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.
