Topic 3: Inequalities in the provision of, and access to, health care in contemporary society Flashcards
NHS founded what year and by who?
1948
Bevan
Increase of NHS waiting times End of 2019- Sept 2024
4.57 million end of 2019
7.77 million Sept 2024
How much NHS spent in private hospitals 2023?
£2.1bn
How many planned operations are carried out by private hospitals? (outsourced by NHS)
1 in 10
What is a ‘two-tier’ system?
-A system where those who can afford to pay for care can access it faster than those who are forced to wait for treatment on the NHS.
-People argue this is happening now
-Goes against founding principles on NHS; access to healthcare is determined by need not ability to pay.
How many patients a year have to be transferred from private to an NHS hospital when there are complications?
6,000
Calnan
2010
Healthcare choices leads to greater inequality:
Lack of knowledge and expertise
Most patients lack the scientific and medical knowledge needed to make informed decisions, Dixon et Al
Unequal opportunity
Richer and more educated patients are better placed to access and make sense of the information needed to choose. Opportunity to pay for private healthcare. AO3- even wealthiest of patients consult doctors
Uncertainty and unpredictablity
Not always a clear cut choice in health matters. Outcomes of treatments are never 100%
Latif in relation to ethnicity and access to healthcare.
2010
Reasons for why there is a poorer access to health care amongst ethnic minorities:
-Lack of interpreters (especially in rural areas), health information in multiple languages, counselling. This can lead to a lack of awareness of services available.
-Ethnic groups may interpret symptoms differently meaning it can be hard for them to communicate their illness- sinking heart syndrome.
-NHS staff lack cultural competence and are ethnocentric, leading to stereotyping, bias and unconscious discrimination.
Dixon et al
2010
7/10 patients still opted for their local hospital and relied on the advice of their GP
Criticisms of Marketisation of the NHS
-Led to more services being provided by private companies therefore profits that could be going to the NHS and diverted into private companies.
-Competition of NHS and private
-Private sector chooses the easiest and quickest cases (probably because most of them lack ICUs), leaving NHS with the most expensive cases.
-2010 evidence of NHS operating like a private business and encouraging paying to jump the queue
-Services move away from poorer, less profitable areas.
Neoliberalists on the Marketisation of the NHS
-Competition creates improvement in healthcare as they consequently have to compete for customers using better services.
The Glasgow effect
Age expectancy is 54 years in Glasgow.
Inverse Care Law
Tudor Hart
Funding is inversely allocated in the UK- most funding goes to the affluent areas that are not in need of it, whereas deprived areas lack funding.
Postcode lottery
Buchan (2011)
Depending on where you live your options are either closed off or opened in healthcare
AO3 to inverse care law
Labour government has introduced direct funding to areas in poverty in the UK
Guillidford et al
2014
Men are 30% less likely to visit their GP than women
Smith et al
2005
Men had greater fears of consulting doctors in relation to cancer
Men considered asking for health emasculating
Why do men have better access to private care?
Greater economic power
Men are more likely to benefit from being in a higher social class than women
What are women at a greater risk for?
Clinical Iatrogenisis
Side effects of oral contraception, link to drugs for women not being tested on women.
Travellers and Access to healthcare
-No established home therefore cannot register with a General Practitioner surgery
-Low level of literacy, can’t read information health guidance
-Difficulty in maintaining cleanliness as they do not have toilets or access to clean water
Sheffield uni on traveller health
2-5x worse than settled populations
Macpherson report on Ethnicity
-Notes of institutional racism as the ‘collective failure of an organisation to provide people the correct treatment because of their colour, culture or ethnic origin’
Equality act
2010
It is against the law to discriminate against someone due to a protected characteristic
2 examples of private healthcare companies
BUPA and Imperial
Disadvantages of Private Healthcare
No intensive care facilities
Not equipped for high risk or unexpected healthcare issues
Only set up for particular treatments
Neglected some fields of healthcare as they are so specialised in other areas
Take easiest cases as those are the ones they are most prepared for and therefore leave the most risky ones to the NHS.
Spire Healthcare scandal
Ian Paterson, a doctor at a Spire Healthcare Private Hospital, told patients they had cancer when they did not.
Hi lights that private healthcare has flaws also.
Neoliberal
Dixon et al
2007
Poorer educated, unemployed or low income households visited teh GP less, relative to their needs,
Lambkin
WC mothers in Sunderland failed to take up ante-natal services due to resentment and suspicion of MC professionals.
Blaxter
Working class do not have availability to go to the doctors as they have shift work rather than being fatalistic.
Alford
1975
Structuralist approach
The dominant interests of hospital managers and CEO’s, attempting to make profit and reduce costs, override the challenging interests of GPs attempting to get the best for patients I.e therapeutic services.
