HEALTH AND SOCIAL CARE

Health and Social Care

Health and Social Care

Introduction

This paper outlines the impact of UK health care and social policy reforms on the quality of healthcare provision. Originally, the health care system catered for those in state employment. In addition, key industries had health services of their own. Not until 1972 were peasant farmers encompassed within the system. Like the UK National Health Service (NHS), the system was centrally funded and formally free at the point of delivery. Unlike the NHS, much of the planning and coordination of the health service was performed at the level of the state, on the basis of detailed information provided by fourteen National Research Institutes. Primary care was not provided by family doctors as in the NHS. But, from 1975 onwards a system of integrated health care complexes existed; which integrated inpatient and outpatient care, was hospital-centred, and relied heavily on specialists.

However, what crucially distinguished the impetus to health care transformation in the Soviet Union and later in state socialist Eastern Europe on the one hand, from health care transformation in Western Europe on the other, was that it represented part of a context of systematic anti-capitalist social intervention which first and foremost included the abolition of private ownership. Thus the goals of transformed health care under state socialism were not understood to be simply technical, but explicitly included the much broader aim of restructuring society as a whole (Sigerist, 1937, 89-102).

Discussion and Analysis

Changes to the Polish health care system had been made soon after the ending of communism. The 1991 Health Care Institutions Act allowed for the existence of diverse owners beyond the Ministry of Health (Wills, Douglas, 2004, 431-434). These included regional and local government, other ministries, private bodies, and non-governmental organizations. It provided the legal basis for publicly owned hospitals in UK to become substantially autonomous and responsible for managing their own budgets. But while primary health care was quick to privatize, for political and economic reasons hospitals were not.

The deduction was originally set at 7.5 per cent of taxable income; between 2003 and 2007 this increased annually by one quarter per cent until it reached its present level of 9 per cent (Samuel, Springett, 2007, 211-214). At 7.5 per cent of taxable income the initial health insurance premium was clearly inadequate for the maintenance of pre-existing levels of care (Samuel, Wills, 2007, 115-119). Revenue was also depleted by the fact that one fifth of the working population was unemployed at the time. In a recent interview discussing current reforms, a former minister of health went so far as to suggest that the 1999 reforms had been consciously designed to bring about the privatization of hospitals.

Health and Social Care Policy Reforms

There has been concern for some time about the future of Health Care both in England and worldwide. Health Care had a chequered history under the New Labour government with policies to address health inequalities and build social cohesion sitting uncomfortably alongside an emphasis on individual behaviour ...