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Health & Wealth


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Health & Wealth

  1. 1. Higher Revision Health Care in the UK
  2. 2. Click on a topic for revision notes Private Health Care How the UK health care system works Inequalities in health PPP Case Study of the Elderly
  3. 3. How the UK health system works <ul><li>Primary Care </li></ul><ul><li>Controlled by Primary Care Trusts – contracts with Hospitals through the Health Boards </li></ul><ul><li>Professionals make decisions </li></ul><ul><li>Reduces inequalities within regions </li></ul><ul><li>Dental services and opticians included </li></ul><ul><li>Hospital Services </li></ul><ul><li>Controlled by Trusts </li></ul><ul><li>Specialist treatment, A&E etc. </li></ul>
  4. 4. <ul><li>Community Care </li></ul><ul><li>For elderly, mental health care etc. </li></ul><ul><li>Use of Primary care – health visitors, district nurses, chiropodists etc. </li></ul><ul><li>Funding </li></ul><ul><li>From National Insurance, Income Tax, charges, private patients </li></ul><ul><li>Labour has pledged to continue to increase spending – 2003/4 £68.7bn </li></ul><ul><li>The NHS remains in crisis as costs have increased </li></ul>Back to topic list
  5. 5. Private Sector <ul><li>Questions on this topic can be in several forms: </li></ul><ul><li>Private health care questions allow you to write about pmi and private hospitals </li></ul><ul><li>Role of the private sector questions allow you to write about pmi, private hospitals and PPP </li></ul><ul><li>Questions usually focus on advantages and disadvantages </li></ul><ul><li>You will require relevant and specific exemplification to improve your answers </li></ul>
  6. 6. Private Health Care <ul><li>Around 10 million people are covered by companies like BUPA- many through their work </li></ul><ul><li>Allows patients choice – who, when, where </li></ul><ul><li>Reduces the burden on the NHS – reducing waiting lists </li></ul><ul><li>Helps keep staff within the NHS as staff can work in both </li></ul><ul><li>Benefits NHS through donations of equipment and pay beds in NHS Trusts </li></ul><ul><li>Increasingly provides care for the elderly through Community Care </li></ul>
  7. 7. Private Health Care <ul><li>Goes against the principles of the NHS – free and universal </li></ul><ul><li>Creates a two-tier system based on ability to pay </li></ul><ul><li>Can take away staff from NHS (who were trained by NHS) </li></ul><ul><li>Does not take away problems caused by the elderly </li></ul><ul><li>NHS still required for emergency treatment </li></ul><ul><li>Standards in private hospitals are not subject to the same regulations as NHS hospitals </li></ul>Back to topic list
  8. 8. Public/Private Partnership <ul><li>PFI in all but name except: </li></ul><ul><ul><ul><li>Hospitals revert to NHS control at end of contract </li></ul></ul></ul><ul><ul><ul><li>Staff transferred to PPP hospital would still have NHS conditions and pay </li></ul></ul></ul><ul><li>Govt. claims it gives taxpayers value for money as there is no upfront money from the taxpayer </li></ul><ul><li>New ‘state of the art’ hospitals are built in a short time span </li></ul><ul><li>Critics see them as expensive due to high interest rates </li></ul><ul><li>Decisions are made in secret and have resulted in a cut in beds </li></ul>Back to topic list
  9. 9. Inequalities in Health <ul><li>Questions may ask about causes of inequalities or may ask for you to describe inequalities in health </li></ul><ul><li>When giving social class as a reason you must be careful not to write about lifestyle as these are causes of ill health – social class is the influence which causes inequality </li></ul>
  10. 10. Scotland on Sunday 14/3/04
  11. 11. Inequalities in Health <ul><li>Lifestyle </li></ul><ul><li>Life circumstances are the most important causes of poor health i.e. poverty </li></ul><ul><li>Poor diet – heart disease, obesity </li></ul><ul><li>Smoking – lung cancer and heart disease </li></ul><ul><li>Alcohol – liver damage </li></ul><ul><li>Housing – may lead to bronchitis, asthma etc. </li></ul>
  12. 12. Inequalities in Health <ul><li>Social Class </li></ul><ul><li>Link first acknowledged in Black Report, but first recognised by Govt. in 1997 </li></ul><ul><li>‘ Acheson Report’ & ‘James Report, 1998’ recognised Govt. responsibility </li></ul><ul><li>Life expectancy lower in lower social classes – chronic illness also higher </li></ul><ul><li>Inequality caused by many lifestyle choices e.g. smoking, diet, drinking, exercise etc. </li></ul>
  13. 13. Inequalities in Health <ul><li>Geography </li></ul><ul><li>Many of these inequalities are caused by social class inequalities </li></ul><ul><li>‘ North-South’ divide – health is poorer in Scotland and north of England </li></ul><ul><li>Heart disease and cancer are more common in these areas </li></ul><ul><li>Inequalties between regions – Grampian/Glasgow </li></ul><ul><li>Inequalities between rural/urban areas </li></ul><ul><li>Postcode Lottery </li></ul>
  14. 14. Inequalities in Health <ul><li>Gender </li></ul><ul><li>Women live longer than men, but more chronic and acute ill health </li></ul><ul><li>Death rates for men are higher in all age groups </li></ul><ul><li>Screening for cervical and breast cancer – no screening for male cancers e.g. testicular, prostate </li></ul><ul><li>Ethnicity </li></ul><ul><li>Some inequalities within groups </li></ul><ul><li>Asians have high heart disease death rates </li></ul><ul><li>Language problems may limit access to NHS </li></ul>Back to topic list
  15. 15. Case Study of the Elderly <ul><li>Questions may focus on Community Care or on NHS services in general </li></ul><ul><li>NHS provides all services including primary care and hospital services for the elderly </li></ul><ul><li>Growing proportion of the population </li></ul><ul><li>Increasing demands on the NHS with more chronic and acute illness </li></ul><ul><ul><li>Increasing rates of senile dementia </li></ul></ul><ul><ul><li>Burden on primary care e.g. GPs </li></ul></ul><ul><ul><li>Bed-blocking - more specialist housing required </li></ul></ul><ul><ul><li>75+ cost 7 times more than those under 64 </li></ul></ul>
  16. 16. Case Study of the Elderly <ul><li>Community Care </li></ul><ul><li>To prevent ‘institutionalisation’ </li></ul><ul><li>Care assessed by Social Work, and provided by Social Work, NHS Primary Care, the private sector, friends and family and voluntary groups </li></ul><ul><li>May be provided in own home, day care, sheltered housing, care home </li></ul><ul><li>Care is means tested – though all medical care in homes is free in Scotland following the Sutherland Report </li></ul>
  17. 17. Case Study of the Elderly <ul><li>Problems with Community Care </li></ul><ul><li>Local Authorities cannot afford to implement all care – this means it is under-funded and is resources led not needs led . </li></ul><ul><li>Standards in Care Homes vary greatly </li></ul><ul><li>Closure of Care Homes due to cost of care making it unprofitable (especially for good homes) </li></ul><ul><li>Burden placed on carers with little support </li></ul><ul><li>Has not reduced ‘bed-blocking’ </li></ul>Back to topic list