Lesson+2+(British+Healthcare+System)

=The British Healthcare System= --Read today's The Straits Times (A13) that talks about how britain is coping with the H1N1 flu--

Everyone is invited to edit and build on this!!! Welcome!!!

Introduction
You can never talk about the British Healthcare System without talking about about the National Health Service, more commonly known as the NHS. The NHS has sparked a lot of controversy in the past because people have debated over the effectiveness of such an elaborate healthcare system. Virtually the citizens of the whole of Britain is covered under this scheme, and most health services are free.

This is a video that introduces the British health care and the benefits that the citizens get.

media type="youtube" key="qG_DH5Yl88o" height="344" width="425"media type="youtube" key="kL6KfGlztmQ" height="344" width="425" NHS Song (some coarse language) =Timeline=

2004-Patients who have waited more than 6 months for treatment can go to another hospital for quicker treatment
=**Role of the Government, Community and Individuals**=

Government || * Runs the National Health Service(NHS) General Practitioners, though skilled and experienced are limited in their ability to help through bureacracy and protocols. Criticises the government on having insufficient funds but still keeping up the complete range of services even to those who cannot afford it. =** Advantages: **= The aim of the health service is to ensure that anyone can receive the medical care they need, regardless of their age, circumstances or financial situation. The NHS (National Healthcare Service) offers many advantages to UK (part of Britain) residents, especially in terms of the cost, the care available and the continuous quality reviews.
 * Collect taxes, which is partly allocated into running the NHS
 * Give salary to doctors(excluding private doctors) based on their efficiency to ensure that they work hard
 * eg. The doctor gets more money if he persuades more patients to stop smoking! ||
 * Community || * Pay taxes, which is partly allocated to healthcare
 * Get ‘free’ healthcare
 * Higher income will contribute more since they have to pay more taxes. Hence helping the more needy people.
 * Lower income can seek treatment as they may not want to waste money on treatment without such a system. But since it is ‘free’, there is no harm in seeking treatment.
 * Does not matter whether one goes to the hospital, he/she has already paid through taxes. ||
 * Individual || * Patients who want faster and maybe better treatment can pay to visit a private doctor which is not working for the government. In this case, they have to pay twice, for the private doctor and for the NHS through taxes.
 * Doctors try their best to treat more patients as they can earn more money. ||

The NHS provides care free of charge to most UK residents. represents the huge advantage compared with the health systems in many other countries which charge for : - health insurance, - quarterly surgery fees, - prescriptions, - particular tests - treatments. You will pay for the NHS when you pay UK taxes; every taxpayer makes the same contribution, regardless of whether : - they rarely visit a doctor - need regular hospital care. The NHS entitles you to diagnostic care and treatment for any illness or health concern. You can receive treatment for everything from : minor ailments -  colds - rashes serious diseases - diabetes, - cancer - heart disease Free of charge.
 * Cost**:

The NHS offers a range of services to provide the general public with suitable healthcare. Depending on the nature of your problem you may be treated by  a doctor, dentist or optician, receive treatment at a hospital or walk-in centre. There are a huge range of healthcare services offered by the NHS, covering every concern from flu to vaccinations, mental illness to ectopic pregnancy care. The NHS is designed to offer you whatever care you need throughout your life, from hearing tests as a baby to hospice care as an elderly person.
 * Care Available**

Advantages: media type="custom" key="4057237"  Disadvantages of the British Healthcare System- ** National Health Service **   (**NHS**)
 * Do take note that there might be some advertisements before the actual Video
 * Disadvantages:**

The ** National Health Service **   (**NHS**)  is a socialized health care system. This means that healthcare such as medicine, clinical aid, and hospitals are funded by the government using public funds. Public funded healthcare is available to all citizens regardless of their status. However, the rapidly increasing demand for medical services has stretched the hospitals thin with regards to funding and resources. Rising number of patients have depleted medical equipment such as beds, medicine and medical staff etcetera. This scenario is possible because the funding of hospitals come from a single source (the government). Compared with the “employer health care system” in countries like the United States, in which each individual who works in a company that has an “employer-paid health care system” has his/her medical expenses paid for by his/her company. Some hospitals are self-run organizations, which do not really rely on the government for funding. As a result, patients seeking treatment under the National Health Service have met problems such as having their medical treatment delayed indefinitely. Ella Cotterell, a three year old girl who required heart surgery, had had the operation cancelled three times due to a shortage of beds in the hospital. This is a growing trend in the National Health Service. More than 57,000 surgeries were postponed for non-clinical reasons, including a lack of beds in 2008. At least 43,000 operations were cancelled in the first nine months of 2008-09, with nearly 1,800 patients not being treated within 28 days of their original scheduled date.

Disadvantages: media type="custom" key="4057239"
 * Do take note that there might be some advertisements before the actual Video


 * Quality Reviews **

The NHS is under constant observation to ensure that the system runs as smoothly and efficiently as possible. Organisational boards such as health authorities and trusts aim to monitor the work of NHS medical practitioners, who in turn are issued with regular guidelines and targets to keep good service and clinical progress foreground issues. Reviews monitor the progress of new schemes and existing objectives. For patients, this consistent attention to quality service ensures high calibre medical care at all times. If you feel that the service you have received from the NHS was below standard, you can complain to the Independent Complaints Advocacy Services (ICAS), which aims to solve problems as quickly and efficiently as possible. ICAS focuses on the service provided by NHS employees, and its independent nature ensures that any complaints are taken seriously: patient care is always top priority.
 * __ 4) what are the challenges face by the State today, and how they are proposing to solve the problem. __**

Today:

Standards in some areas of UK remain low Long waiting lists and inefficiency of the system is still present Insufficient doctors and nurses is a pressing problem in present day Dangers of abuse to the system Heavy reliance on government spending in healthcare means inefficient distribution of budget to other sectors Many citizens are still unhappy with NHS Services Britain's universal health care system faces a multibillion pound deficit that could force the government to skimp on dentistry, fertility treatments, and cutting-edge drugs
 * __ Economy Problems: __**

"Having had seven years of plenty it now looks like seven years of famine from 2011 onwards," the NHS Confederation's head of policy, Nigel Edwards

The health service is likely to be squeezed by the global recession, the costs of managing an aging population, and spiraling drug costs. The downturn could increase the burden on hospitals by feeding into mental health problems and alcoholism.

Combined with the prospect of a faltering pound currency and rising energy prices, the health service could find itself unable to cover up to 3 percent of its annual costs starting in 2011-2012. Over the next five years, the unfunded outlay could rise to 15 billion pounds. Law enforcement authorities are stepping up an attack on health-care fraud that they say costs taxpayers more than $60 billion each year.
 * __ Abuse of system: __**

FBI officials yesterday reinforced their commitment to crack down on medical companies that send phony bills or provide excessive treatments, pointing to 2,400 investigations in 2006 and warning that a fresh spate of cases is on the way.

National health-care expenditures last year surpassed $2 trillion, according to government estimates, and they are likely to grow even larger as aging baby boomers require more medical treatments. That is spurring federal officials to renew their focus on health-care fraud.

The soaring cost of new drugs is placing a huge financial burden on Britain's state-run health system. Everyone can still get treatment for free, but in some parts of the country — depending on local budgets — that treatment is not as good as it could be. It is possible to die of poverty- to get adequate treatment under NHS because of one lives.
 * __ NHS a post-code lottery: __**

The NHS is already rationing health care, and often unfairly. Free treatment for every medical condition is an impossible ideal.

Because people's expectations of what they should get "free" on the NHS far exceed the growth in available funding. In the past ten years, open heart surgery, hip and knee replacements and keyhole surgery have become routine, but the NHS simply can't keep up with the phenomenal growth in medical advances - all of which require costly equipment and more highly trained staff. Meanwhile, the number of people over 65 (a group whose demands on the NHS are disproportionately high) has risen to 20% of the population - double what it was 50 years ago
 * __ Too expensive: __**
 * __ NHS deficits: __**

-Number of NHS organizations forecasting deficits has now increased to 35%. -Number of primary care trusts (PCTs) forecasting deficits has now increased to 47% -Gross NHS deficit in England has now increased to 1.318 billion euros.

-Nurses and other clinicians are being denied access to essential training courses. A survey revealed that 83% of nurses surveyed believe training has been reduced or cut as a result of financial pressures in the NHS. -Over 86% of nurses surveyed believe patients are at an increased risk as a consequence of these reductions and cuts. -The survey further revealed that 38% of nurses had study leave cancelled and 54% of nurses have had a request of continuing professional development training refused. -Research shows that NHS posts are being lost as cost savings are made through a combination of compulsory redundancies, voluntary redundancies, recruitment freezes and deleting vacant posts. The financial crisis on overall NHS workforce numbers is serious and as of April 2007, total number of NHS posts lost across the country due to deficit stands at 22,363. -Due to the use of public health budgets being used to plug deficits, threats to public health have been undermined as initiatives to tackle major health challenges such as smoking; obesity and sexual health have been undermined.
 * __Threat to patient care__**:

Deficit led to impacts on patients and services such as -Loss/reduction of access to specialist services such as multiple sclerosis and epilepsy. -loss of rehabilitation and intermediate care services -loss of mental health in-patient and day care services -failure to meet 18 week waiting list targets with waiting times of up to 9 months for some diagnostic and specialist services. -an extension of closure programs for community hospitals in rural communities -loss of bereavement and end of life services for children and families -imposition of limits on the types and levels of conditions that can be admitted into secondary care via the accident emergency departments of acute hospitals
 * __ Detrimental impact on service provision and patient care: __**

Patient mortality increases where there are fewer registered nurses on the ward. (i.e. wards with lower nurse to patient ratios had a 26% higher patient mortality rate)

__ Too few nurses and increasing workloads: __ -It has been estimated that 180,000 nurses are set to retire in the next ten years. -In seeking to reduce costs and balance books, many trusts have targeted these specialist nurses. As a result, specialists posts have been frozen, jobs lost through redundancy and specialist nurses redeployed at lower grades. Health Service Journal has predicted a shortage of 14000 nurses within four years- along with a shortage of 1200 GPs and 1100 junior doctors. __ Newly qualified nurses but not enough nursing jobs: __ -The absence of joined up workforce planning has also been evident in the fact that newly qualified nurses have been experiencing difficulties in finding jobs due to planned redundancies, recruitment freezes and the targeting of Band 5 posts in deficit hit trusts. - Newly qualified nurses have been asked to work without pay during their preceptorships, while in some places, they are being asked to work at rates below the national minimum wage.
 * __ Nursing Workforce __**

__ Low pay and Low morale: __ Pay level are fundamental to the ability of our health service to recruit and retain the skilled nurses needed to deliver quality patient care. Fair pay is also an essential means of maintaining good levels of staff morale. Unfortunately, nurses are now the worse paid professional group in the public sector and morale has dropped significantly.

 Solutions  -Sustainable workforce planning that assesses long term consequences of short term actions: to end current culture of vacancy freezes, post deletions and compulsory redundancies, moving towards consultation and suitable alternatives. -Centrally funded pilot programmes and fully-cost implementations and roll-out plans for new policies. -More time and flexibility for trusts to achieve financial balance, including a centrally funded sustainability fund which can be used annually to achieve balance. -Government should ensure continued funding support for medical services and innovation. -Healthcare professionals should be given the time, resources and capacity to help patients make informed choices about their care. -Full-risk assessment and inclusive consultation processes should be carried out in the face of proposed cuts to, or changes in, services. -Ministers must recognize roles of nursing in tackling root causes of ill-health as well as the link between social deprivation and public health. -Ministers should fund and implement pay awards nurses reflecting the real cost of living, honor the recommendations of the Pay Review Body and fairly reward nurses for their skills, dedication and professionalism. -Introduce student nurses who are guaranteed one year employment and preceptor ship in NHS. Newly qualified nurses and midwives who wish to work in NHS to be given offer of employment. -Clear HR standards should be incorporated into contracts with non-NHS providers of NHS services.   **Reforming Reforms** -Government needs to work with key stakeholders to develop and implement a sustainable and properly resourced transition plan for delivering care closer to home. -Robust mechanisms put in place to ensure that patients, the public and the organizations that represent them are properly and fully consulted in respect of all health service reforms, reconfigurations and redesigns. These should be backed up by sanctions such as penalties for those disregarding their consultation obligations. -Forthcoming NHS code on advertising and marketing must be backed up by credible and enforceable sanctions to prevent, and if necessary, punish rule breaches. -Clear “failure framework” and a nationally binding arbitration process for when contracts are challenged or terminated and services are reconfigured. -financial and human resources should be put in place in order that the full, and yet untapped, capacity of the NHS can be used for the benefit of patients and taxpayers. 
 * Compulsory private insurance as the solution? **
 * Yes **
 * 1) Compulsory private insurance-based schemes produce more money overall for healthcare.
 * 2) Competition between insurance companies and hospitals puts the patient, not the bureaucrat, in the driving seat.
 * 3) <span style="font-size: 10pt; font-family: 'Tahoma','sans-serif';">People will only be prepared to pay more into the system if they know the money is going on health.
 * <span style="font-size: 10pt; color: black; font-family: 'Tahoma','sans-serif';">No **
 * 1) <span style="font-size: 10pt; font-family: 'Tahoma','sans-serif';">Private insurance schemes are far more wasteful and inefficient than the NHS.
 * 2) <span style="font-size: 10pt; font-family: 'Tahoma','sans-serif';">Insurance-based schemes tend to create a two-tier system, with the poor routinely getting the worst deal.
 * 3) <span style="font-size: 10pt; font-family: 'Tahoma','sans-serif';">The real need is to spend more money on health. How that spending is organised is of secondary importance.
 * <span style="font-size: 10pt; color: black; font-family: 'Tahoma','sans-serif';">Tackling Deficits **
 * Safeguarding Patient Care**
 * Value Nursing Workforce**

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