Health Promotion in NHS - Essay Example

Introduction Healthcare across the globe is important in terms of ensuring that the world’s population leaves longer and healthy. In order to maintain a healthy population, governments across the world need to invest in healthcare systems that can lead to a sustainable future( Deebel, 2013 ). On the other hand, health has an impact on all spheres of life; For instance, when one is ill it affects all aspects of daily living. Similarly, an unhealthy person cannot participate in economic ventures to improve their living standards. Furthermore, an ill-health population would not be productive of building a developed economy. Consequently, improving the health of a nation requires governments across the world to develop a health care system that is accessed by everyone (Deebel, 2013).This paper examines the origins, structure and function of the UK’s NHS in comparison to the healthcare system in France. The NHS was established in 1948 due to a need of its citizens to provide equitable health care for both the rich and poor in the United Kingdom. Prior to the establishment of the National health service(NHS), citizens make contribution to access United Kingdon National health services. In the initial stages of developing theNHS, the system provided three services that included hospital services, primary care and community services. As a result of a huge government expenditure directed towards the NHS, a charge was introduced for prescription and dental treatment. Over the same period (1950s), the size of health care providers also increased, which enhanced hospital outpatient services(Lapsley&Shofield, 2009). However, in 1956, the system was stretched in terms of finances, thus affecting the work of doctors. Consequently, the Royal Commission targeting doctor’s pay was established in 1957. In the 1960s, the NHS experienced significant growth in terms of providing equitable health care for every citizen. For instance, prescription fee was eliminated but reintroduced later in 1968 (Lapsley&Sheffield, 2009). The development of new drugs also revolutionised healthcare provision in the UK, particularly the polio vaccine, treatment of cancer and kidney dialysis. However, improved treatment meant a surge in health care costs. As a result, other reforms were needed in the established healthcare system. Concerns about the NHS’s structure related to its effectiveness in the provision of equitable healthcare also emerged (McMurray, 2010). The initiatives were implemented as a result of concerns regarding the effectiveness of NHS’s structure at that period. Accordingly, what emerged as a result of the concern with NHS structure was the idea of primary health care. In addition, there was advocacy for better facilities and improved practices among health care providers (McMurray, 2010). The other developments during this period included the introduction of modern group practice among doctors; for example, a health care facility consisting of two or more doctors and experienced practice nurse working in collaboration within an interprofessional team (McMurray, 2010). In the 1970s, the NHS structure underwent re-organisation with the aim of uniting hospital services and local authority services under Regional Health Authorities (Fernandez & Forder, 2012 ). Further restructuring of the health care system also took place in the year 1982. As a result of financial constraints, the system experienced scarcity of resources to meet the demands of medical treatments at that time (Fernandez & Forder, 2012 ). Due to limited resources to enhance the services of NHS, major reforms in the system were needed to improve efficiency. Under the Thatcher government, a new management method was introduced and replaced consensus management previously used by NHS. Managers were introduced into the system and took responsibility for ensuring the NHS becomes efficient in providing health care services (Gray& Higgins, 2012). However, due tocontinued reforms in the 1980s and 1990s, integrated care later replaced the internal market system. This involved giving doctors and nurses a greater role and more resources chanelled to patient care. Hence, as a result of ensuring quality care and the use of modern evidence based for treatment, the Government reviewed the NHS system and introduce measures that cangive impetus to the internal market system(Sue, 2008). Reforms in the modern times have been driven by surging costs related to medical technology and medicines hence this provide quality care for all. In addition, the need for quality, patient-based care, population demographics and cutting down expenditure also drives reforms. Within the system, new services have been introduced in the modern day to accommodate the high demand and improve efficiency. For example, NHS Direct, IT innovationsand continuous research on medical conditions that more in demand- Dementia (Sue, 2008). After the system underwent a significant transformation, the current structure includes the Secretary of State being who is responsible for the health sector in Britain. In addition, the secretary represents theNHS in the parliament. His or her main role involves providing strategic leadership in England’s health sector that also includes the NHS. Within the system’s organizational structure, there is also NHS England (Mannion et al., 2015). This is a body operating independently from the government and is charged with improving health outcomes for the population in England. The body is also concerned with the national leadership in terms of enhancing the quality of health care and oversees the operations of Clinical Commissioning Groups. New England as a body in the NHS structure also ensures that CCGs have adequate resources. On the other hand, the CCGs have usurped the position previously held by Primary Care Trusts (Mannion et al.,2015 ). Their activity involves planning and approving health care services within their localities. The members of this group include GPs, nurses and consultants (Dickinsonet al., 2013). In essence, CCGs approved 60% budgetary allocation for the NHS and are also in charge of commission secondary care in England. In the structure, there is also a board responsible for health and wellbeing(Dickinson et al., 2013 ). The Public Health England that also forms part of the NHS structure is engaged in providing leadership and expert services needed in public health(Mannion et al., 2015 ). In addition, they support the local government and the health care system in terms of responding to emergencies. PHE also engages in supporting the public on how to make choices that are healthier (Marks et al., 2011). The functions of the NHS include funding primary care that ensures citizens in the country access health care in different ways. This includes providing general medical needs at the first point of contact. These services are offered by independent GPs, who have a contractual agreement with PCTs(Chacha-Mannie, 2014 ). However, the GPs are also employed directly by other providers, for instance, the commercial sector (Chacha-Mannie,2014). Community Health, NHS Direct is among other healthcare services provided by NHS under primary care. In addition, primary care under NHS acts as a gatekeeper in terms of influencing access to other specialized health care services. Such services are normally hospital-based or acute health care services (Chacha-Mannie, 2014). NHS also funds secondary care that involves the services offered by consultants, nurses and other health care providers. These health professionals are paid a wages and work in government-owned hospitals under NHS trusts(Chacha-Mannie, 2014 ). Other than secondary care, the NHS also provides a variety of specialized tertiary services and complex or rare health problems. Such tertiary services provided by NHS involve medical schools or teaching and referral, meant to improve medical research (Rivas et al., 2010). The health care system in France ranks top globally inbeing more efficient in terms of providing universal cover. In France, their health care program consists of an established network of hospitals, both public and private that integrate various functions and individual expertise to improve efficiency (Steffen, 2010). The system emphasizes universal coverage in proving health care regardless of social status or demographic factors. In terms of funding, France’s health care system is financed through taxes levied on a citizen’s salary that is remitted by employers, workers and the self-employed. The central government also makes contributions towards financing the health care system (Guthmuller, Jusot&Wittwer, 2014). In terms of expenditure, the healthcare system in France incurs fewer costs compared to other developed countries. In addition, patients have a wide variety of choices in terms of health care providers. The French NHI has gone through stages since 1928 and previously encompassed salaried employees. However, it was later expanded to include all industrial and commercial workers regardless of a worker’s wage level (Simone, 2010). In the 1960s, workers in the agricultural sector were also included in the scheme and the 1970s, independent professionals also joined NHI. Presently, NHI forms part of the France’s social security system. The NHI encompasses various health care services that include hospital care, outpatient care, nursing home-based care, monetary benefits and also to a certain degree, dental and vision care (Simone, 2010). In terms of organisation, the system is considered to be more liberal compared to other systems in the United Kingdom. For example, doctors can practise anywhere they prefer, and in hospitals.Liberalism in the health sector enhances the relationship between government hospitals and private hospitals(Sparer, France, & Clinton, 2011 ). In essence, France as a country tends to embrace organizational diversity as a result of pluralism. With respect to complex cases, these are normally left for the public sector to decide. Similar to other healthcare systems elsewhere, France also faces challenges with its health insurance scheme. As such, there is the need for support in terms of funding from the government’s general budget. In addition, increase population in terms of age and immigration has led to the rise incosts of health service due to advancement in medical technology (Sliteen et al., 2011). In both countries, almost all their citizens are entitled to health coverage; however, challenges still exist with a publicly defined coverage. For example, in France, dental and vision care are catered for through supplementary insurance. Due to advancement in medical innovations, challenges emerge in terms of defining the benefits that health care provides to the public and the responsibilities that individuals or families are supposed to carry personally (Pelletier-Fleury&Vaillant, 2013). The core values in both countries that drive the need for universal coverage include equity, solitary, dignity and community. In terms of funding, the governments of both Britain and France are involved in setting up a statutory framework that is necessary to finance universal coverage (Pelletier-Fleury & Vaillant, 2013). The NHS obtains funds for its universal coverage from general revenues. Conversely, in addition to supporting its health care services through general revenues, France also has a cost emphasizing cost sharing by patients. In comparing costs, both Britain and France spend minimal share of their country’s resources in advancing healthcare programs. However, containing costs in both countries are counter-productive in the face of an increase in the ageing population, technological advancement, economic meltdown and consumerism (Le Bihan, 2012). In containing cost, the budget for public health care in Britain limits over spending. Conversely, France parliament over the years has continued to pass legislation that controls national spending on an annual basis. Concerning health care providers, there are challenges in terms of policies related to health and improving terms of payment for health care workers. In Britain, doctors’ organisations and various hospitals bargains with Government agencies on a regular basis (Bourlakis, Clear& Patten, 2011). In France, groups formed by doctors tend to negotiate differently with government agencies concerning the sickness funds. When it comes to integration, there tends to be dissatisfaction on how the delivery systems in both countries are organised. In Britain, there used to be fundholding among GPs and hospital trusts; however, primary care trusts in the country is taking shape (Sparer, France, & Clinton,2011). The need for co-ordinated care in france is gaining prominence. Treating health care as a commodity can increase competition and thus interfere with the core values that guide the provision of universal health care (Simonet, 2009). In terms of hospitals and the number of physicians in both countries, the public authority plays a role in planning and distribution respectively. In both countries, a large percentage of citizens are happy with the health care system being implemented. With respect to leadership in the health sector, both countries are similar in terms of advocating for a strong and consistent leadership from the central government(Simonet, 2009). A strong and consistent leadership is also necessary to implement sustainable universal health coverage;for example, Britain emphasises socialised medicine (Simonet, 2009). On the contrary, both countries also acknowledge the challenges associated with managing health policy entirely by the central government. As such, both countries have established regional and community bodies such as primary care trust in England, regional hospital councils and public health conferences evident in France. However, both countries still require an effective centralisation when it comes to policy authority (Simonet 2009). In conclusion, the UK NHS services has contributed growth in terms of its citizens living longer. As depicted above, France depends solely on its citizens for her to provide affordable healthcare system. In a nutshell, both countries, funding has been affected because of bureaucracies where numerous bodies are established in the management of health care system. An efficient health care system is essential in promoting a healthy nation that can contribute significantly to the well-being of her citizens. References Bourlakis, M., Clear, F. & Patten, L., 2011. ‘Understanding the UK hospital supply chain in an era of patient choice’, Journal of Marketing Management, 27(3), pp. 401-423. Chacha-Mannie, C., 2014.‘Health promotion in NHS walk-in centres: a literature review’, Primary Health Care, 24(5), pp. 24-28. Deebel, J., 2013. ‘A healthy beginning: the origins of Medicare’, Australian Economic Review, 46(2), pp. 191-195. 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