Training Blog

According to Action for Blind People more people could end up going blind as they avoid getting their eyes tested. This is because the majority of people have to pay to get their eyes tested so when money becomes tight people are reluctant to pay for things like that instead they focus on ensuring that they keep up with the payment of bills and mortgages instead. Other things that have seen a decline is people taking time off work to have treatments such as those to remove cataracts; it is assumed that the reason for this is that during times when businesses are making cut backs of staff people are becoming scared to take time off for whatever reason as they feel that when deciding who to “get rid of” any time off will count against them.

Dental care has also seen a decline in the number of people getting regular check ups and then the subsequent treatment that may follow. It would seem that treatments that are not deemed to be essential are being ignored by people as they worry about the cost and the issues previously mentioned about having time off.

The number of people purchasing condoms has declined as people are trying to save money which is ultimately resulting in more people putting themselves at risk. One particular clinic noted an increase on the number of patients presenting at the clinic with severe cases of various STIs as people aren’t taking precautions and then ignore the problem until it becomes a severe problem.
It may be worth reminding people that condoms are free from family planning clinics and your GP. Also if you end up pregnant as a result of not using a condom it will ultimately cost you more and may go against you when employers are making staff cut backs.

In summary whilst I can appreciate that money is tight at the moment the cost of the basic check ups and contraceptives it is worth it because it detects problems earlier on therefore means less time off work and treatment may be cheaper and to some extent cheaper.

The credit crunch has hit private healthcare organisations, pretty hard as it has forced alot of people to return to the NHS for treatment; as they can’t afford to pay to receive the treatment privately. It is estimated that the 25% of the population who paid for private healthcare has declined to approximately 16% and experts estimate that this will continue to decline in the current economic crisis. The number of cosmetic procedures carried out has fallen as the banks are refusing loans, so people are unable to raise substantial funds to cover the cost of the procedures. To give you some idea of the scale of the problem in 2008, 215,000 ‘self-pay’ customers spent £515million on private treatments, of which £170million went on cosmetic surgery. A fifth of bank loans are taken out to fund cosmetic surgery and experts said that they were now much harder to get.

Private healthcare professionals blame not only the credit crunch but also the reduction in NHS waiting times for a decline in their business. According to Spire Healthcare, one of the UK’s biggest private providers, those who would normally pay for procedures were delaying treatment. Another private organisation BMI Healthcare, noted demand had fallen, particularly for operations such as hip and knee replacements.

So after an increase in the privatisation of healthcare it seems that the situation is being reversed as a result of the credit crunch, however it is possible that after the credit crunch has been resolved that the situation may revert back to private healthcare becoming more popular again.

The NHS is facing an uncertain future because of the credit crunch. This is because lower spending as well as more stress related illnesses caused by worries such as unemployment and money related issues means the health service must plan ahead if it is to survive.

John Appleby states: “at best the NHS might expect no real growth in funding from 2011 when the current budget runs out. Although the prime minister pledged not to cut spending on health, with foundation trusts reporting cash balances of £2.5 billion and the rest of the NHS planning a surplus of £1.7 billion, the government may look to claw back end of year NHS surplus funds — taking back unspent money may not be viewed as a cut.” He also says that it is the long term issues that cause him the most concern.

The increase in inflation will have a huge impact when every 1% increase is costing the health service around £380 million. The higher living expenses means even more pressure on NHS staff’s disposable income meaning higher wage claims and calls for contract renegotiation.

It isn’t just long term that the credit crunch is affecting the NHS in the short term, the credit crisis has had an impact on private sector health providers and foundation trusts. Virgin Healthcare has already pulled back from plans to enter the health market and it is likely that future private finance initiative schemes will slow down.

It is said that: “NHS spending is guaranteed up to April 2011, what happens after then looks decidedly less rosy. The health service will almost certainly have to plan for lower growth in funding from 2011 onwards.”

Professor Appleby said the NHS is now better equipped to deal with the economic downturn than in previous years, with almost two thirds of trusts now showing solid financial management. He also adds that the Government’s financial system bailout using £387 billion of taxpayers’ and borrowed money will push national debt to over half the UK’s gross domestic product and this will inevitably affect public services.

Therefore it would seem that the NHS has its work cut out with the cut in the budget allocation imminent and the increased demand on its resources with staff demanding more money in order to maintain the standard of living and also with more people suffering stress related illnesses. It would seem that there is no area of society that hasn’t been affected by the credit crunch which orginated from the banks therefore it’s safe to assume that all areas of society are interconnected.

Personal budgets have been used in social care since the mid 1990s and ministers claim that they can encourage patients to get more from the NHS. Evidence shows that personal budgets have allowed people in social care to be more imaginative and use funds more “carefully” than the system did. It is said that the personal budget programme employed in social care includes direct cash payments to the individual as well as budgets that a patient can put in the hands of a social care professional.

Those who support the idea of patients having their own personal budget have said that there is no reason why this should not happen in health, although it will need to be carefully introduced.

There are those who claim that the system who say that the system can be misused if you are simply giving patients money however the information on this scheme states that where direct payments are handed over to individuals the way they are used is carefully monitored and people receive help from professionals about what services are available. The chief executive of the NHS Confederation, which represents managers, states: “There is a growing body of evidence to suggest health outcomes are improved when the patient is directly involved in making decisions about their treatment and the way in which care is delivered by NHS staff.” Despite this there are a number of obstacles to overcome before the scheme can be launched nationally.

There are lots of questions from those who have their doubts about this new system such as, should patients be allowed to spend their personal budgets on non cost-effective treatments? or should individuals be allowed to top-up their care? Should patients be allowed to invest personal budgets to be spent at a later date? Dr Hamish Meldrum, who is the chairman of the British Medical Association, said the policy appeared to “further establish the idea of healthcare as a commodity”, which would not be in patients’ “best interests”.

Those who support the idea of patients managing their own budget claim that “Personal health budgets could revolutionise the way in which care is delivered, but they are not without risks.”

Niall Dickson states: “Getting the initial payment level right will be important as will deciding what restrictions to place on the kind of treatment a patient is allowed to purchase with tax payers’ money, and from whom.”

Ministers imagine that it will be of particular interest to those with long-term conditions such as diabetes and people using mental health services, for example, a person with diabetes may choose to use their budget to get treatment from a community clinic rather than being referred to a hospital specialist. Launching the Bill, Health Secretary Alan Johnson said: “People rightly have high expectations of the care the NHS offers, and they want more control over their own health – which is why this Bill will give more power to patients and drive up the quality of care.” Andrew Lansley adds: “Personal budgets have been at pilot stage since 2005. If Labour had stuck to their promises to deliver them then patients would already be benefiting”.

It would seem that the majority of people are dubious of this new scheme as it seems that they are worried about several factors:

• It is essentially privatising the NHS
• Some people may get a higher budget than others
• Some people may use their budget to jump through the waiting lists for procedures

Without a detailed plan of how the scheme will actually work it is impossible to know whether the scheme will actually work basically I’m not sure if the scheme is good or bad. Although the evidence would suggest that there is the potential for the scheme to work I think it may cause some people to lose out or be unable to get the treatment they need.

Healthcare in Europe is run through a variety of systems which operate on a national level, in Germany it is a mix of public and private funded healthcare; although throughout Europe it is predominately funded by private health insurance Although their are government alternatives such as the EHIC which has replaced the E111.

Here is a list published by the World Health Organisation which shows the top European countries ranking both within Europe and also in terms of the whole world:

• 1st France
• 2nd Italy
• 3rd San Marino (its at the top of Italy)
• 4th Andorra (its between France and Spain)
• 5th Malta

In France people earning less than 6,600 euros per year do not have to contribute to the cost of their healthcare; but due to the fact that it is largely privatised there is a high quality service without the waiting times of the NHS. Apart from those mentioned above people pay a premium for their healthcare which is approximately 20% of their payroll (employers paid 12.8% and employees 6.8%) this however caused problems with employers complaining that they were meeting too much of the burden…probably because it meant less profit for them; anyway this led to reform. The insurers are non-government, non-profit agencies, which owe allegiance to employers and employees. As well as their compulsory contribution most employees pay an additional voluntary 2.5% of their salary to a mutual insurer.

The French are able to enjoy freedom of choice when choosing their medical practioner, whether GP or specialist, and typically pay their doctor’s fee and then claim back 75-80%. Payment may deter the poorest people from seeking care and so when this was recognised legislations were introduced to help these people so about 6 million people are not expected to pay. All patients, may go directly to a specialist either outside or within a hospital.

The evidence suggests that French Healthcare is considerably better than that provided by the NHS, but as the saying goes “the grass is always greener on the other side”. If you weigh up the merits of both systems they probably work out about the same

Health care in the United States is provided by several separate legal entities it is estimated that the U.S. spends more on health care than any other nation in the world. In 2007, the U.S. spent a projected $2.26 trillion on health care, or $7,439 per person. In the U.K that would equate to approximately £3,700 per person. This is due to the sheer size of the U.S.A and the fact that it is divided into many states therefore a system such as the NHS would be impractical.

According to the Institute of Medicine, the U.S. is the only wealthy, industrialized nation that does not have a universal health care system. Around 84.7% of U.S citizens have some form of health insurance; either through their employer, purchased individually or provided by government programs. There are a few publicly-funded health care programs to provide for the elderly, disabled, children, veterans, and the poor. There is a federal law in place that basically states that the public are entitled to emergency treatment regardless of their ability to pay.

As with any system the U.S healthcare system is not without problems. For example it is estimated that 47 million U.S citizens, 8.7 million of which are children, are without any health insurance with this figure rapidly increasing as employers are shifting the cost to employees who are unable to meet the cost of the premiums. The costs of healthcare are rising at 5 times the rate of inflation. As a result of employers shifting the cost to employees there are strikes taking place all over the U.S such as the Southern California grocery workers’ strike and lockout in which nearly 60,000 workers saved health care benefits and beat back employer demands to freeze pension funds after holding strong on the picket line for five months. Under grocery management’s original proposals, a worker making slightly less than $20,000 a year would have had to pay nearly $5,000 to maintain the same level of benefits they had in the previous contract. Other cost increases hitting workers include larger hikes in the cost of family coverage, less access to needed prescription drugs through stricter HMO formularies and higher prices for more comprehensive coverage. According to the statistics consumers are using more prescriptions, at younger ages and for more conditions, and substituting newer, more expensive medications for established products.

In the U.K on the other hand healthcare is provided by the central government and is mostly free but there a few areas where costs apply; although there are private practices within the healthcare sector. Forming the basis of healthcare in the United Kingdom, each system—National Health Service, NHS Scotland, NHS Wales and the Health and Social Care in Northern Ireland—operates independently, and is politically accountable to the relevant devolved government of Scotland (Scottish Government), Wales (Welsh Assembly Government) and Northern Ireland (Northern Ireland Executive), and to the UK government for England.

The NHS is divided into two sectors the primary sector which includes the following:

• NHS Direct
• NHS walk in centres
• GP practices
• Dentists
• Opticians
• Pharmacists

The secondary sector includes the following:

• Emergency and urgent care
• Ambulance Trusts
• NHS Trusts
• Mental Health Trusts
• Care Trusts

The NHS is also not without problems for a start the NHS is over budget in several areas by as much as £105 billion. It is also understaffed. As a result waiting times are at an all time high, although some argue that it is due to the credit crunch and the growing immigration to the U.K. As previously mentioned in the article “The privatization of the NHS” the government’s idea to resolve some of the problems with the NHS is to privatise healthcare; the question is will this actually help or is just a social construction created to justify increasing taxes to make more money for the government?

Everyone unless you are really lucky has had the “pleasure” of an encounter with an arrogant doctor; the type that don’t listen to a word that comes out of your mouth. According to the General Medical Council doctors should face up to the fact that patients now “call the shots”.There are still some doctors who dislike what they perceive as their authority being questioned, they claim that they (the doctors) resent the assertive patients and goes on to say we have to end the state of affairs whereby a minority of patients have to put up with – or worse, be put at risk by – professional practices that are considered by any rational person to be dangerous, offensive or otherwise unacceptable. A classic example of an arrogant doctor is Harold Shipman who actually killed people as a result of his arrogance.

We frequently see articles in the media of “arrogant doctor” involved in some kind of scandal, such as the scandal where doctors in one hospital were removing the organs of children without their parents knowledge or consent; this is affecting people’s perspective of doctors in general; so much so that many people tend to suffer in silence rather than go to the doctors. If the majority of people have this view point then surely privatisation will make it worse as people will take the view that they don’t give a damn and are only there for the money. With negative views like this is it any wonder that the NHS is having problems.

We’ve all seen the media items on this topic but what exactly does it all mean?
According to some articles the UK’s Department of Health (DoH) is seeking urgent help to create a “failure regime” in the National Health Service, this is because the NHS is apparently over budget in several areas but this can’t be resolved through shifting the managerial responsibility in other words you are simply shifting the problem rather than solving it. Politics of today states that there is a noticeable commitment to the virtues of private enterprise and competition in the free market. However, there is no need for the government to relinquish control of the NHS. General health care for all is a widely accepted as a right in this country. If the government wants to improve the NHS they should raise taxes in order for the public to raise the standard of a national health care service for all. People have always paid for public services through taxation – this is not a new radical solution. However in the current situation people will resent an increase in taxes as the prices are increasing as a result of the “credit crunch”. The nature of private businesses creates an environment of competition, as a result resources and facilities as companies compete for “business” and consequently facilities and services improve. These “funds” are essential to the NHS system can only raise the standard of treatment patients will receive.

On the other hand the privatisation of the NHS will result in an emphasis on efficiency and profit; the vulnerable and the poorest in society will suffer from such a scenario. The question of prioritising health care and rationing will always favour the rich, since targeting vulnerable groups will be an inefficient use of resources so it will result in the poorer people within society suffering as they will be unable to afford adequate healthcare this will create a vicious circle because the poor will perish then the next “level of in income” will become the poor and so in until eventually you end up in the same situation that you started with. So ultimately “you’re damned if you do and you’re damned if you don’t” because you need the funds to resolve some of the issues within the NHS but then a large percentage of society suffers if you privatise so either way you can’t win.