The National Health Service (INS) is a state run entity set up by the Labor government after 1948 as part of the welfare state. It was originally run by local authorities with funding from public money allocated by central government. Though in recent years this money has been moving to the private sector and many have speculated that this Is prevarication by stealth. In this essay I will attempt to understand this process by giving some historical context to the events of the last few decades while pointing out some of the advantages and disadvantages, and the forms it could take, of prevarication.
In conclusion I hope to point to a future where the INS can exist with public money and private management. “It came out of a working class movement. The ‘powers that be’ Introduced various health and welfare reforms after the Second World War In response to working class agitation and manifestation health system seemed a better option than a Russian revolution”l This is a institution that does not fit easily into the world of market liberation’s and globalization, but it is a right many people feel should be free and is even recognized by the U. N. As a fundamental human right.
Selling off the INS, as previous Tory governments have done to other parts of the U. K. s infrastructure “… Would be politically unacceptable especially given the general popularity of the INS and Its entrenched public nature. “but reform and change have accrued. The first change, by the Tories in 1983, was in the way funding was allocated. “For example, budgets where previously allocated on the basis of geographical areas’ needs… Now funding is allocated as payment per patient… “3 This change allowed for the transfer of money from the public to the private sector.
This can be seen in the provision of private long term care “which grew from 175,000 places In 1 985 to 650,000 In 1998. This growth was funded almost entirely out of the public purse”4 This has led to a system where money Is now thrown at the private sector through arrangements such as Independent treatment centre (Cists) and the private finance initiative (PI). One such arrangement “Ravenous Park cost mm to set up and closed with a deficit of ;m. These are figures that have to be borne by the INS”clearly the INS is now a half-way house between the public and private sectors.
While the present Labor government seems set on pushing ahead with more ways of prevarication. John Carver noted that “Health secretary Patricia Hewitt Is preparing to transfer INS hospitals buildings into the private sector as part of a Bon scheme to promote competition in the health service… Companies bidding for contracts… Will be allowed to take over INS premises, doctors and nurses. “the implementation of this document are already in motion. Recently DHAL gained a contract worth ban to provide non pharmaceutical supplies for ten years.
Payment will be made “… According to the savings It can make, which the government implementation of grand investment projects… Is hardly the governments strong point. “8 So to make this work DHAL would have to be finely regulated. Given enough freedom so that they can destroy coos past relationships, but not be allowed to bully suppliers and lower standards due to a need to please shareholders and make profit. To see what problems a health service run for profit creates we only have to look at the USA and its private health system.
The system of Homos was set up in the asses by the Nixon administration. We can see from these comments recorded on the Nixon White House tapes, (Nixon quotes), that this system was created not to look after patients but to make profit. While the US may have the most advanced health care system available, if a customer does not have enough money or adequate insurance their options are limited. These problems where highlighted in Michael Mores’ documentary Kicks, which compared the US system to that of Cuba, Canada and the I-J.
It could be said that the narrator was unabashed in his bias against the Homos, but the case shown, that healthcare will become unaffordable for average people, may arise here if prevarication becomes dispersed. At the same time though because of the lack of reinvestment in the Nash’ infrastructure and Gordon Browns’ adherence to EX. spending targets, alternative funding methods must be found. A recent study by the European Health Consumer Index (EACH) showed the UK at 17th place behind Ireland, Czech Republic and Estonia in provision of healthcare. Three countries a long way behind the economic development of the I-J.
In fact while per capita spending placed the UK in 12th place, the Czech Republic placed 21st showing that efficiency targets are possible if money s spent wisely. This of course is the main argument for the involvement of the private sector in the provision of health care. That they will cut bureaucracy, while subjecting spending plans to stringent management oversight and thus provide better services for cheaper. Unfortunately the “reduction in public provision of long term care, INS dentistry, optical services and elective surgery shows the trajectory for the INS under the PI. II We only have to look to Austria to find a publicly funded health system that allows patients who “.. Regardless of salary, are entitled to SE the services of the health system for free although they do pay higher income tax”. Al While looking at the EACH tables we see Austria ranks in first place but only spends (figure here) more than the UK per capita. This suggests that the UK could indeed improve services without the need of the private sector but this would involve raising taxes, a strategy both political parties seem wary of due to potential lose of electoral support.
One new potential direction for the health service could be the internet. The main advantage of the internet is the access to knowledge that it can provide the customer hill providing savings within the administration of the INS. Unfortunately there is one problem that would need to be overcome, computer illiteracy. In most cases least computer literate. This suggests to me that while saving could be made, they would not be worthwhile while we have a generation of customers who do not feel comfortable with computers or the the internet.
In the long term there is potential, but unfortunately it does not provide any solutions in the short. In does seem that the disadvantages of prevarication on its present course do seem to outweigh the advantages. The present government though has already started down a path that appears to be irreversible. While many within the service would agree that reform is necessary the problem is that healthcare is seen as a fundamental right provided by the INS, a endowment to the citizens of the I-J after the trauma of World War 2 and the sacrifices they had endured.
The I-J government has also shown on many occasions that it cannot regulate private companies, that are funded through public funds, to put the general public before profit. Looking at past prevarications of industries we can see, even in the case of the most successful, electrification, that this sector lags behind other European countries such as France where for example broadband infrastructure is far ahead of that provided in the I-J.