The INS has enlarged significantly, improved technically and clinically, and changed in many aspects during the past 60 years or so (Leister, 2008). Life expectancy has been rising and infant mortality has been falling since the INS was established (INS choices, 2013). In addition, According to the Commonwealth Found (2010), compared with six other developed countries (Australia, Canada, Germany, Netherlands, New Zealand and USA), The INS was the best healthcare system regarding efficiency, effective care and cost-related problems in comparison with six developed countries.
However, although the INS enjoys a reputation as the largest and the oldest single- player healthcare system in the world and has had many achievements so far, it is by o means perfect and still far and away the most popular of the public services (Leister, 2008). Maybe even worse, the INS is arguably facing its most challenging period since it was created in 1948 (Trigger, 2012). Through this report the reader can comprehend the current challenges that the INS Is facing. Also, it will help the reading to have an better understanding of the development and the future of the INS.
This report aim to identify some threats which the INS is facing despite of the massive expanse. Besides, with the purpose of developing a better national health yester, the development as well as some possible improving methods of the INS will be introduced. In order to let the reader have a deep understanding of the INS, this report will begin by describing the historical development of the INS and then some current challenges the INS is facing will be identified. Finally, it will predicted the future development of the INS. 2.
Development of the INS In 1948, Labor overcame objection from leaders of doctors to create the INS which provided treatment free at the point of use and financed by central taxation (Butler, 2010). Everything Is hard In the beginning and running the INS is not a exception. By the asses, Health service spending was much the 1 budget pressure (Leister, 2008). This is explained by Rivet (2009) who indicates that the massive innovation such as ultrasound raised the cost of the INS and government had little experience to run a health service.
Therefore, in order to relieve the pressure, charges of one shilling for prescriptions and El for dental treatment were produced, which was an exception to the INS being free at the point of use (BBC, 2008). The INS was beginning to settle down in asses. The Hospital Plan, bring forward by Health Secretary Enoch Powell in 1962, proposed a 10-year development of district general hospitals covering populations of approximately 125,000 and laid out a pattern for the future (INS, 1962).
Although it soon became clear that the time and cost for building new hospitals had been underestimated, it was considered as the birth of the modern hospital and ” took an important step towards setting up a nationwide plan and a coherent policy’ (Leister, 2008). The asses was the end of the economic support which was experienced in asses, and therefore he growth rate of the INS was reduced (Rivet, 2009).
In comparison, Butler (2010) argues that the most important event in asses was the first administrative reorganization of the INS by Labor government, which “placing all health services into regional and area health authorities”. As the asses wore on, the gap between the funding that the government provided for the INS and the financial needs to meet the increasing demands became wider (Ham, 2004). In addition, oil crisis made the financial problem of the INS worsen and caused a drastic cuts in spending which was contribute to severe long waiting list (Leister, 2008).
The consumer society was beginning to take off from the late asses (Rivet, 2009). In 1987, A White Paper, a review of the INS, was commissioned by Conservative prime minister Margaret Thatcher with the purpose to address problems, such as growing waiting lists which was serious in the asses due to the shortage of money (Ham, 2004). This led to the creation of the “internal market” in 1991, which concerned the delivery of health services and changed responsibilities of health authorities through the separation of purchaser and provider (Ham, 2004).
Rivet (2009) in his report states that competition was one of the keys. He further explained that as a ‘provider’ in the internal market, health organizations became INS trusts, organizations were managed by their own companies and competing with WAC other. However, after a few yeas of “steady state”, the INS market system itself was out of control with the “trolley crisis” happened in London and other big cities where medical emergency admissions could not be handled due to the bed shortage (Leister, 2009).
In the winter of 1996, there was even worse problems, with many hospitals had used up the 2 New Labor under Tony Blair won the 1997 election with a promise to abolish the internal market and general practitioner foundling, and to develop a modern INS which based on cooperation not competition (Klein, 2008). However, as a result of continued financial crisis, waiting lists still experienced a upward trend and many health bosses intended to reduce the hospital service to emergencies only (Leister, 2009).
Therefore, as a renouncement of former direction, the Blair government brought forward an ambitious “INS Plan” and largely increases investment in 2000. Rivet (2009) claims that “the INS Plan of 2000 was the most significant”. This 10-year derivations programmer readopted the Principles of competition and market as well as expanded the Private Finance Initiative in order to improve service standards and extend patient choice (INS Choices, 2011).
Meanwhile, private sector was supported and outsourcing of medical services was encouraged by the Blair Government. While provision was no longer necessarily by a publicly owned infrastructure, and waiting lists and waiting time were reduced sharply after the INS Plan of 2000 published, there has been a growing concern that increasing private sector organizations came to build and operate hospitals and run clinical services, which was not the original intention of the “INS Plan” (Rivet, 2009).
Before the election of 2010, the Conservatives promised to avoid “massive structural reorganization”, but the new Secretary of State, Andrew Langley carried out a radical plan with the aim to alter the INS structure again and cut its administration costs by nonwhite and made efficiency savings of $20 billion, which was claimed by Timing (2010) as the biggest structural reorganization in decades. 3. Current challenges of the INS 3. 1 . The ageing population One of the great achievements on human health development of the last century has been the sustained increase in life expectancy.
Since the INS was established, life span have increased by years for both male and female, and the trend is forecasted to continue. According to the data showed in the research of Channel (2010), there are 10 million people in the I-J are over 65 years old and it is predicted the number will be almost doubled to approximately 19 million by 2050. However, the rise in the ageing population accompanied with challenges for the INS as well.
This situation is particularly conspicuous nowadays due to the inevitable retirement of the so-called baby boom generation whom were born during a period of fast population growth from 1946 to 1964 (21st Century Challenges, 2011). An ageing population means increasing patients with chronic diseases and complex conditions, such as diabetes complicated, particularly when such patients have more than one 3 condition. According to Taylor et al (2012), In 2005, 65 percent of the Britain’s over ass had two or more chronic diseases, of which even had five or six long-term conditions.
In addition, Growing numbers of elder also has a significant impact on the INS spending. In 2007/08, the average cost of INS services for retired households was E,200 whereas only E,800 for non-retired (Crandall, 2010). He furthermore states that as the INS and state benefits constituted nearly half of government spending in 2009/10, and with much of this expenditure was used for elderly people, their growing number will hugely challenge the INS providers as well as the public finances.
Another negative impact which is pointed out by Trigger (2012) is that the over ass occupies approximately two thirds of hospital beds at any one time, which might the explanation of limitation of beds all along. Besides, since a hospital bed costs about IEEE a day, it is a huge daily spending Just in terms of beds use (Apple Medicine, 2012). 3. 2. Private healthcare invasion The last Labor government added private health firms as providers for competition and allowed them to be paid from state funds has resulted the rapid growth of private health firms, which is off track for the development of INS (Rivet, 2009).
In contrast, Campbell (2012) argued that embrace of competition by Labor government has positive effect in reducing patients waiting lists and provides patients with greater choice. Nevertheless, the situation is changed when the Conservative government reform carried out which expand the private sector’ role in the health service that accused of weakening the INS by opening its “core” to competition (Campbell, 2012). Under the new roles, every primary care trust of INS in England must open up at minimum of three health services to “any qualified provider” which including private sector.
As a result, private firms now treat nearly 20 percent of the total INS patients with certain conditions. The Department of Health claims that among 87 providers of different kinds which begun treating tenets with various conditions, 38 are private while only 26 from the INS (Campbell, 2013). This massive invasion into the INS has made senior doctors worried that the health service is being splinted and will force INS service to be close. (Campbell, 2013).
In addition, Beckman (2013) claims that the INS organization have to follow suit with the purpose of stay competitive if the private firms start advertising to attract more patients, which is definitely not the original intention of INS. Gerard (2013) furthermore argued that 13 different providers of the same lath service operating in the same area will puzzle both patients and Gaps, who will no ideas of which is the best for treatment. 3. Financial crisis The recent economic and the downturn in the global economy has brought unprecedented pressure to the INS which has the laxest budget of approximately El 10 billion per year (INS Choices, 2013). According to The Lancet (2010), Government borrowing reached the highest level since World War II to El 75 billion. To recover the deficit, the health service have to save EYE billion by 201 5 which means the finances are under more strain than ever. According to Nation Audit Office (201 1), spending on the INS rose on average 6. 6 percent per year.
However, it is expected that the INS budgets will increase by no more than 0. 4 percent per year by 201 5 (HEM Treasury, 2010). This was claimed by Powell and Thompson (2010) as “the most austere period for the INS in over thirty years”. They further argues that even the budget remained stable, growing demand from the ageing population, advancement of medical technology and higher public expectation made the “funding gap” even harder to be filled nowadays. Campbell (2011) even states that the INS financial crisis is so serious that it may contribute to loser of departments and cutting services to patients. . Future development 4. 1 Future of health care management. The INS is a massive, complicate, knowledge based organization which requires first class management. Developing a better health services calls for a good health management (Ferrier, 2006). In the report of Wangles (2002), he argued that the key point for developing a better health care management is to reduce “waste” and increase productivity on INS management. In comparison, according to Ferrier’s report (2006), he claimed that although general managers manage the INS officially, health care professionals undertake the “real work”.
The future of health care organizations should make doctors and managers work together as a interdependent partnership. Therefore, he proposes for the future by involving doctors into management and developing medical leadership. This idea also recommend in Griffith report (1983), which however still not be implemented. In comparison, Dobson and FitzGerald (2005) argues that what is needed in the future is to “switch from prescribed to customized” and enhance organizational capacity in local health care systems, which has positive effect on increasing the quality of the relationships between managers and linsang. . 2 Future of Primary care Primary care has been a cornerstone of the Auk’s healthcare system since the establish of the INS in 1948 (Taylor, 2012). Cross (2010) claims that the bright future of Primary care should built with the 5 aim of delivering many effective community services and educate people to have a healthy lifestyle, which ultimately reduce the need for expensive hospital care.
Historically, while making great success in ill treatment, hardly does the INS make effort to guild people to adapt the unhealthy lifestyles such as obesity and excessive ringing and smoking which are estimated constitute 70 percent of all hospital admissions. Therefore, Cross (2010) proposed that Transforming community services which introduced in 2009 with the aim to implement the government’s vision for primary and community care should be fully supported, and in particular enhancing the role of community nurses who have the experience and practical knowledge.
In comparison, Taylor (2012) argues since nowadays the patients expectancy are high and it will much easier to change providers if providers are failed to meet patients emend, primary care should develop a more customer service type model. Same as other industries, primary care will need to more focus on the end user and inscribe the notion of “knowing what’s best and not listening to the patient enough” (Wake, 2011). The change which supplies more care choices and new ways of communication is inevitable in a consumer-driven healthcare market (Taylor, 2012). . 3 Alternative funding models The debate of feasibility on altering healthcare funding has never ebbed away due to the continuous financial pressure, although politicians are reluctant to meddle with INS funding. Health Policy Consensus Group (2003) states that localism the tax funding and provision might be a alternative for the INS. Denmark is using this healthcare funding system which approximately 80 percent of healthcare is financed through local taxation raised by 14 county councils (Minister of Health and Prevention, 2008).
Butler (2006) claims that this system allows people to see more critically about the value of the delivered money and focus on healthcare spending without be distracted by many other spending programmer. Nevertheless, comparing the efficiency of funding systems are much more limited in completely free private market due to it base on local monopoly (Butler, 2006). Another alternative funding system which was commonly used in other EX. countries is social insurance, and in particular social insurance without competition used in France which was named by the WHO that provided the “close to best overall health care” in the world (WHO, 2010).
French healthcare system is a system that mix of public and private funding and provision (HP, 2003). It has a social insurance system that employers and employee both need to pay. Approximately 20 percent of age is used for compulsory insurance, of which about two-thirds is constituted by the employees. Butler (2006) claims that this system enables people have a good choice of family 6 doctor, and can go to specialists directly unlike the UK which have to see GAP first.
This funding system enables people to compare the efficiency of the different insurance funds, which are duplicities due to not mixing up with the funding for other social issues (Butler, 2006). However, He further argues there is little competition in the funding system. 5. Conclusion Throughout the history of the INS development, while the INS has expanded massively and caused positive changes in many respects, it has been beset with challenges and problems as well. The ageing population, financial crisis and private care firms invasion has made the INS experiencing a very challenging period.