Comparative Analysis of Healthcare Systems

Introduction

The healthcare system has the sole purpose of providing healthcare support and care services to the target population to meet their needs and demands so that healthy and illness free surrounding can be developed. According to WHO, the four key goals of healthcare system around the world are improved responsive care, social as well as financial risk protection, improved the health of service users and improved efficiency in providing care (WHO, 2010). The key building blocks of healthcare are service delivery, health information system, health workforce, leadership or governance and access of essential medicines (WHO, 2010). The building blocks strengthen the healthcare system such as health information and effective leadership helps in developing effective overall regulations and policies for all blocks of healthcare services (WHO, 2010). In this assignment, the use of the eight-factor model is to be made for analysing the healthcare system of the UK along with 8 other countries that are to be compared with the UK healthcare system. This is to be done to learn regarding the strength and weakness of the UK healthcare system and later recommendations are to be provided for improving the UK healthcare system. which can benefit from healthcare dissertation help in formulating effective strategies.

Reason behind UK healthcare is chosen as a base country

The UK healthcare is ranked by the Commonwealth Fund in 2017 as the best healthcare among 11 developed countries (Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the US) on terms of affordability, safety and efficiency (commonwealthfund.org, 2017). However, in terms of cancer survival and preventing early death among the population, the UK healthcare system is seen to have failed. It is evident as in case the UK is able to have the same survival rates with other countries having better health outcomes then they would have been able to save over 46,400 lives per year (bbc.com, 2017). It is also evident as UK stands in 23rd position in respect to breast cancer treatment and prostrated cancer treatment in comparison to Sweden which stands at the first for breast cancer treatment and the US who stands at first for prostate cancer treatment (uk2020.org.uk, 2018). Moreover, with respect to treatment for lung cancer, Japan stands at the 1st position whereas the UK stands at the 30th. In relation to treatment regarding leukaemia, Norway has the first position whereas the UK stands at the 20th and in respect to ovarian cancer treatment, France stands at the first whereas UK in 25th position (uk2020.org.uk, 2018). This informs that though the management and services provided by the NHS are of high class but institutionalising them to develop effective outcomes is poor. Therefore, UK is considered as the base countries to be compared with Sweden, US, France, Norway, Japan, Germany, Nigeria and Sierra Leone healthcare system which are few of the world’s healthcare system for identifying ways in which UK healthcare system lags as well as aspects they are to improve to become better in providing effective healthcare outcomes.

NHS Background

In the UK, the NHS was intended to be built as a government body who would offer free healthcare to all. It led NHS to be established on 5th July 1948 which for the first time allowed people of the UK able to avail free healthcare rather than paying insurance of money to receive care (nationalarchives.gov.uk, 2019). At present, the NHS is the governing body which operates the UK healthcare system to deliver care to the population for ensuring their healthy living. The NHS provides healthcare services to four areas which are Northern Ireland, England, Wales and Scotland and the NHS of one area do not interfere with the work of other NHS in different areas. The NHS was developed with the key intention to provide holistic care to all individuals in the society irrespective of any discrimination (nuffieldtrust.org.uk, 2018). The term "free at the point of use" in NHS means that the people who are legitimate as well as fully registered with the healthcare system in the UK is only able to access any nature of care under the body. The NHS offers wide nature of care under free services such as dental care, long-term care, eye tests and others. The budget for the NHS since its establishment has grown 12 times which is evident as in 1949-50 the allocated budget for them is only £12.9 billion but in 2016-17 it has grown to £140.2 billion (kingsfund.org.uk, 2019).

Critical analysis of health issues in the UK

The health issues mainly occur when the metabolism of the body fails or is alerted through a pathogen or pollutants. In the UK, the leading health issue as per reports of 2017 is dementia and Alzheimer's disease. This is evident as nearly 12.7% of people present in England and Wales died due to the illness (ons.gov.uk, 2018). Moreover, it is informed that 1 in 6 people in the UK is determined to be experiencing common health mental health issue (mentalhealth.org.uk, 2019). Thus, it indicates mental illness is one of the leading health issues in the UK as most of the death occurring are as a result of mental disability and stress. The second leading health issue identified is ischemic heart disease as in 2017 it accounted for 10.9% deaths in the UK (ons.gov.uk, 2018). It is also seen that in regarding ischemic heart disease treatment the UK stands at the 21st position in the world and the first place is held by Switzerland (commonwealthfund.org, 2017). This indicates that NHS though assisting to allows effective healthcare management but is failing to deliver proper establishment of plans so that effective outcomes for major health issues such as ischemic heart disease can be developed. The health issue in the UK on the basis of gender indicates that dementia and Alzheimer's are the key mental disorder which has contributed to the death of 16.5% females in 2017 within the country. This is an increase from 15.5% of deaths of females in 2016 within the UK (ons.gov.uk, 2017). Thus, it informs that mental health issues such as dementia and Alzheimer’s are not only leading health issues of the country but is one of the leading health issues to be resolved among females in the country.

Overview of Eight Factor Model

The Eight Factor Model mentions eight key factors that are to be considered for analysing whether or not a healthcare system of a country is providing true access to healthcare for the population. The eight factors are historical, structure, financing, interventional, preventive, resources, health issues and health disparities. The historical factor refers to the health of each nation and it explores the way healthcare and access to health support are been historically provided by each nation (Lovett-Scott and Prather, 2014). The structure factor mentions the way and system of healthcare being delivered within a country. The financing is the third factor which refers to the way nation's fiscal policy and finances are arranged for managing healthcare. The interventional factor creates focus on understanding whether the healthcare delivery is primary care, acute care or restorative care in respect to the health outcomes seen in the nations. The preventive mentions the measures that are been taken in the country or nation to preserve the emotional, physical and social health of the population (Lovett-Scott and Prather, 2014). The resources are mentioned as the key fiscal resources available whereas major health issues mention the key health problems in the area. The health disparities mention unequal treatment and characteristics present in a health system of the country that is leading to unequal healthcare access among the population (Lovett-Scott and Prather, 2014).

Comparison and analysis of the UK Healthcare System

Historical

The history of the healthcare system of UK indicates that before 1911 the healthcare was managed in such a way so that only the wealthy were able to avail care unless any free treatment is arranged for the poor through teaching or charitable hospitals. In 1911, the National Insurance Act 1911 was established with the intention to provide effective healthcare to the people. According to this Act, a fixed capitation fee was charged on a compulsory basis from the employees (nationalarchives.gov.uk, 2019). This was effective to allow healthcare for the low paid workers and those who are employed but was not efficient to offer care to the people who are unemployed and living below the poverty level. The following of World War II many social reforms were seen to be aimed at developing free healthcare for the population. These thoughts led the leaders in the UK to establish National Health Service (NHS) as the key governing body of healthcare who would provide free care service and support to the people (nationalarchives.gov.uk, 2019). The NHS was respectively built for England, Northern Ireland, Scotland and Wales as independent institutions. In 1947, Bupa was founded in the UK healthcare system which became the largest health insurance organisation in Britain. In 1948, the Park Hospital was built in England which became the world’s first hospital to provide free health to all individuals (nationalarchives.gov.uk, 2019). This indicates that UK healthcare system was trying to progress in providing free healthcare so that no individuals irrespective of their financial or social position be unable to avail care.

In between 1950 to 1955, the National Health Service Central Register (NHSCR) was developed for facilitating the transfer of patients from one health border to another within the countries present in the UK. In 1952, the Royal College of General Practitioners in established in the UK. This was developed with the intention to bring together all the general health practitioners to help them in education, research, training and maintaining medical standards (nationalarchives.gov.uk, 2019). In the 1990s, the government in the UK was seen to create changes in the NHS by creating an internal market where all doctors are to be present to provide services to the patients (nuffieldtrust.org.uk, 2018). In 1998, the NHS plan was established which led to the modernisation of NHS. In this plan, framework was established to create improvement for care regarding cancer, diabetes, coronary heart disease and others (nuffieldtrust.org.uk, 2018). This was an effective step as it led the NHS to improve their working as per national standards as well as create better performance in providing care to the patients.

The history of the healthcare system of Norway informs that after World War II the country planned to implement national healthcare system to ensure welfare of the state. The state was seen to have the role to provide good and required healthcare services to the citizens and others in the country (WHO, 2019). The responsibility was seen to be divided among three levels of the government. The first is the state government, the County is the second and the local county council is the last. The government was made responsible for developing laws as well as pass healthcare bills but the key responsibility for healthcare is to be managed by the Health and Care department. A reform in the healthcare system came in Norway in 2002 where the government took the responsibility to manage and operate all the hospitals present within the country. Before this, the County and the Local County Council is found to be responsible for managing the hospitals (fhi.no, 2017; WHO, 2019). This was executed with the goal to improve the healthcare system in the country. The reform made in 2002 within the Norway healthcare system was inspired by the New Public Movement (fhi.no, 2017). The history informs that Norway healthcare system progressed in a similar fashion like the UK as both of them made major changes after the World War II to ensure healthcare is able to be received by all within the country and not just confided to be available only for the wealthy.

In respect to recent history of Norwegian Healthcare system, the National Strategy for Quality Improvement in the Health and Social Services was established by the federal government in between 2005-2011 to frame improved efficacy, patient-centred care, the safety of patients, equal access to healthcare and others. The Norwegian government also develop a Five Year Plan from 2014 to 208 under which they have planned to ensure improved patient safety and promoting learning to manage adverse events in hospitals (international.commonwealthfund.org, 2019). This is similar to the Five Year Forward View plan in the UK, England where they plan to offer better primary care and improved patient safety to the service users (kingsfund.org.uk, 2019). This indicates that both the countries that are Norway and the UK have similar history of progress in managing and improving their healthcare system to attain the well-being of the population.

The healthcare system of Japan informs that in between 1203-1603 many physicians and Buddhists monks were seen to use different formulas and theories as well as practices to develop effective and practical medicines within the country (japanhpn.org, 2019). In 1922, the present modern healthcare system of Japan is established under which health insurance of the people is made compulsory. In 1927, the first Employee Health Insurance Plan is established by Japan which is done with the aim to provide assured healthcare to the miners and industrial employees (japanhpn.org, 2019). In 1938, the health insurance was seen to be extended to the farmers, fosters, fisherman and other groups who were not previously covered in 1922 (japanhpn.org, 2019). This indicates that Japan healthcare system progress at a faster rate compared to the UK healthcare system as they were able to ensure overall healthcare being received by all people irrespective of their status on the society by 1938 whereas UK accomplished it at first in 1946 through NHS establishment. The history of Japan healthcare also mentions that in between 1950-1990 huge rise in life expectancy is seen and at the present, they have the most life expectancy than any other country (Zhang and Oyama, 2016; japanhpn.org, 2019). This is evident as per 2016 data the life expectancy in the UK is 80.96 years whereas in Japan it is nearly 83.98 years (ourworldindata.org, 2019). This indicates that better progress of healthcare system in Japan is seen compared to the UK due to which they are having a better life expectancy among their population compared to the UK.

Structure

The UK Healthcare System has a government-sponsored universal system of healthcare known as the National Health Service (NHS) which was framed after the Second World War and came into operation on 5th July 1948 to deliver systematic healthcare to the population. The introduction of Health and Social Care Act 2012 led to the structural reform in the UK healthcare system and NHS as a result of which a series of the organisation are developed both at the local as well as national level. The structure of NHS England includes the Department for Health, NHS England, Clinical Commissioning Groups (CCGs) and NHS Foundation Trusts (kingsfund.org.uk, 2017). The Department of Health has the responsibility to fund and develop policies to ensure better healthcare in the UK. The NHS England is regarded as the umbrella body who is responsible for offering healthcare to the people and the being an independent body the Department of Health cannot interfere in its matters. The CCGs have the responsibility to provide healthcare in the local areas. The NHS Foundation Trusts offer assistance to CCGs to provide healthcare. The Trusts include mental health, primary care services, hospital and ambulance (kingsfund.org.uk, 2017).

The NHS Scotland is seen to have 14 territorial NHS boards and 7 special NHS Boards along with 1 Health Body. In NHS Wales, there are 22 Local Health Boards and 7 NHS Trusts and in NHS Northern Ireland there are 5 Health and Social Care Trust (scot.nhs.uk, 2018; gpone.wales.nhs.uk, 2019; niassembly.gov.uk, 2016). The territorial NHS Boards provide protection and act to improve the health and delivery of care to the people. The special NHS Boards are responsible to support NHS Boards in acting to offer healthcare benefit to the people of Scotland (scot.nhs.uk, 2018; gpone.wales.nhs.uk, 2019; niassembly.gov.uk, 2016). This indicates that structures of NHS in each area are effectively maintained under the supervision of the UK government. The advantage of offering universal healthcare is that it lowers the administrative cost for accessing care, simplifies the care process as well as lowers the healthcare cost for the economy (mencap.org.uk, 2018). Thus, the presence of universal healthcare system in the UK offers them the benefit to ensure better care to the citizens as well as control healthcare management cost.

The healthcare system in Sierra Leone is seen to be divided mainly into 13 health districts which correspond to the districts except for the Waters Area Urban Western Area Rural districts that have been combined to form Western Area Health District. In each of the health districts in Sierra Leone, there is an average of 50 peripheral healthcare units and more than 100 technical employees are seen. The healthcare management team is mainly responsible for the planning, organisation and monitoring the training personnel, health provision, supplying medical equipment and working with healthcare and social communities. The peripheral healthcare units (PHU) are the place from which the people in Sierra Leone receives primary healthcare (Robinson, 2019).

There are three types of PHUs one of which is community healthcare centre which has the key task to implement health prevention measures, health promotion activities and ensure cure to the people from illness. They are in charge of other types of PHUS present surrounding the areas. It is considered and planned that each of the local government in Sierra Leone needs who are present below the district level required to have at least one community healthcare centre develop for the people (Robinson, 2019). The community health posts are another nature of PHUS who have the similar function as the community healthcare centres but they have few facilities as well as mainly used for referring patients to the hospitals present at the district level (Robinson, 2019). The Maternal and Child Health posts are the third type of PHUS which is regarded as the first to be contacted for availing healthcare in smaller towns who have population of 500-2000 people (Robinson, 2019). The structure of the healthcare system in Sierra Leone is found to be similar with the UK as, like the NHS, the Community Healthcare Centres acts to manage the healthcare needs and demands along with other PHUs types in the area.

The healthcare system of Nigeria informs that it is decentralised in structure as a three-tier system exists where responsibilities are shared at the local, state and federal level. At present, nearly all the three tiers of the healthcare system in Nigeria are equally involved in stewarding, financing, service provision and healthcare system functioning (Adeloye et al. 2017). At the Federal level, the Federal Ministry of Health (FMOH) is held as responsible to ensure the formation of healthcare policies and offering technical support to the overall healthcare system in the country. It is also responsible to execute national healthcare management and \ensure proper provisions of healthcare services are available to the individuals through the teaching and tertiary hospitals as well as national laboratories (Adeloye et al. 2017). This indicates that the federal level of healthcare mainly ensure proper healthcare management in the country exists so that improved well-being of the country can be ensured. The State Ministers of Health in Nigeria have the role to ensure regulation of secondary hospitals and offer technical support required by the primary healthcare services (Adeloye et al. 2017). At the local government level, primary healthcare has the responsibility to offer proper healthcare services in each ward. The local government in Nigeria is seen to be divided into 7-15 wards (Adeloye et al. 2017). However, though the structure informs that the healthcare sector in Nigeria is coordinated in an effective manner but in reality, the management of the system is not seamless. This is because often duplication and error in healthcare services are reported leading to weak healthcare service delivery to the population (Adeloye et al. 2017).

The community healthcare acts as the most important link in the healthcare system of Nigeria as they act to implement the primary healthcare services for the people. The National Health Policy 1988 indicates that the development of primary healthcare management as well as technical communities is to be present at the local government level (WHO, 2019). Thus, it informs that the structure of the Nigerian healthcare system is different from the UK healthcare system as the UK system is centralised whereas in Nigeria it is decentralised. The lack of a centralised healthcare agency leads health professionals to focus more on managing files and distributing codes rather than focussing on patient care. Moreover, decentralised healthcare system leads create issues with connecting with patients and carers as well as increased administrative cost (Gaede, 2018). Thus, the structure of the Nigerian healthcare system is comparatively worse than the UK healthcare system in terms of management.

Financing

The NHS is 80% funded by the general taxes received from the population and the rest 20% of its funds comes from the contribution made for National Insurance. In England, a small amount of money is charged for the patients to receive dental care and prescriptions that were introduced in the 1950s after the formation of the NHS. In 2016-17, the prescription charges in England led them to collect £555 million. However, in Northern Ireland, Scotland and Wales no such prescription charges are allocated by the NHS (fullfact.org, 2018). This indicates that each of the NHS is mostly funded through government but few charges are accessed from the patients in certain nature of care to be used as funds for the NHS. The reports regarding private healthcare funding present in the UK informs that a minimum of £1.47 billion is spent by patients in the market. In 2016, the NHS is found to increase their income by 8.1% through attending private patients which indicates a total of £360 million in earning (hsj.co.uk, 2018). The increase in the waiting time to avail care from the NHS contributed to its rise of private healthcare. In between 2012-2016, the personal payment to avail healthcare in the UK increased by 53% which indicates rise in an amount from £454 million to £701 million (telegraph.co.uk, 2018). As per reports in 2018, nearly 75% of the healthcare in the private within the UK for its citizens is funded through private healthcare insurance (hsj.co.uk, 2019). Thus, it informs that a major part of UK healthcare is also accessing funds through the management of private healthcare to offer services to its citizens and others.

In France, it is seen that 75% of healthcare is funded through the money received by the government through national health insurance. This means a part from the salary of the employees is deducted on a compulsory basis in a nominal amount to provide them healthcare services. In 2016, it is informed that 13% is contributed by employers and 6% by the employees in availing healthcare insurance (international.commonwealthfund.org, 2019). The state provides finances for health services to undocumented immigrants who have currently applied for availing residence in the country. However, people who belong from country other than EU are provided support only on emergency purpose and they have to use private healthcare for availing general healthcare services (international.commonwealthfund.org, 2019). This informs that French healthcare system is funded in a different way from the UK as in France the healthcare charges are received through national health insurance whereas in the UK the charges are received from the tax already paid by the people. In France, it is reported that in 2014 the total out-of-pocket spending done towards healthcare is 8.5% of the total expenditure and it is lower than the previous year (international.commonwealthfund.org, 2019). However, in the UK, it was seen that in 2014 the nearly by 42.4% of total healthcare spending in the country was through out-of-pocket expenses (international.commonwealthfund.org, 2019a). This indicates that France has a better managed financial system for their healthcare compared to the UK in ensuring fewer out-of-pocket expenses are made to finance the healthcare system of the country.

In Germany, the healthcare system is mainly funded through compulsory insurance, insurance premiums, self-governing bodies and statutory health insurance. The compulsory insurance is provided to people based on their gross earnings. The insurance premium is the money paid by insured employees as well as their employers. Moreover, the tax revenue surplus funds the healthcare system of Germany. The statutory health insurance is jointly carried by the organisation and the individuals to manage the cost of healthcare during illness. Each of these organisations has the liability to pay any amount of money for the individual to avail care until their illness is resolved. The Federal Joint Committee in Germany is regarded as the highest self-governing community acting with the statutory healthcare insurance system to fund healthcare for the individuals in Germany (Berens et al. 2016). This informs that the people in Germany, unlike the UK, have to pay expenses from their salary to the state to avail healthcare as well as the certain part is paid by the voluntary and statutory organisations. Therefore, it indicates that the UK healthcare system is mainly funded by the government whereas the Germany healthcare system is funded by the people and multiple healthcare institutions.

In 2017, the expenditure made by the UK government with respect to healthcare was £197.5bn. This indicates that 9.6% of the GDP is spent by the NHS to arrange proper healthcare for the population and it mentions that £2,989 was spent per person to offer them healthcare (ons.gov.uk, 2018a). However, in 2017, the Germany healthcare system is found to spend 11.3% of their GDP for offering healthcare support to the public. This equates to spending $5,728 per person for healthcare in the country (OECD, 2018). In 2017, the French government contributed 11.4% of their GDP for the healthcare indicating $4.902 being spent for each individual in the country (OECD, 2018). The figures inform that the UK government spends far less amount for improving and managing healthcare to be provided to the public compared to Germany and France. As mentioned by Loganathan et al. (2015), low healthcare expenditure by the government for care services and support create issues for gathering and maintaining healthcare resources. This is because lack of finances creates financial issues for the government to invest in to buy and arrange required resources for patients and service users.

Resources

The key human resources of healthcare for the population are the doctors and nurses as they are one who through right diagnosis of health issues of the proper provide them care by using of proper medication and care support techniques (Chib et al. 2015). The data regarding number of GPs present in various countries published by the World Bank indicates that there are 2.8 GPs on an average per 10,000 populations in the UK compared to 4.17 GPs pr 10,000 populations in Sweden and 2.6 GPs per 10,000 populations in the US as per data collected till 2014 (data.worldbank.org, 2019). This indicates that the number of GPs present in the UK is comparatively lower than Sweden but is slightly higher than in the US. Thus, it informs that UK healthcare in regarding human resource is lagging behind Sweden and needs to follow their principles to ensure more allocation of doctors per 10,000 populations so that effective care can be provided in timely and proper manner.

In 2010, it was found that there were 6.1 general health practitioners (GP) per 10,000 populations in Wales, 7.1 GPs per 10,000 populations in Scotland along with 6.7 GPs and 7.4 GPs per 10,000 populations in England and North East England respectively (nuffieldtrust.org.uk, 2014). The data collected in 2018 informed that there were 5.8 GPs per 10,000 populations in England, 6.3 GPs per 10,000 populations in Wales, 6.7 GPs per 10,000 population in Northern Ireland and 7.6 GPs per 10,000 populations in Scotland (nuffieldtrust.org.uk, 2019). Thus, the statistics indicate that though a small rise in GPs per 10,000 populations is located in Northern Ireland, Scotland and Wales but the number of GPs has fallen at a concerned rate in England with progress in years. Therefore in respect to create rise on GPs in the UK, England is the key area which is to be focussed at first in comparison to other areas as the numbers of GPS has fallen at a massive rate in the area.

The number of nurses and midwives present in 2017 mentioned by WHO for the UK is 82.8 per 10,000 populations whereas 85.5 nurses are present in USA and 115.4 in Sweden per 10,000 populations respectively (WHO, 2019). This informs that there is lack of effective presence of nurses and midwives within the UK compared to Sweden and the USA. As commented by Traczynski and Udalova (2018), shortage of nurses and health practitioners leads to an increase in deaths of patients. This is because the patients with health issues have to wait for longer time to access healthcare assistance. As argued by Chapman et al. (2018), lower number of nurses and health practitioners leads to create workload on them to care for large number of patients which leads them to make error in care and deliver low-quality care. This is because the nurses and health practitioners are unable to manage the way many patients are to be provided effective nature of healthcare in turn leading them to develop confusion resulting in hindered and care error. It is also evident as it is been reported that shortage of healthcare staffs has led the 4.3 million patients to be waiting to avail surgery which is highest in 10 years (theguardian.com, 2018). Thus, the shortage of human resource in the healthcare system of the UK compared to Sweden and the USA is to be resolved so that they can provide better health outcomes to the public.

The reports published in 2017 indicates that the number of hospital beds in England, the UK for mental illness, maternity, general and acute disease and day-only beds has comparatively decreased from 299,000 to 142,000 till 2017 for the past 30 years. However, the number of patients has considerably increased. The last collected data in 2013 by the World Bank regarding number of hospital beds present in various countries indicates that 28 beds per 10,000 populations were present in the UK whereas 29 beds in the US and 26 beds in Sweden is present per 10,000 populations in respective countries (data.worldbank.org, 2019). The statistics indicate that hospital beds in the form of healthcare resource are present in an increased amount in the UK compared to Sweden but are lower than the US. The presence of proper amount of hospital beds for the population is required so that the individuals suffering from major health issues who require continuous care from nurses and supervision from health practitioners are able to access proper support according to their need (Beeknoo and Jones, 2017). Thus, shortage of hospital beds in the UK even though it has more beds than Sweden would result majorly ill patients to be unable to receive required care, in turn, making them prone to experience complex health issues and death at early stage due to negligence of care.

In the UK, there are nearly 45,000 hospital consultants who receive salary between $95.539 and £100,446 each year. The salary of 42,000 general physicians in the UK is on an average $128,805each year and the GPs who are employed by the Primary Care Trusts received salary between $68,965 and $104,072 each year (telegraph.co.uk, 2012). In the US, it is seen that the average salary of health practitioners is $228,000 per year as per last reports in 2018 published by the Bureau of Labour Statistics (bls.gov, 2018). In Sweden, the average salary of resident physician is $55,020 per year, $92,523 per year for chief physician and $76,029 per year for specialist health practitioners (scb.se, 2018). The salary of district midwives and nurses in Sweden is $48,262 per year and geriatric nurses are $46,011 per year (scb.se, 2018). The average salary of student nurses in the UK is $69,869 per year and the registered nurses and midwives are $44,501 per year (indeed.co.uk, 2018). In the US, the average salary of a registered nurse is $73,550 per year (bls.gov, 2018). The figures inform that the salary of doctors or GPs or health practitioners in the UK is comparatively lower than Sweden as well as the US. As mentioned by Gill (2016), low salary of nurses and doctors leads them to experience lack of value for their efforts making them avoid showing interest in providing high-quality services. This is because lack of proper remuneration makes the doctors and nurses feel demotivate and less inspired to work as they feel they are being used.

Conclusion

The above discussion informs that the UK has been selected as the base country because even though its healthcare system is ranked at number position among 11 major European countries but their health outcome for the patients is at low level compared to other European counties. This is evident in the case of cancer and heart disease treatment it is seen that Sweden and the US are performing at a better rate than the UK. Thus, the major countries with which UK's healthcare system is to be compared are considered to be Sweden, the US, France, Germany, Norway and others. In order to analyse the healthcare system, the eight-factor model developed by is to be used. The four key factors from the model that are focussed are historical, structure, financing and resources. The historical factor regarding the UK healthcare system indicates that in 1946 the NHS was established as the central body to ensure offering free healthcare to the people. In Norway, at a similar phase after World War II the current healthcare system was implemented. However, Japan has developed its current healthcare system in 1922 indicating they have a better history of developing thinking to provide healthcare to all. In respect to structure, it was seen that Sierra Leone has followed a similar way of structuring their healthcare system like the UK but Nigeria is seen to have a decentralised healthcare system which is totally different from the UK. In respect to financing, it was seen that the amount of money spent by the UK for healthcare is comparatively lower than France and Germany. In regards to resources, it was seen that the number of hospital beds, salary of doctors and nurses and the presence of healthcare staffs in lower in the UK compared to Sweden and the US.

Recommendations

Increase resources: The UK Healthcare System is recommended to increase the number of health practitioners and nurses. This is because the increase in staffs would act to provide more efficient and immediate services to the service users as there would fewer patients per doctor to be diagnosed in turn offering the health practitioners have more time to be spent per patient and less workload to arrange care. In addition, the numbers of hospital beds are to be increased within the UK. This is because it would offer the opportunity to the patients to have lower waiting time and hindrance in accessing care. In order to achieve this, the UK healthcare systems are to increase numbers of hospital beds in the existing healthcare intuitions as well as arrange more hospitals to be opened within the UK. Moreover, they are to act to avoid closure of hospitals by providing proper funds to them.

Increase the salary of health professionals: The salaries of doctors as well as nurses are recommended to be raised in the UK. This is because in other countries such as the US and Sweden they offer the health professionals more salary than the UK which has result them to ensure better healthcare outcomes in the country. The rise in salary is recommended for UK healthcare system because it would help to increase more individuals to be engaged in the profession as they feel they can experience more value and benefit in the domain compared to others industries. In addition, increase in salary results to create competition among employees as they wish to achieve more productivity to get an increased salary, in turn, helping the organisations to deliver better care to the service users to ensure their well-being. The increase in salary would lead the doctors and nurses to have better social condition making them improve their performance out of zeal and improved stability.

Increase healthcare spending: The healthcare spending by the UK is comparatively lower than the other European countries. In this respect, it is suggested that the NHS, UK develop better budgeting policies and framework where more amount of money is present for developing healthcare in the country. This is because increased amount expenditure for the healthcare in the UK wild led the government to more effectively invest in medical researches and improvement to create and deliver innovative care services for the patients to ensure their improved well-being.

Focus on preventive care: The NHS, UK is suggested to create more focus on preventive care regarding diseases like cancer and cardiovascular diseases. This is because more individuals due to these diseases are dying in the country compared to other countries. In this respect, the UK healthcare system can call various healthcare companies to showcase medical equipment and pharmaceutical products to be used in ensuring better treatment of these diseases.

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