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 GiantsThe 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 1948Nye 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.

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 WayLabour 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

Health ImprovementsLife 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?

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