Unit 13 - National Health Service and Social Welfare

Question 1

What is the key principle of the NHS?

Answer 1

The key principle of the NHS is a free comprehensive service based on clinical need for all who need it.

Question 2

Distinguish between the roles of commissioners and providers of healthcare in England.

Answer 2

In England there is an internal market where commissioners plan and purchase healthcare from the providers. The main commissioners are the Clinical Commissioning Groups and the main providers are GPs, dentists, NHS trusts, foundation trusts. Services may be purchased from “any qualified provider” and not solely NHS providers. This has been used by opponents to suggest the NHS is being privatised.

Question 3

Outline the role of the department of health and social care for healthcare in England.

Answer 3

The key roles of the department of health are: proposing legislation and national policy; providing strategic leadership; negotiating and distributing funds to NHS England; ultimately answering to parliament for the performance of the NHS.

Question 4

Outline the role of NHS England.

Answer 4

NHS England oversees and monitors the delivery of health care; commissions some health care itself (in particular GP services) and allocates funds to CCGs.

Question 5

Outline the role and composition of clinical commissioning groups.

Answer 5

Clinical Commissioning Groups comprising mainly GPs plan and purchase the majority of health services in the area – spending about 80% of the health budget.

Question 6

Outline the role of Health and Wellbeing Boards.

Answer 6

Health and Wellbeing Boards are local authority bodies (one for each county council and each unitary authority). They promote the health and wellbeing of their residents; encourage the integration of health and social care; and may undertake some joint commissioning of services with the CCGs.

Question 7

What is the employment status of GPs, dentists and opticians?

Answer 7

GPs, dentists and opticians are all self-employed and enter into contracts to provide services for the NHS.

Question 8

Outline the role of the National Institute for Health and Care Excellence (NICE).

Answer 8

NICE advises on drugs and procedures that are both clinically and cost effective and should be provided on the NHS.

Question 9

Outline the role of the Care Quality Commission (CQC) in relation to healthcare.

Answer 9

CQC sets standards of health care that should be provided and licenses and inspects all providers (including the private sector). Providers deemed to be inadequate may be put into special measures and ultimately closed down.

Question 10

Briefly explain the funding of the NHS and indicate its importance in government spending.

Answer 10

NHS is funded from general taxation (including a proportion of national insurance contributions) together with a small amount from charges. Health accounts for the second highest amount of government spending.

Question 11

Identify five local sources you would go to get quotes for a story concerning proposed changes to local healthcare provision.

Answer 11

Local sources may include:; members (chair) of local Health and Wellbeing Board; chair or member of CCG; chair of NHS / Foundation Trust; local member / representative of the Patients Association; local GP; local consultant (BMA representative); nurse (member of Royal College of Nursing / Midwives); recent hospital patient(s); local representative of the elderly (e.g. Age UK); local representatives of bodies representing those with disabilities (MIND; Scope, etc.) local representative for young mothers (National Childbirth Trusts,)etc.

Question 12

Identify five issues relating to the current provision and administration of healthcare.

Answer 12

Issues may include: too many managers; lack of funds; population and demographic changes (growing population and increasing number of elderly); health inflation (new drugs and procedures); healthcare by postcode; NICE and unwillingness to provide costly cancer drugs; internal market (including the private sector – PFIs); possible closure of hospitals / units; A & E close to collapse; seven-day NHS; shortage of doctors / nurses; doctors’ contracts; new inspection regime; poor links with local authority community care.

Question 13

Which government department is responsible for welfare? Which agency runs the employment and benefit services for the unemployed?

Answer 13

Department of Work and Pensions. Job Centre Plus.

Question 14

Distinguish between contributory and non-contributory benefits.

Answer 14

With contributory benefits, the claimant has had to pay (national insurance) contributions in order to claim benefits. With non-contributory benefits, no contributions have had to be paid and payment will be automatic providing the claimant qualifies.

Question 15

Briefly outline the key principles of the national insurance scheme and identify three benefits covered by, or linked to, the scheme. List five criticisms of the scheme.

Answer 15

Main principles: contributions have to be paid to get benefits; comprehensive insurance (covers most reasons for loss or interruption of earnings); universal scheme (most workers are covered); both employer and employee pay contributions.

Benefits covered include: statutory sick pay; statutory maternity pay; incapacity benefit; income related jobseeker’s allowance; retirement pension.

Criticisms include: contributions are earning related but benefits are flat rate (it can be seen to be a tax); benefits are being removed or limited and made means testable; it is no longer a comprehensive insurance (cradle to the grave); seen by employers as a payroll tax and a disincentive to take on workers; retirement pension is recognised as insufficient on which to live.

Question 16

What is the difference between universal and means-tested benefits? Identify an example of each type of benefit.

Answer 16

Universal benefits are paid to those who qualify, irrespective of their income, pension or savings. Means tested benefits take into account any income, pension or savings (above a certain figure) that the claimant may have. Child benefit is a universal benefit; income based job seeker’s allowance is means tested.

Question 17

What is child benefit and who will not receive it?

Answer 17

Child benefit is paid to those with a child or children (higher rate for first child; lower for second and subsequent children). Families where a member earns over £60,000 will not receive the benefit but families with two wage earners, both earning just below the cut off figure will get it.

Question 18

What is child credit and how is it to be limited?

Answer 18

Child credit is a means-tested benefit made to people on a low income who have a child or children. This is in addition to child benefit.

Question 19

What is jobseeker’s allowance?

Answer 19

Jobseeker’s allowance is paid to the unemployed who are actively seeking work. Those who have paid sufficient national insurance contributions will for six months receive it, irrespective of their savings or other income. After six months or if insufficient national insurance contributions have been made, the benefit is means tested and the amount payable will depend on the claimant’s savings, other income and needs.

Question 20

What key change to welfare benefits is being rolled out nationwide?

Answer 20

A universal credit (benefit) has been introduced to replace the myriad of benefits that currently exist and the intention is that the benefit system will be such that makes work pay – when people start work, benefits will be reduced (withdrawn) gradually.