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 (Wills, Evans, Samuel, 2008, 521-531). 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).

The NHS was influenced by the existence of the experimental Soviet model (Ferge, 1979, 52-71). But the NHS in Britain differed fundamentally from the Soviet model in that it sought to attenuate the effects of but not remove the pre-existing class-based social relations of capitalism summarizing the difference between social policy East and West before the end of communism. From its inception to our days, and everywhere where the market is a dominating force, Western type social policy has been torn by basic conflict. It was created to fill a vacuum, to ensure the individual's right to survive a right accepted by most societies as a fundamental right and categorically negated by the market logic. And yet such social policy could not assume this self-imposed task unconditionally as long as it was reluctant to jeopardize the domination of the market economy. If the domination of the market is abolished, then the relative autonomy of the economy, which was only apparent, but which served the dominant interests very effectively, necessarily disappears (Ferge, 1979: 52-71). Then the relative autonomy of the economy, which was only apparent, but which served the dominant interests very effectively, necessarily disappears.

Discussion and Analysis

Background and History

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 ...