Justice and Rationing in the NHS Flashcards
On which date was the NHS founded?
July 5 1948.
On which principle relating to justice and rationing was the NHS founded?
That good health care should be available to all according to need and regardless of wealth.
List 2 of the 10 core principles of the NHS plan of 200 that relate to justice and rationing.
1 - Universal - care is given on the basis of clinical need rather than ability to pay.
2 - Comprehensive - provide clinically appropriate, cost-effective services.
Describe the 2007 case of limiting treatments for Alzheimer’s disease.
- NICE issued a recommendation to provide only limited coverage on the NHS of drugs to treat Alzheimer’s disease.
- It was argued that this was a breach of the disability and discrimination act and the race relations act.
- Others argued that some of the drugs that were recommended against were ineffective, such as donepezil.
List the 4 pillars of medical ethics.
1 - Respect for autonomy - self determination and informed consent.
2 - Beneficence - the patient’s welfare comes first.
3 - Non-maleficence - Do no harm.
4 - Justice.
Define justice.
Behaviour or treatment that is morally right and fair and equal.
Define rationing.
The equitable distribution of limited resources.
List 3 causes of pressures on rationing.
Shifts in:
1 - Demography.
2 - Pattern of disease.
3 - Medical technology.
List 4 distributive justice philosophies.
1 - According to what is deserved.
2 - According to fairness.
3 - According to needs.
4 - Maximising utility.
List 2 possible problems with a utilitarian approach to distributive justice.
1 - Trivial diseases outweighing serious ones.
2 - Ultra-orphan (very rare) diseases not prioritised as there may only be expensive treatments.
What is section 1 of the NHS act of 2006?
The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement in:
1 - The physical and mental health of the people.
2 - The prevention, diagnosis and treatment of illness.
What, relating to justice, is made unlawful by the Human Rights act of 1998?
For a public authority to act incompatibly with the European Convention on Human Rights:
1 - Prohibition against discrimination.
2 - Prohibition against inhuman or degrading treatment.
3 - Right to life.
4 - Right to privacy.
5 - Right to found a family.
What is prohibited by the equality act of 2010?
The discrimination against people according to protected characteristics:
1 - Gender reassignment.
2 - Pregnancy.
3 - Race.
4 - Religion / belief.
5 - Sex.
6 - Sexual orientation.
7 - Age.
What obligation is given to the secretary of state by the Health and Social Care Act of 2015?
The obligation of no avoidable harm to service users.
List 6 ways by which the NHS rations healthcare in England.
1 - A three year budget is determined in parliament.
2 - The department of health allocates most of the budget to NHS England.
3 - NHS England allocates 75% of the budget to clinical commissioning groups.
4 - NSH England and clinical commissioning groups allocate the budget to GPs and trusts.
5 - Trusts and GPs allocate the budget to specialities, treatments and patients.
6 - Doctors tailor the treatment to patients.
What is the purpose of NICE?
To provide national guidance on the promotion of good health and the prevention and treatment of ill health.
List 5 special considerations that might be taken into account when recommending costly treatments.
1 - Severity of the disease.
2 - Disadvantaged populations.
3 - Children.
4 - End of life timespan.
5 - Significant innovation.
List 3 arguments against the NHS using Pemetrexed for mesotheliomas.
1 - Clinical evidence is limited to one trial.
2 - It is more toxic than other possible medications.
3 - All analyses showed pemetrexed to be not cost effective.
List 6 arguments for the NHS using pemetrexed for mesotheliomas.
1 - It is an innovative drug.
2 - Used elsewhere in Europe and the USA.
3 - Mesotheliomas are rare diseases.
4 - It is currently the peak of a time-limited disease (as mesotheliomas are linked to asbestos exposure).
5 - It is often disadvantaged patients that suffer from mesotheliomas (due to the nature of the cause).
6 - There is societal responsibility for an industrial disease.
