Study of the extent and features of private sector service practice by medical physicians in the UK - comments on legislation concerning the public service health service, and covers private health insurance facilities, the characteristics of patients prefering private medical care, the views of general practitioners and medical consultants, the future of private medical practice, etc. References at the end of each chapter.
No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.
Samuel Mencher spent a year in Great Britain (1965-1966) interviewing leaders of professional medical associations, executives of the health insurance societies, and general practitioners and specialists engaged in private practice. His study of the private medical service twenty years after the passage of the National Health Service Act reviews the changes, problems, and successes of the National Health Service: trends in the amount and types of private medicine, the issues of conflict between private medicine and public policy, and attitudes of the public and of medical professionals.
Consultants employed within the publicly funded health service have the opportunity to work in the private sector. Part 1 of this report focuses on how the Department of Health, Social Services and Public Safety and the health service trusts in Northern Ireland have monitored and managed consultants to date to ensure that they fulfil their commitments to the health service. Most consultants are highly committed and work beyond their contractual obligations. But, prior to the introduction of a new contract in 2004, the quality of timetabled work programmes in the trusts was poor, and there was little monitoring of compliance by consultants. This led to a lack of clarity and accountability in the relationship between the public and private practice of the consultants. The new contract is based on the overriding principle that a consultant's first and foremost commitment is to the health service patients, and provides the opportunity for the trusts to improve management of consultants. Part 2 of the report examines how successful trusts have been in recovering the full cost of services provided to patients receiving private care within the trusts' facilities, a useful additional income stream. There is evidence of slow recovery of costs from private insurers, and a lack of basic debtor controls to gather money owed for treatment received, which is not compatible with good governance and accountability. NIAO feels there is an urgent need for some trusts to improve their cost recovery systems so that the full potential of income generation is realised and the needs of accountability are satisfied.
This review incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England, and has been developed in discussion with patients, carers and the general public. The changes proposed are locally-led, patient-centred and clinically driven. Chapter 2 identifies the challenges facing the NHS in the 21st century: ever higher expectations; demand driven by demographics as people live longer; health in an age of information and connectivity; the changing nature of disease; advances in treatment; a changing health workplace. Chapter 3 outlines the proposals to deliver high quality care for patients and the public, with an emphasis on helping people to stay healthy, empowering patients, providing the most effective treatments, and keeping patients as safe as possible in healthcare environments. The importance of quality in all aspects of the NHS is reinforced in chapter 4, and must be understood from the perspective of the patient's safety, experience in care received and the effectiveness of that care. Best practice will be widely promoted, with a central role for the National Institute for Health and Clinical Excellence (NICE) in expanding national standards. This will bring clarity to the high standards expected and quality performance will be measured and published. The review outlines the need to put frontline staff in control of this drive for quality (chapter 5), with greater freedom to use their expertise and skill and decision-making to find innovative ways to improve care for patients. Clinical and managerial leadership skills at the local level need further development, and all levels of staff will receive support through education and training (chapter 6). The review recommends the introduction of an NHS Constitution (chapter 7). The final chapter sets out the means of implementation.
An analysis of the transition from universal, publicly funded health care to New Labour s application of market principles: a national institution reaching crisis point and a key lesson for those concerned with health care everywhere.
First published in 1991, this book charts the inception of the British National Health Service from 1911 to 1948. It pays specific attention to the struggle of doctors to achieve work control in the medical marketplace during this turbulent time. With particular focus on the medical profession, it discusses key themes such as restrictions to the inception of the Health Service under David Lloyd George’s government and the relationship between the Beveridge report and the National Health Service Act in 1946. In its final analysis, the book asks what, if any, gains were made by the medical profession in the creation of Labour’s crowning achievement. This book will be of interest to those studying the history of the British welfare state, social welfare and healthcare.
