HEALTH IN THE UK

HEALTHCARE IN THE U.K.

1) Healthcare

in the United Kingdom is a devolved matter, meaning England, Northern Ireland, Scotland and Wales each have their own systems of private and publicly-funded healthcare, together with alternative, holistic and complementary treatments. Each country having different policies and priorities has resulted in a variety of differences existing between the systems. That said, each country provides public healthcare to all UK permanent residents that is free at the point of need, being paid for from general taxation. In addition, each also has a private healthcare sector which is considerably smaller than its public equivalent, with provision of private healthcare acquired by means of private health insurance, funded as part of an employer funded healthcare scheme or paid directly by the customer, though provision can be restricted for those with conditions such as AIDS/HIV. Taken together, the World Health Organization, in 2000, ranked the provision of healthcare in the United Kingdom as fifteenth best in Europe and eighteenth in the world. Overall, around 8.4 per cent of the UK's gross domestic product is spent on healthcare, which is 0.5% below the Organization for Economic Co-operation and Development average and about one percent below the average of the European Union.

2) Healthcare in England
Norfolk and Norwich University Hospital, a National Health Service hospital. Most healthcare in England is provided by the National Health Service (NHS), England's publicly funded healthcare system, which accounts for most of the Department of Health's budget (98.6 billion in 20089). The actual delivery of health care services is managed by ten Strategic Health Authorities and, below this, locally accountable trusts and other bodies. Social care services are a shared responsibility with the local NHS and the local government Directors of Social Services under the guidance of the DH. From the birth of the NHS in 1948, private healthcare has continued to exist, paid for largely by private insurance. In recent years, despite some evidence that a large proportion of the public oppose such involvement, the private sector has been used to increase NHS capacity. In addition, there is some relatively minor sector crossover between public and private provision with it possible for some NHS patients to be treated in private healthcare facilities and some NHS facilities let out to the private sector for privately funded treatments or for pre- and postoperative care. However, since private hospitals tend to manage only routine operations and lack a level 3 critical care unit (or intensive therapy unit), unexpected emergencies may lead to the patient being transferred to an NHS hospital as very few private hospitals have a level 3 critical care unit (or intensive therapy unit), putting the patients at greater risk and costing the NHS money.

3)

Health and Social Care in Northern Ireland (or HSC) is the

designation of the publicly funded service responsible for the administration of the public health and other social care services in Northern Ireland. The Northern Ireland Executive through its Health Department is responsible for the funding of the service. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom. For services such as A&E, patients simply walk in, state their name and date of birth, are given treatment and then leave. Patients are unaware of costs incurred by them using the service. It is often called the NHS, as in Scotland, England and Wales, but differs in that it provides not only health care but social care too. In Britain, the three NHS services only provide health care. Social services are provided by local councils. The Northern Ireland Health and Social Care Service was created by the Northern Ireland Office after the Beveridge Report. The Department is organised under a Permanent Secretary into several groups and one agency. These are the Planning and Resources Group, Strategic Planning and Modernisation Group and Primary, Secondary and Community Care Group and the 5 Professional Groups. The Departments Executive Agency is the Health and Social Services Estates Agency (known as Health Estates). The five professional groups are Medical and Allied Services Social Services Inspectorate Nursing and Midwifery Advisory Group Dental Services Pharmaceutical Advice and Service

4)

Healthcare in Scotland is mainly provided by Scotland's public

health service, NHS Scotland, that provides healthcare to all permanent residents that is free at the point of need and paid for from general taxation. Health is a matter that is devolved, and considerable differences are now developing between the public healthcare systems in the different countries of the United Kingdom.Though the public system dominates healthcare provision, private health care and a wide variety of alternative and complementary treatments are available for those willing to pay. The National Health Service (NHS) in Scotland was created in 1948 at the same time as the NHS was created for England and Wales. It remains a separate body from the other public health systems in the UK although this is often not realised by patients when "crossborder" or emergency care is involved due to the level of cooperation and co-ordination. Primary and secondary care are integrated in Scotland, unlike in England, where secondary services are commissioned by NHS primary care trusts. Indeed, NHS trusts do not exist in Scotland, healthcare being provided through fourteen regional health boards. Health boards are, however, subdivided into Community Health Partnerships, to provide local services more effectively.

5) Healthcare in Wales is mainly provided by the Welsh public health

service, NHS Wales. NHS Wales provides healthcare to all permanent residents that is free at the point of need and paid for from general taxation. Health is a matter that is devolved, and considerable differences are now developing between the public healthcare systems in the different countries of the United Kingdom.Though the public system dominates healthcare provision, private health care and a wide variety of alternative and complementary treatments are available for those willing to pay.The largest hospital in the country is the University Hospital of Wales hospital. NHS trusts and health boards Wales is divided into 10 NHS trusts: Abertawe Bro Morgannwg University Health Board Cardiff and Vale University Health Board Cwm Taf NHS Trust Conwy & Denbighshire NHS Trust Gwent Healthcare NHS Trust Hywel Dda Local Health Board North East Wales NHS Trust North West Wales NHS Trust Powys Teaching Local Health Board Velindre NHS Trust Welsh Ambulance Services NHS Trust manages all ambulance services in Wales from its base in Denbighshire.

6) Comparisons between the public health systems in the UK

Each NHS system uses General Practitioners (GPs) to provide primary healthcare and to make referrals to further services as necessary. Hospitals then provide more specialist services, including care for patients with psychiatric illnesses, as well as direct access to Accident and Emergency (A&E) departments. Pharmacies (other than those within hospitals) are privately owned but have contracts with the relevant health service to supply prescription drugs. Each public healthcare system also provides free ambulance services for emergencies, when patients need the specialist transport only available from ambulance crews or when patients are not fit to travel home by public transport. These services are generally supplemented when necessary by the voluntary ambulance services (British Red Cross, St Andrews Ambulance Association and St John Ambulance). In addition, patient transport services by air are provided by the Scottish Ambulance Service in Scotland and elsewhere by county or regional air ambulance trusts (sometimes operated jointly with local police helicopter services) throughout England and Wales. In specific emergencies, emergency air transport is also provided by naval, military and air force aircraft of whatever type might be appropriate or available on each occasion.Each NHS system also provides dental services through private dental practises and dentists can only charge NHS patients at the set rates for each country. Patients opting to be treated privately do not receive any NHS funding for the treatment. About half of the income of dentists in England comes from work sub-contracted from the NHS, however not all dentists choose to do NHS work.

7) Differences
Best practice and cost effectiveness In England and Wales, the National Institute for Health and Clinical Excellence (NICE) sets guidelines for medical practitioners as to how various conditions should be treated and whether or not a particular treatment should be funded. These guidelines are established by panels of medical experts who specialize in the area being reviewed. In Scotland, the Scottish Medicines Consortium advises NHS Boards there about all newly licensed medicines and formulations of existing medicines as well as the use of antimicrobiotics but does not assess vaccines, branded generics, non-prescription-only medicines (POMs), blood products and substitutes or diagnostic drugs. Some new drugs are available for prescription more quickly than in the rest of the UK. At times this has led to complaints. Cost control The National Audit Office reports annually on the summarised consolidated accounts of the NHS, and Audit Scotland performs the same function for NHS Scotland. Prescription charges Northern Ireland, Scotland and Wales no longer have prescription charges. However, in England, a prescription charge of 7.40 is payable per item, though patients under 16 years old (19 years if still in full-time education) or over 59 years get prescribed drugs are exempt from paying as are people with certain medical conditions, those on low incomes and those prescribed drugs for contraception.