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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
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