http://www.forbes.com/sites/niallmccarthy/2015/10/01/the-countries-with-the-most-foreign-trained-doctors-infographic/#56a0d999345b
- Office for National Statistics. (2013). [Graph illustration the public sector healthcare expenditure, 1997-2013]. In 2013, Public Sector Healthcare Expenditure Was $125.5 Billion, While Private Sector Healthcare Spending Was $25.1 Billion. Retrieved from http://www.ons.gov.uk/ons/rel/psa/expenditure-on-healthcare-in-the-uk/2013/art-expenditure-on-healthcare--2013.html?format=print
- Seàn Boyle. Health systems in Transition: United Kingdom (England). Vol.13 No.1 2011 http://www.euro.who.int/__data/assets/pdf_file/0004/135148/e94836.pdf
- E.Mossialos and M. Wenzel. International profiles of health care systems,2014. http://www.commonwealthfund.org/~/media/files/publications/fund-report/2015/jan/1802_mossialos_intl_profiles_2014_v7.pdf?la=en
- Grosios K, Gahan PB, Burbidge,J (2010). Overview of healthcare in the UK. The EPMA journal,1(4), 529-534 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405352/
- Guide to the Healthcare system in England ; including the statement of NHS Accountability. May 2013 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/194002/9421-2900878-TSO-NHS_Guide_to_Healthcare_WEB.PDF
Beland and Waddan Reading:
- The Harper government did not directly attack universality but made it clear to the 10 premiers that federal funding to the provinces would soon become less generous
- The annual 6% increase in federal funding adopted as part of a 2004 health agreement between Ottawa and the provinces will soon be replaced by a funding scheme tied to economic growth, with a guaranteed annual increase of only 3 per cent
- Policies cover primary, acute, and chronic care
- Before 1950s: isolation
- After 1950s: providing treatment
The David Cameron Years...
Affects on the United Kingdom's Health Policy
- There were explicit rebukes to universality, notably the ending of free eye-tests in the late 1980s
- Healthcare providers introduced market mechanisms into the NHS under former Prime Minister Thatcher
- This continued under the Labour Party from 2000 to 2010
- From a patient’s perspective, universal access free at the point of use to medical care remained unchallenged
- Ageing population
- Rapid technological and cientific developments
- Cost of pharmaceuticals
- Internationalizaion
- Health and Social Care bill enacted after a protracted legislative process
- This bill was the most controversial measure passed by the government and the encouragement of market mechanisms within the NHS
- I.e. offering tax breaks for private insurance
- The law promises considerable change
- The universality built into accessing the NHS continues, and the service remains predominantly funded out of general tax revenue
Any Questions...?
Health Policy & the United Kingdom
United Kingdom Health Care System
The Provision of informaiton
- Centralized health care system
- Internal market system: "Purchaser" separated from "buyers"
- Health care policies vary across the territory
Health Care Policy in the United Kingdom
- Purpose: To enable public to become better informed and advised about health-related issues as well as to shape, debate, discussions, and ultimately, policy in health-care
- NHS Direct Hotline
Patterns in Health Policy
- Centralized, single payer health care system funded by the government
- 13% of the population are covered by voluntary health insurance
- At the National level, the department of health is assisted by by different bodies
- The care quality commision (CQS)
- Health protection agency (HPA)
- National institute of health and clinical excellence (NICE)
A Closer Look...
- In 2003, accordng to the Health Policy Monitor, there has been an increase in initiatives that address public health concerns, access and equity and population health outcomes
- Primary objective of health policies is to improve the health outcomes
- Health policies are set in place to help the process and to structure health services provided
- Improving the population health outcomes are more likely to rest under the agenda of a tax-based system
- The United Kingdom was labelled a tax-based system
- Highest form of health services offered is pharmaceuticals
Continued...
By: Kareem Al Hammuri, Waleed Faisal,
Vivian Grinfeld, Lilian Nakiyemba & Te-Anne Sutton
- NHS is the main body or organization that provides primary care and hospital services
- NHS services follow 3 systems (1) primary funding, (2) secondary funding (3) tertiary funding
- NHS funded primary care is provided in 3 ways
- 1. Community health serveices
- 2. NHS walk in centres
- 3. Denitists, opticians and pharmacists
- A private health insurance exists to replicate the coverage provided by NHS
In Conclusion...
Continued...
- Objective:
- Insight into the Health Policy and system within the United Kingdom
- A comparison of health policy with the United Kingdom and other regimes
- Insight into the tools of health policy used
- A deeper look at the connection between political parties and the affects on health policy and new developments
- Tax-based systems tend to offer greater potential to connect public health to health care services
- The United Kingdom displays strong connection between health policy and the politics behind it supported by the government
- The United Kingdom, much like other countries, offer a range of health services:
- Pharmaceuticals
- Mental Health
- Aged-Care
- Public Health
- Disability
- Long-Term Care