Access to Health Care

Question 1

When was the NHS set up and what did it aim to do?

Answer 1

1948

Aimed to provide free and equal healthcare for everyone in the country

Question 2

What is a problem with the NHS

Answer 2

Although being a general success, doesn’t give 100% equal healthcare.

Question 3

What are 2 regional inequalities of the NHS?

Answer 3

1) NHS in England is split into regional “trusts” each with their own budget. Money is spent differently in different regions, so some regions have access to different levels of care.
2) Specialist hospitals are unequally distributed across the country.

Question 4

What are 2 social class inequalities of the NHS?

Answer 4

1) NHS hospitals are carrying out an increasing number of private treatments/operations to raise funds. Some sociologists claim this is creating a two-tier system in the NHS - paying patients are seen faster and get better treatment. Those who can’t pay left waiting.
2) Working-class people less likely to attend screening programs

Question 5

What research talks about working-class people and screening?

Answer 5

Cancer Research survey - people from deprived backgrounds less likely to be aware of the screening offered, as are people with lower literacy levels.
Other reasons include practical reasons such as childcare problems or not having paid time off work

Question 6

Who made the Inverse Care Law and what does it state?

Answer 6

Tudor-Hart 1971

Those whose need for healthcare is greatest are the least likely to get it

Question 7

What is an example of the inverse care law?

Answer 7

Working-class areas tend to have the worst health facilities, fewer doctors, and the fewest hospitals

Question 8

What did Le Grand’s (2003) survey find?

Answer 8

• Middle class benefit more from NHS than the working class.
• Middle class benefit from NHS disproportionate to actual health needs.
• Working class were 20% less likely to get hip replacement than middle class despite being 30% more likely to need one.
• Professionals were likely to get on average 2 more minutes during a GP consultation than working class patients.

Question 9

What does research by Cartwright and O’Brien (1976) suggest?

Answer 9

Middle-class patients tend to have a better relationship with their doctor than working-class patients.
Working-class patients said they felt like the doctor doesn't listen.

Question 10

How can age affect access to healthcare?

Answer 10

1) Research shows older people don’t get same treatment as younger people suffering from the same problem, due to health care rationing.
2) There is a greater risk of complications for older people undergoing operations.
3) In a survey, over half of the older people surveyed agreed that their symptoms were dismissed as old age.
4) Older people may put their own symptoms down to old age and not bother going to a doctor

Question 11

What is said about Ethnic minority health needs and what is the suggested reason why?

Answer 11

• Ethnic minority health needs are “relatively high” (Department of Health, 1992)
• They may have poor health due to being less likely to get full benefit of NHS.

Question 12

What are 4 possible reasons suggested for ethnic minorities not getting as much benefit from the NHS?

Answer 12

1) NHS cultural values are different from those of the ethnic groups.
2) Language barriers - older people from ethnic minorities may not speak enough English to communicate with healthcare staff.
3) Some evidence that discrimination and racism affects access to HC. (1980s research found that Asian women in family planning clinics experienced racism).
4) Some ethnic minority groups see illness and disease as part of life that you can’t do much about, so don’t bother going to the doctor.

Question 13

Why might women go to the doctor more than men?

Answer 13

• Women traditionally look after health of the family more e.g taking children to doctors.
• Women tend to use the NHS earlier in life than men (contraception, pregnancy, childbirth)
• So this may make them more comfortable consulting a doctor than men.

Question 14

What does research suggest in order to achieve equality?

Answer 14

• Policies should be more gender-sensitive for different health issues
• Policies should take into account how conditions affect men and women differently + differences in how men and women see treatment
• Report found that locating mental health services in bars + clubs more successful in meeting the needs of young men

Question 15

What is healthcare rationing?

Answer 15

Not enough money to treat everyone so people who will get the most benefit from healthcare are the priority.

Question 16

What are 3 ways that disabled people face barriers to healthcare?

Answer 16

1) Physical barriers make it difficult to use doctors/dentist surgeries, communication difficulties make it hard to book appointments.
2) MENCAP (2004) - People with learning difficulties often suffered from discrimination from health care professionals - sometimes denied treatments that would be offered to a non-disabled person. Study fond that communication was difficult, both in terms of patient describing symptoms and doctor explaining solution.
3) Diagnostic overshadowing - Physical symptoms mistakenly attributed to disability despite being completely unrelated.