CONFIDENTIAL PAPER

Confidential Paper

Table Of Content

Introduction3

Discussion3

The national Health Services5

Success And Failures Of Health Policy Since 1997 In Uk7

Approaches And Reforms13

Social Learning and the Reforms13

Policy Transfer and the Reforms15

Common law of confidentiality16

Data Protection Act 199817

Honorary contracts18

Researchers within clinical teams18

Conclusion20

References23

Confidential Paper

Introduction

This paper is a confidential paper as I am as a Chief Executive of NHS asked by a new Secretary of the state of Health briefing on the success and failure health policies are practicing in England since 1997. In the response of this inquiry from the new Secretary I have made a detail effective paper on the information given by the New Secretary. This is a great briefed paper on the success and failure of health policies of the England. This paper provides a multidimensional account of the U.K. National Health Service reforms of the since 1997, attempting to utilize the most relevant insights coming from the policy-transfer, social learning, and path-dependency perspectives with honest and confidentiality. The detailed paper is discussed below.

Discussion

Public health has long been an arena of political struggle between those who embrace an individualistic market-orientated approach to health care and advocates of collective action to improve community health (Colema, 2003, 219-228)). During the 18 years of Conservative government from 1979 to 1997, the opposition Labour party allied itself with the broader public health field and attacked the government for its failures to take effective public health action, in particular its perceived indifference to growing inequalities in health between rich and poor. Boyd, (2003, 24-27) reminds us that this is also a struggle between 'upstream' strategies concerned with the determinants of health and a 'downstream' focus on health care.

There is a simple truth behind the government's latest White Paper1 on the future of out of hospital health (and social) care in England—the way in which services are currently delivered is inefficient and unsustainable. Despite substantial change over many years, there is too much secondary care, too many patients are referred unnecessarily to hospital,2 too many are unnecessarily admitted, and too many stay too long. All this has been known for many years yet the UK has been relatively slow in reshaping its services. The focus of National Health Service (NHS) policy has until very recently been on reducing waiting, rather than avoiding costly admissions, particularly for people with long-term conditions. There are gross and unaccountable variations in referral rates between family doctors and hospitalisation rates by Primary Care Trusts of residence. The NHS spends 6% less on primary care than the OECD average;1 Germany has moved virtually all its outpatient work away from hospitals,1 and it is hard to explain away the shorter bed stays in systems such as Kaiser Permanente in the USA. Will the NHS repeat the mistake it made in the 1990s—words and no action based on ignorance of new models of care in other parts of the world? (Coleman et al 2003, 219-228)

The absence of action so far has not been helped by the long-standing schism within the medical profession, shown in the ...