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National Health Service (NHS) is an organisation that is offering healthcare services to the citizens of UK. This is funded by UK government which is working effectively for offering high quality healthcare and medical services to the citizens of UK without asking them to pay the full cost for the service (Iacobucci, 2020).
Rationale for development of the NHS in 1948
In 1948 UK government had established NHS and the major reason behind this is to solve the issues related to accessibility of having better healthcare services. There is not having much money to afford better and high-quality healthcare services and with this concern the government had established NHS in 1948. The motive behind the development of NHS is to develop a more reliable and good healthcare service provider for people of the nation. There is different factor such as lack of proper health care system, better accessibility to healthcare and lack of healthcare assess due to economic conditions are some of the factors that had developed the need to develop an effective healthcare system(Hardy and Rhodes, 2017). And these factors had created a view that the present healthcare system is insufficient, and the UK government should take an action against it.
With the increasing concern for the health of the citizens the UK government had established NHS in 1948 that offers free healthcare service to the people based on their citizenship. In this year, the government had also developed a National health service act which came into effect on 5 July 1948 which states that it is the duty of health minister to promote and establish health service for securing the improvement in the physical and mental health of the citizens of UK. Form the day of establishment NHS is offering high quality healthcare services to all the citizens of UK irrespective of their caste, race, gender, disability, age, and beliefs (NHS, 2019).
Both labour and conservative parties are the political parties in UK, and they had supported NHS and its operations from 1948-1978. The labour party had won the elections in 1945 and had supported the establishment of NHS. Labour party had supported NHS to a greater extent and had developed a healthcare system that offers care to the patients as per their needs rather than their ability to pay for the treatment (Gorsky, 2008). The party had continued supporting NHS and they have worked effectively for increasing the number of hospitals, beds, doctors and healthcare professionals. This had helped NHS in improving the quality of the care offered by them and working on their aim of improving the health of the citizens of UK.
In 1953 the conservative party had also supported NHS by appointing a committee which is headed by leader Griffith for reviewing the cost of NHS and worked for supporting NHS that had help them in bringing modifications in the firm and developing more efficiency. In this time period with the changing technologies the NHS had also undergone to significant changes that had expanded the services offered by NHS and the quality of healthcare services had also improved with time. With the changing trends in the health and illness, NHS had also brought significant changes in their services with the support of both labour and conservative party (Cowper, 2018).PRIVATISATION IN THE NHS MADE SINCE 1980
Margaret Thatcher, the then prime minister of UK and leader of conservative party had given the idea of privatisation and later this has been implemented great to be taken place in UK. It was the Thatcher’s government that had brought privatisation in NHS in 1980. Thatcher had paid emphasis on the Griffiths report that had suggested that NHS should have run like a supermarket for enhancing the performance, efficiency, and effectiveness. The aim of this privatisation is to produce more cost-effective NHS that can help the government in offering the healthcare to the population in a cost-effective manner. Privatization had brought a significant change in the management and the patient care offering by NHS by introducing an internal market (Ruane, 2019). The major idea was to create a competitive environment and creation of market so that each hospital would become a competitor of another one.
The privatisation had reduced the role of government in the healthcare service offered by NHS and had increased the role of private sector as they would be managing NHS after privatisation. But criticism said that with reference to the international comparison it can be said that the healthcare services need to be publicly funded and publicly run. As this would help the nation in offer better- and high-quality service rather that the care offered with privatisation (Maynard and Williams, 2018). When the government had announced the privatisation of NHS then different private firms came forward as they wanted to buy up NHS. Through this privatisation the private firm had become responsible for delivering the services that was been delivered by NHS staff previously.
The Thatcher government had shown that privatisation is for making the NHS more cost-effective save money and direct more finance towards the patient care, but this just not happened. In return the privatisation had proved to be a political move because it had not decreased the cost of healthcare services for the government. For tendering the conservative medical society had brought a proposal for compulsory competitive tendering to NHS that it can help in better privatisation of the firm (Krishna, 2019). The government’s belied that the use of private contractor would be a cost-effective way for them to provide the support services to the population.
But the privatisation had not helped the government in reducing the cost because the administration cost in the NHS in 1979 was around 6% but after privatisation and introduction of the internal market it just doubled. This shows that privatisation was not a better option. But the privatisation had not affected the quality of the care offered by NHS although it had affected the management of NHS to a greater extent (The Lowdown, 2020).
NHS is reforming continuously from the year of establishment to the present year. There are several changes made in NHS for improving the quality of healthcare services offered by them and the overall health of the nation. With the shifting healthcare needs and emerging diseases, it had become important for the healthcare system of UK to update and bring modification in their working pattern so that they can offer better services to their patients. One of the important reforms of NHS is the introduction of privatisation and this had made major changes in the management and had offered several advantages and disadvantages associated with it (Benbow, 2019). The introduction of internal market in NHS is still a debating topic. Along with this the different policies made by the government had also made major reforms in the way in which NHS operates.
With time NHS had reformed and had started focusing on the health of the population instead of focusing on the health of their patients only. Since 1948, NHS is going under significant organisational changes that are focusing on having highly skilled and trained healthcare professional and using the latest technologies for offering effective care to the patients (Fattore, 2019). From the day of establishment NHS had faced some of the major issues related to funding. Staffing, performance, rising cost of social care and changing technologies is significant.
NHS is facing issues related to funding and this is affecting their operations to a greater extent. The reductions in the local authority funding were affecting the social care to a greater extern and this increasing pressure of NHS. The government had focused on developing alternate sources of funding so that they can provide better funding to NHS for offering better care to the population. For solving the issues related to the management of the employees the NHS had reform and had made major changes in their organisational management (The King Fund, 2015). They have started focusing on bringing significant changes for staff and focused on motivating the staff by offering better pay and good work condition. The human resource is an important resource for the entire organisation and for offering better care to the patient better and effective human resource is required by NHS. It can be said that the reforms related to this had helped NHS in having productive workforce that is offering high quality care to the patients and raising quality of care offered to them.
In 1999 the labour government had established the primary care groups, and this is for the first time when primary and community health services had come together for working as a single organisation that controls the unified budget for delivering healthcare services to the UK population (Vittal Katikireddi et. al.2014). The establishment of primary care groups and trusts have proven to the beneficial for NHS because it had replaced the market culture with the corporate culture. The new corporate culture had helped NHS in developing better cooperation among the management teams and healthcare professionals that focuses on working collectively. This had helped them in improving the quality of the care offered by NHS to their patients. NHS had also reformed by making changes in the organisation related to the development of the workplace wellness initiatives for improving the health and well-being of employees at the workplace. This change is important as effective workforce is required for offering better care to the patients.
For improving the quality-of-life NHS had focused on working on different major healthcare issues and had reduced them with the use of better technologies and planning. With the years of transforming and reforming NHS had improved the health of the population. The death rates had decreased, effective complex care is being offered to the old age peoples. Also, NHS had made the government to make rules and regulation related to the things that can bring lifestyle changes for improving the quality of life with a healthy lifestyle (Gray, 2015).
The image mentioned below provide a presentation of how different changes in the healthcare had been bought by NHS with time. It can be said that NHS had reformed effectively for offering the best healthcare service to their patients and raising the quality of life of the UK population.
(Source: The Day, 2020)
In the recent pandemic situation also, NHS is focusing on bringing major reforms that can help them in managing the pandemic situation in an effective manner and offering better care to their patients (Triggle, 2021). The new reform made in NHS during pandemic has allowed in working for supporting the population to stay healthy instead of just focusing on their treatment.
Benbow, D.I., 2019. Juridification, new constitutionalism and market reforms to the English NHS. Capital & Class, 43(2), pp.293-313.
Cowper, A., 2018. What did the party conferences tell us about the NHS and social care?. Bmj, 363.
Fattore, G., 2019. Cost containment and health care reforms in the British NHS. In Health care and cost containment in the European Union (pp. 733-781). Routledge.
Gorsky, M., 2008. The British National Health Service 1948–2008: a review of the historiography. Social History of Medicine, 21(3), pp.437-460.
Gray, R. 2015. he battle over NHS reform: many shades of grey [Online]. Available through: <https://www.kingsfund.org.uk/blog/2015/02/battle-over-nhs-reform-many-shades-grey>. [Accessed on 25th May 2021].
Hardy, B. and Rhodes, R.A.W., 2017. Beliefs and institutional change: The UK national health service. In Government Reformed (pp. 65-87). Routledge.
Iacobucci, G., 2020. UK will still attract overseas doctors despite ending free movement, government insists. BMJ: British Medical Journal (Online), 368.
Krishna, S.S., 2019. Privatisation of NHS. Sushruta Journal of Health Policy & Opinion, 12(1), pp.34-36.
Maynard, A. and Williams, A., 2018. Privatisation and the National Health Service. In Privatisation and the welfare state (pp. 95-110). Routledge.
NHS, E., 2019. The NHS long term plan.
Ruane, S., 2019. Access to data and NHS privatisation: reducing public accountability. Data in Society: Challenging Statistics in an Age of Globalisation, p.171.
The Day, 2020. The NHS [Online]. Available through: <https://theday.co.uk/briefings/the-nhs>. [Accessed on 25th May 2021].
The King Fund, 2015. Three priorities for the new government: health and social care [Online]. Available through: <https://www.kingsfund.org.uk/publications/three-priorities-new-government?gclid=CjwKCAjw47eFBhA9EiwAy8kzNGo6EB96JbQZf0Ia1bgZQapK5e9niEdDn-GCrCzKxVP4bmpBG6KXBRoCPZYQAvD_BwE>. [Accessed on 25th May 2021].
The Lowdown, 2020. The History of Privatisation – first in a series of articles by John Lister [Online]. Available through: <https://lowdownnhs.info/analysis/long-read/the-history-of-privatisation-part-1/>. [Accessed on 25th May 2021].
Triggle, N. 2021. NHS reform: 'No better time than now' for changes, says Matt Hancock [Online]. Available through: <https://www.bbc.com/news/health-55985910>. [Accessed on 25th May 2021].
Vittal Katikireddi, S., McKee, M., Craig, P. and Stuckler, D., 2014. The NHS reforms in England: four challenges to evaluating success and failure. Journal of the Royal Society of Medicine, 107(10), pp.387-392.
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