My study blog

health care

Posted by lednum on December 17, 2006


The National Health Service was set up as part of the post-war Welfare State. Its original aims were to provide a comprehensive, integrated service free at the point of use. Its intention was to provide the best possible care for all citizens and, wherever possible, prevent ill health.

The NHS has not been able to fully meet these aims due to the unexpected cost of healthcare and an ever-increasing demand for limited resources. The NHS has treated more patients every year and introduced many new treatments. But with limited resources it has had to deal with ill health caused by changes in lifestyle such as obesity, alcoholism and new problems such as AIDS. The care needs of the increasingly elderly population are also putting a significant strain on the NHS. As such it is often said to be ‘a victim of its own success’.

Reasons for health inequalities

There are many reasons for inequalities in health in the UK. Although some parts of the country have poorer health records than others, this is linked to poverty rather than geography. Differences between the poorest and richest parts of Glasgow are greater than average differences between Scotland and South-East England.

There are significant differences in life expectancy of up to 10 years between different groups in society. Those living in poverty generally have poorer life chances and poorer health because of lower living standards, including bad housing and bad diet.

Those in lower paid, unskilled jobs have a greater risk of accidents at work and can suffer from stress linked to unemployment. Professionals enjoy healthier lifestyles, not just because they have a better standard of living but also because they are more likely to be aware of health issues than unskilled workers. Similarly, women are more aware of health issues and more likely to consult doctors than men. As a result, women appear to have higher sickness rates than men, but this may reflect the fact that more male ill health is unreported.

Some specific health problems are localized or only affect minority groups, such as sickle cell anaemia, which only affects the Afro-Caribbean community.

Healthcare and the elderly

As well as requiring treatment for specific health problems that are linked with old age, the elderly are the biggest consumers of general healthcare in the UK. They are more likely to have accidents, which take longer to heal, and are also more likely to suffer from such major causes of ill health as heart disease and cancers. As well as specific healthcare, they need to be looked after in other ways as they become infirm and incapacitated. Thousands of old people take up beds in wards specially for the elderly, called ‘geriatric wards’, because there is no other suitable accommodation available. This is known as ‘bed-blocking’.

Under the Care in the Community policy, local authorities are now responsible for the care of old people for whom medical treatment in hospital is not required. Social workers and medical staff assess the needs of old people to determine what level of support is needed for their proper care. Most old people stay in their own homes, which may be adapted to meet any mobility or other problems they have. Sheltered housing is also specially designed accommodation to meet the needs of the elderly. Residents can remain independent of full time care but professional carers will visit to provide specific needs such as meals or physiotherapy. Full residential care is provided for old people who cannot cope on their own and those who need more intensive support are placed in nursing homes.

Although healthcare is free at the point of use, social care is subject to means testing. Until recently the elderly were expected to pay towards their care throughout the UK. In practice, under 50 per cent had to pay a contribution. The Sutherland Report was commissioned by the Labour Government to recommend the best means of delivering the most appropriate care to elderly people. The report made recommendations that supported free personal care and argued that there was no real difference between an old person in hospital with cancer and another old person living at home with dementia. Although the UK Parliament has not yet taken on these recommendations, the Scottish Parliament has done so. Free personal care (such as help with washing, dressing or meals) is now provided in Scotland.

Funding healthcare

Private healthcare

Private healthcare has always existed alongside the NHS, through insurance schemes such as BUPA or through health benefits provided by some employers. It is only used by a minority of the population and has both advantages and disadvantages.

Private healthcare can be seen as a basic right for those who choose to use it. It reduces pressure on the NHS and allows medical staff an opportunity to improve their incomes. It is also convenient for big companies and their employees as it enables them to arrange treatments at times that do not interfere with their work schedule.

Private care is criticised because it allows those on higher incomes to gain access to treatment ahead of those who are unable to afford it. It is also seen as taking resources away from the NHS, as staff who are initially trained at a cost to the NHS may go on to treat patients under conditions that yield a profit for the private sector.

Public-private co-operation

In some areas the NHS has always relied on private companies, such as in the provision of drugs, equipment and other services. Recently, co-operation has increased between the NHS and private sector in new areas of operation, including such things as:

  • Putting to competitive tender ancillary services such as cooking, cleaning and other non-medical provision. This is where private companies compete for the contracts from the NHS in order to try and get best value for money.
  • Recruiting hospital managers from the private sector into the NHS. The NHS recognises it can learn something from the success and efficiency of private healthcare organisations.
  • Contracting private hospitals to carry out operations to reduce NHS waiting lists.
  • Using the Private Finance Initiative (PFI) to build new hospitals such as Edinburgh Royal Infirmary. This means that the health authority does not have to find the money to pay for the building. There is controversy over the quality of PFI schemes and the long-term costs to the taxpayer. These schemes usually involve the NHS paying the private developers for a 30-year lease, after which the building becomes public property

One Response to “health care”

  1. Roex

    The question whether one should go on a strict diet in order to loose abdominal fat, can best be answered by first trying to understand what exactly is meant by the term diet.

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