The Health of the People - Essay Example

Introduction The health of the people within a given nationality has always been one of the priorities of the governments across the world. A healthynation means that the people will manage to work and create more wealth for the nation, killer diseases will be controlled, children will have the hope to see their adulthood and the sick will get proper medical care for their condition that will assist them get their healthy status back and contribute to nation building. This has in most countries become the driving force behind the adoption of systems that will ensure the population within them manage to meet their medical needs. Health care systems can be defined as organized arrangements planned to meet needs that will ensure the wellbeing of an intended population. There are a number of health care systems within a nationality that may include the occupational safety and health, military medicine and school health services among many others. The health care systems have identified a number of goals to meet to ensure the health concerns of the population are met. Health systems seek to ensure good health among the people, to help the people to have a fair system of contributing their finances towards the system, and to increase the rate of responsiveness in order to meet the expectations of the beneficiaries of the system. To meet this goals therefore quality of service provided, the efficacy of the provision of these services, their acceptability among the people and their equity in dealing with the target population must be on the forefront of all the health systems. England has adopted a health system known as The National Health Service (NHS) which has the mandate to provide healthcare for English nationals. Serving under the department of health of the government of the United Kingdom, this body is publicly funded and it provides most of its health care services for free apart from some medical services that relate to the eye tests, prescriptions and the dental care as well. This body provides health services like in-patient care, dentistry, primary care, ophthalmology and long time health care to the patients in need. The body has a private clause as well where the patients can privately pay for their medical care. This system of private medical care has been used to expand the services of the National Health Services. Most of the funding used to cater for the services in the National Health Service comes from taxation among other sources. The largest portion of the expenditure of the department of health is taken up by the National Health Service. Main body The National Health Services (NHS) is driven by a number of goals in its service to the people of England. It has identified its core value as the provision of quality medical attention to the people regardless of their ability to pay for the services they require. It provides a great number of services to the people including the fore mentioned dentistry services, optical services and the overall medical care among others (Brodie 2003). It aims at providing medical services that are customized in relation to the needs of the people, their preferences and those of their families as well as those of their careers. Some of the aims of the NHS include to; utilize public funds to offer healthcare services to the patients in the NHS system; support and treat staff as valuables; be sensitive to the needs of the different sections of the population; to adopt a collaborative approach to ensure optimal provision of medical services to the patients; and to assist with ensuring the physical as well as emotional well being of the people in the process mitigate inequalities of health among many other aims. Structure The department of health of the government of the United Kingdom has been charged with the control of the NHS. It provides a political inclination to the NHS representing the will of the government in its jurisdiction. Under the department of health are a total of ten Strategic Health Authorities which directly take up the overseeing of the general operations undertaken by the NHS. These strategic health authorities exert most of their influence on the primary care trusts found within the particular areas they are meant to cover (Wanless, 2002). The NHS trust comes in a number of regional types which include the NHS primary care trusts charged with the responsibility of managing the primary care and communal health. The trusts therefore provide basic care within their areas of operations; and manage initiatives and undertakings of primary and secondary prevention, control of epidemics, and the organization of inoculations. To do this, the NHS primary care trusts has great number of medical practitioners who include approximately 29000 general practitioners and 18000 dentists. They are also mandated to charge services considered acute from other NHS trusts and the private sector. The NHS hospital trusts and the NHS foundation trusts offer specialist care in approximately 1600 hospitals under the care of NHS, hospitals as well as the treatment centres. There also are the NHS ambulance services trusts which offer emergency services to the critically ill patients and generally any sick persons requiring the ambulance services. The NHS care trusts are basically charged with the role of provision of health and communal care services. The NHS trusts dealing with mental issues offer these services to the patients in need of them. The NHS direct and NHS special health authorities both offer their services on a national scale of providing support through telephone and internet; and providing varied specialized services respectively (Walshe 2001 p28-32). The NHS has a very large staff base that approximated 1.3 million workers in the year 2005. Almost all doctors and nurses in England are employees of NHS working in the hospitals that are managed by the NHS. On the other hand, all the dentists, general practitioners, optometrists and providers of local healthcare are almost entirely self employed but they pact their services to the NHS. This category of medical practitioners may operate in their own capacities in terms of having their private premises, operating patients privately, employ staff on their own accord and form partnerships with other medical practitioners yet however, the NHS undertakes the provision of centrally employed professionals within the healthcare system and facilities in the areas that suffer insufficiency of practitioners that are self employed. The NHS is also takes up the role of training and recruiting doctors into the health system (Banks 2001p4-8). They basically do this by providing 8000 yearly spaces for student doctors in the NHS university Hospital Trust where they offer medical practices and theoretical information to the students. Funding The NHS utilizes great amounts of funds in their endeavor of offering health services to the public. Most of the funding comes from the pool of tax money collected from the English taxpayers. Funds are held primarily by the Primary Care Trusts in the NHS system who have a direct connection with the general practitioners and the healthcare in the NHS hospitals. The department of health offers the primary care trusts a budget that computes the needs of the people with the general population. The primary care trusts disburse funds to these areas under the binding of an agreed upon tariff but may also do it on the basis of a contract. The department of health makes a follow up with the money disbursed always demanding that the financial obligations of the money be met without the health facilities running into deficit (Coulter and Ellins 2006). Though the NHS offers its services free of charge to the UK residents, it charges its patience for the services related to dentistry, optometric as well as for the prescriptions made. The non ordinary residents are often charged for the services offered but are exempted in the cases of involvement in accidents and emergencies. This condition also applies to the British citizens who have in the past contributed to the National Insurance. Tax money forms the greatest source of the funding for the NHS. The NHS exempts from the making of contributions all the people who undertake overseas missionary work for organizations based in the UK. This exemption disregards the arrangements of payments for the individual with the organization that has sent the missionary. The move is meant to improve the chances of the missionary to manage to seek and pay for the medical services offered in the country they are in on mission in the event that they might require medical attention. Other groups of people exempted from making contributions to the department of health include armed forces stationed overseas and some specific civil servants within the government (Enthoven 2003 p46). Medicine prescribed is often charged for the UK residents but nevertheless certain categories of people are exempted from this payment and they include individuals aged over sixty years, patients who suffer from certain conditions, children who are aged below sixteen years and the individuals who are low income earners. On the same note patients who have been prescribed for medicine that might need repeated doses can be assisted to foot the bill through purchasing a pre-payment certificate that they can use to collect required prescriptions without limitations from the health services during the period of validity of the certificate (Alborz 2002 20-28). A newly revised system of the dentistry system has led to the adoption of a system that had the effect of reducing the dentists working under the NHS from the year 2006. Patients are therefore increasingly seeking services from the private sector where they are charged exorbitantly as compared to the rates charged by the NHS. NHS has also been known to charge patients for offering a sight test. Nonetheless needy individuals are often tested for free. At the same time, they are assisted with the payment of or reduction of the charges made for lenses and frames through a check system. Some needy patients receive partial subsidies for their conditions. Another source of revenue for NHS is fees charged from car park services which have been known to contribute a significant portion of the overall revenue collected by the NHS. Fees charged by the hospitals are controlled by these individual hospitals then remitting the amounts collected to the NHS. The NHS runs a significant number of charities across England and Wales which are administered either by boards of independent trustees or by appropriate NHS trust which acts as corporate trustees. Functions of these funds include improvement of environment, medical based research, and for larger items relating to equipment used for medical purposes (Bruni et al. 2008p15-18). These services offered under the charity fund are basically meant to increase the comfort of the patients. The NHS has other charities which are useful kin raising funds for medical research as well as satisfying appeals for capital. The above named are some of the areas where the NHS acquire the funds they need for offering the medical services under their operations. Regulations The NHS has made regulations for entirely all its areas of operations. All the regulations are provided in the section 176 of the Health and social care Act (2003) and they have been made by the secretary of state. Under the local ruling for primary care practitioners, the arrangements for catering for complaints are put down in the 2004 regulation requiring them not to handle any complaints but to act as brokers between the practice and the complainant. In relation to the medical practitioners solely, it has been clearly stipulated that all contacts must be made through a general medical practitioner while entering into a contract between two or more people in partnership will require that at least one of the partners will have to be a general medical practitioner among others. The essential services under the regulations have been identified as those services provided to the registered patients who believe that they are ill but their conditions are recoverable; are terminally ill; or are carrying a chronic disease. This category includes the medical practitioners giving relevant advice on good health, and the referring patients for other services that might be listed on the Act. The general services include the specification of the medical service that both the patient and the medical practitioners expected to be included in a contract, an address depicting the premises to be used for the provision of the medical services, the name of the patient, the identification of the area to be used as the premises for which the medical services will be offered and an indication of the acceptance of both the contractors to take up the premises indicated. The NHS regulations of 2005 pertaining to the pharmaceutical services include the dispensing regulations for the rural population; the guidelines with which entry of provisions area controlled; the terms of service framed under the contractual framework which has been newly formulated; and the directions indicating fitness required for practising the required provisions for contractors of pharmacy. Strengths and weaknesses The adoption of separate bodies for regulating the NHS in the UK in both the government sector and the non governmental sector has ensured the provision of quality health care within the UK. The governmental bodies charge with this role include the council of general medical practices, the department of health as well as the midwifery and the nursing council while the non governmental bodies charged wit this role includes the Royal colleges. The move directed towards the improvement of the services offered to attain the level offered by the United States and other major developed governments led the NHS to adopt high quality modes of assessment, improvement and maintenance services. In addition they have set the healthcare commission as the principle body for assessing the quality of services offered - an undertaking they accomplish by comparing the quality of the NHS services with that set by the department of health. At the same time, the quality assessment was transferred to care quality commission from April 2009 which has boosted the quality of the services greatly (LeGrand 2007 149-151). Administration of the medical services has been considered as a great success in the sense that it satisfactorily satisfies the required medical requirements of the residents indiscriminately. The satisfaction of the populace can be attributed to the small percentage of utilization of the private sector of the medical department which has been running parallel to the NHS provided services. The private sector manages to offer 8% 0f the required medical services while the other 92% is served by the NHS. This indicates that the public is happy with the services they receive from the NHS and therefore consider the private option only as a complimentary service of the public services offered. This suggests careful and organized administration of the NHS (Light and Dixon 2004 763-765). In comparison to the United States of America, health services are offered by numerous entities which are nonetheless legalized through a system that involves the government approval of the practitioners and the standards of the premises. The Americans highly utilize the private sector where the greater portion of the health care system is in private hands. The varied types of services offered by the NHS has proved effective in satisfying the great number of medical conditions suffered by the patients in the United Kingdom. The services offered by all the regional NHS trust are basic and cover a wide category of the medical services desired by the people. The primary care trusts services are satisfactorily found within the reach of all the residents of the UK who may be in need of them therefore convenience in the provision of the services is highly enhanced. The NHS often step in whenever a deficit is experienced in the provision of medical services by the private general practitioners thus ensuring the equal distribution of the medical services to the targeted groups. Among the Americans, the health care system lacks a nation-wide system of health care facilities owned by the government for which the general public is open to. This means that the citizens have to foot their own medical bills with private insurance playing a great role in clearance of bills. Some weaknesses identified as existing in the NHS system include the lack of provision of cost -ineffective drugs for the patients with the NHS managed health centres though these medicines are always available within the private sector. A condition placed for access of the medical services within the secondary level of medical care includes the characteristic issuance of referrals of the general practitioners as well as those of the primary care trusts. The innovation of the referral management centres has offered a cheaper option to the general practitioners' referral services (Abelson and Eyles 2002p7). This system has the effect of controlling the access of patients to higher levels of medical care and even may discourage the patients from visiting the health centres due to financial considerations. They may also cause a delay for treatment of conditions that may prove dangerous when delayed. The drugs available for the Americans on the other hand are as varied as the patients would need since the drugs to be used by the patients depends on the ability of the patient to buy them. The individuals who choose to pay for their private healthcare in England do not have an option of avoiding the contribution towards the NHS and therefore often end up paying a double portion for their medical services (Titmuss 2001 p17). This system of contributing towards general medical services through taxation is not valid in the USA since contribution towards the medical services offered to the patients is carried out on a private basis. Outcries of continual political pressures for the government to increase its spending on the medial services offered by the NHS and to increase the scope of treatments which are available has offered a stage for the politicians to spice up their political concerns. Political parties have over time promised to evoke the improvement of the NHS in order to win their political mileage. This indicates a weakness in the operations of the NHS since if it were up-to-standard, then it would offer politicians a chance to use it as a centre stage to win the political loyalty of the people (Arnstein 2000 p216-220). The NHS clinics have failed to come up with means of identifying the UK residents in the clinics thus some people from the neighbouring nationalities have been known to seek medical attention on account of the UK's taxpayer's money. This is by virtue an oppression of the taxpayer and a check system is necessary to ensure that the individuals with access to the NHS medical services have actually paid for these services. The 'health tourists' must pay for their medication. The implementation of the National programme for IT has evoked a row of protests from the medical practitioners, the House of Commons, and the National Audit Office as a system of administration for electronic prescriptions, elective surgery, making appointments and maintenance of national care records due to the high chances of loop holes the system will create. This is in terms of provision of secrecy for the patients' records. At the same time, the initial budgetary allocation has to keep on being added to meet new challenges with the effect of drawing more and more from the treasury. This step might need to be reconsidered by the government for the sake of saving the country more financial losses and a controversy over the medical implications it might on the NHS medical system (Brodie 2003). The budgetary allocation for each of the NHS managed hospitals might need to be revised to avoid the chances of running into deficit. The funding offered to all this health care is expected to satisfactorily cater for the needs of the institutions without the institutions running into deficits. This has proved rather tricky for the institutions which have to draw more than the allocations to meet practical needs stumbled on in the course of them offering the medical services (Health affairs p27). Conclusion The National Health Services has displayed positive impact in the provision of the medical services to the UK residents. It has proved itself by offering its services to a significant level of satisfaction with most of the services offered for free many others subsidized, despite the many challenges and hurdles it faces in the administration of the duties it has for the public. The move to the quality of the services offered is a real plus to the provision of quality services. It aims at providing great services for the residents of the UK without having to consider the financial status of the beneficiaries and from the facts provided in the essay, it is quite clear that NHS is doing quite well. Even then some weaknesses have threatened the aim of NHS like the politicization of its operations, financial allocations for the budgetary needs of the health centres that are administered by the NHS, eruption of scandals and the intrusion of the nationals from the neighbouring countries into the medical services of the UK in order to avoid paying the medical charges among other weaknesses. If only the government of the United Kingdom can pursue the weaknesses through the introduction of radical measures and encourage appropriate means of offering the best medical services, the hopes of ever reaching their goal would be highly boosted. References Abelson, J. &Eyles, J. (2002) Public Participation and Citizen Governance in the Canadian Health System. Discussion paper NO 7. Alborz, A. et al (2002) 'Are primary care groups and trusts consulting local communities' Health & social care in the community, 10 (1), 20-28. Arnstein, S. (1969) 'A ladder of citizen participation'. 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