Does the NHS have a future? Flashcards
What are the 3 main principles of the NHS?
- Free at the point of delivery
- Comprehensive service available to everyone
- Funded mainly through taxation.
There is debate whether these principles will still apply to the same degree in the future.
What is the NHS patient pathway?
The patient receives a service from the clinician, e.g., A&E, doctor/GP.
What factors input into the patient pathway?
- The patient has health needs and may have social care needs as well.
- Social determinants of health shape the nature of the patient before they get to the clinician (housing, diet, exercise, income, education).
- The doctor-patient relationship is not a usual exchange relationship; the doctor has more power.
What is the structure of the UK healthcare system?
- The public/patients pay tax to the government.
- The government allocates resources based on various formulae to third-party groups (clinical commissioning groups in England).
- These groups provide funding to NHS trusts and independent providers to deliver services to patients.
How is money distributed to the NHS?
- The government collects taxes and allocates them to different departments.
- The Department of Health and Social Care allocates most of it to NHS England.
- NHS England allocates it to clinical commissioning groups, which decide the balance of spending.
What are the 2 ends of the spectrum of the typology of health systems?
- Free market: The public are free to buy any healthcare at any time in any way.
- Government monopoly: There is no private practice.
The NHS is a tax-based system, Germany has social insurance, and the USA has private insurance with heavy government involvement.
What are some arguments against charging patients to see their GP?
- Patients most in need are least able to pay.
- Affluent patients may demand more, making healthcare a commodity.
- It deters patients from seeing the GP, leading to late presentations and higher costs.
- Admin costs of a charging scheme could be high.
- It would have a major impact on health inequalities.
Is the NHS being privatised?
- GPs are independent contractors.
- Pharmacy services involve the private sector.
- NHS pay beds and private sector treating NHS patients are examples.
The debate about privatisation is linked to NHS internal market and commissioning.
Can the NHS survive the current crisis?
- New models of care are required due to the NHS being called a ‘burning platform’.
- Examples include better use of IT, virtual wards, and better health and social care integration.
What are the external and internal challenges of the NHS?
External challenges include improving population health, while internal challenges involve staffing and finances.
What is the paradox of the NHS?
There are calls for better management to behave more like the private sector, yet salaries and staffing are not equivalent.
What are statistics around spending in the NHS?
The UK spends 12% of national income on health, and NHS spending is reliant on the state of the economy.
What are 3 policy solutions for more NHS spending?
- Increase taxes to maintain current NHS spending levels.
- Reduce spending on other services to maintain NHS spending.
- Reduce the level of care and services provided by the NHS.
Does the NHS have a future?
Yes, but there are urgent questions about how to organise and pay for healthcare in response to changing population needs and workforce challenges.
