scholarly journals Public versus private health care in a national health service

2007 ◽  
Vol 16 (6) ◽  
pp. 579-601 ◽  
Author(s):  
Kurt R. Brekke ◽  
Lars Sørgard
2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.


2018 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne

BACKGROUND Recent advances in technology have reopened an old debate on which sectors will be most affected by automation. This debate is ill served by the current lack of detailed data on the exact capabilities of new machines and how they are influencing work. Although recent debates about the future of jobs have focused on whether they are at risk of automation, our research focuses on a more fine-grained and transparent method to model task automation and specifically focus on the domain of primary health care. OBJECTIVE This protocol describes a new wave of intelligent automation, focusing on the specific pressures faced by primary care within the National Health Service (NHS) in England. These pressures include staff shortages, increased service demand, and reduced budgets. A critical part of the problem we propose to address is a formal framework for measuring automation, which is lacking in the literature. The health care domain offers a further challenge in measuring automation because of a general lack of detailed, health care–specific occupation and task observational data to provide good insights on this misunderstood topic. METHODS This project utilizes a multimethod research design comprising two phases: a qualitative observational phase and a quantitative data analysis phase; each phase addresses one of the two project aims. Our first aim is to address the lack of task data by collecting high-quality, detailed task-specific data from UK primary health care practices. This phase employs ethnography, observation, interviews, document collection, and focus groups. The second aim is to propose a formal machine learning approach for probabilistic inference of task- and occupation-level automation to gain valuable insights. Sensitivity analysis is then used to present the occupational attributes that increase/decrease automatability most, which is vital for establishing effective training and staffing policy. RESULTS Our detailed fieldwork includes observing and documenting 16 unique occupations and performing over 130 tasks across six primary care centers. Preliminary results on the current state of automation and the potential for further automation in primary care are discussed. Our initial findings are that tasks are often shared amongst staff and can include convoluted workflows that often vary between practices. The single most used technology in primary health care is the desktop computer. In addition, we have conducted a large-scale survey of over 156 machine learning and robotics experts to assess what tasks are susceptible to automation, given the state-of-the-art technology available today. Further results and detailed analysis will be published toward the end of the project in early 2019. CONCLUSIONS We believe our analysis will identify many tasks currently performed manually within primary care that can be automated using currently available technology. Given the proper implementation of such automating technologies, we expect considerable staff resources to be saved, alleviating some pressures on the NHS primary care staff. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11232


1996 ◽  
Vol 26 (2) ◽  
pp. 269-308 ◽  
Author(s):  
Rae Barrantes

In this report the Labour Party gives its view of the current status of the British National Health Service (NHS), and outlines its plans for the NHS under a Labour government. The values underlying the NHS—comprehensive health care, free at the point of use, based on need rather than ability to pay—have been betrayed. The truly national health service, created by a Labour government in 1948, has been replaced by a market-based service led by accountants. Patients are suffering, health care professionals are dissatisfied, some of the nation's finest hospitals are closing, community care is in chaos, and NHS dentistry has all but been privatized. Under the Tories, the NHS faces a future of privatization, competition, and markets, money wasted on bureaucracy, and the unfairness of a two-tier system. Under Labour, the NHS faces modernization, planned progress, money spent on frontline services, and excellence for all. Labour will follow a model of health care that is patient centered and community led, a properly coordinated and efficient public service.


2005 ◽  
Vol 35 (3) ◽  
pp. 479-483 ◽  
Author(s):  
Richard Lewis

A new political consensus has emerged over the benefits of new rights for patients to choose their provider of elective health care in the English National Health Service. From December 2005, patients will be able to select from a number of alternative providers at the time they are referred for treatment. In the longer term, patients will be able to access care at any public or private provider that meets national quality and cost standards. The government intends that this policy will lead to improvements in the quality and efficiency of health care and will reduce levels of inequity among patients. Pilot schemes have shown that a majority of patients will exercise a choice of provider when this is offered. However, the policy of patient choice may involve significant costs to the NHS and may be more difficult to implement outside urban areas. Further, the information needed to support patients' choices is not yet available. Whether such a policy will increase or decrease levels of equity in the English NHS remains open to debate.


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