In the UK, the National Health Services (NHS) is the publicly funded healthcare system who provides care services to the public mostly free of cost except in few areas were minor charges are applied. The NHS was established under the National Health Service Act in 1946 along with the introduction of subsequent other regulation as well as legislation (nhs.uk 2018). In this poster, the factors which led to the creation of NHS is to be analysed along with the way it is responding to the changing demands in the healthcare field are to be explained. Moreover, the way changes made in the funding to healthcare have affected NHS is to be analysed.
Political: The political factors which led to the gradual creation of NHS can be dated back from the year 1900. This is evident as in 1906, when the liberal party took charge they tried to implement the ideology that shackles regarding poverty in the society are to be removed for the upliftment of the poor for which they introduced Old Age Pension Act in 1908 and National Insurance Act 1911 (researchbriefings.parliament.uk, 1908; researchbriefings.parliament.uk, 1911). In 1909, Lloyd George who was the Chancellor of Asquith introduced the “People’s Budget” under which he mentioned that taxation on the rich is to be increased through increase of the land taxes so that the extra money can be used for making social welfare projects to resolve poverty (Grimes, 2016). This can be regarded as the initial political factors which lead to the gradual creation of the NHS in later years and before this no budget was developed that supported to resolve poverty. Thus, with the introduction of the budget consideration regarding activities for the poor people was initiated.
After the end of World War I, the UK government faced increased demand for medical facilities and hospital services from the wounded soldiers and people of the UK. However, at the time due to expenses made for the war led the government has limited finances left to be used for meeting the demands (Ellis, 2019). This led the Labour Party of the UK to think of developing an organisation at the national level who would have the ability to provide care and meet demands of the public to most extent. In relation to the thought, within the 1920s and 1930s, the Labour Party tried to arrange resources to establish the thoughts (Middleton, 2019). In 1942, the Beveridge Report was published that mention effective steps had to be taken to improve the health of the UK citizen so that positive health environment can be promoted (nhs.uk 2018). In 1945, when the Labour Party came to power they used the Beveridge Report in 1946 to develop ideas in the NHS Act which resulted the development of NHS that came into power to allow free care services for all living in the UK (Sloman, 2016).
Social: In the 1930s, when the Great Depression came it expressed the extent of vulnerability being faced by the poor individuals in the UK in relation to their lifestyle and health. This is because during the condition it was seen that lack of health support from the government led many poor people of the UK die out of diseases and without any treatment since they were unable to bear the expenses to arrange cure for the conditions (Langthorne and Bambra, 2019). In addition, the Great Depression led many individuals of the UK to lose employment making them unable to maintain economic stability and arrange finances to avail required healthcare intervention for their health issues (Arora et al. 2016). Therefore, the rise of poverty and unemployment due to Great Depression led to become the social factors which aspire the creation of NHS as accessing fund from the government was thought to create low-cost healthcare to be available for all.
Ideology: During World War I and II, the labour movement started where the key focus was of socialist ideology that mentioned people of the lower class and living below poverty are to be uplifted so that they are able to live a better and healthy life. The Socialist Theory mentions that resources in the society are to be shared by all in equal manner so that all have the ability to live equally (Corrigan, 2019). Thus, the labour movement with the socialist ideology acted as the factor to influence politicians to think of developing a national organisation which has the ability to arrange equal healthcare services for all in the society irrespective of their social class to ensure effective health outcome for the population as a whole.
The changing healthcare scenarios in the UK lead NHS to develop different strategies and improvement in management for responding to the changes. The ageing population in the UK was found to be rising at a steady rate and more people in the UK were found to face various diseases that were at times incurable. This led the NHS to face £384 million (£14.8 billion in today's money) to be paid by the taxpayers and government in the financial year of 1951. In order to lower the rising financial burden for NHS, the UK government at the end of the year introduced expenses to be paid for spectacles and false teeth by the public (nuffieldtrust.org.uk, 2019). In addition, in 1952 when the Labour Party was removed from power and the Conservative Party came into power they led NHS to implement a charge of one shilling (equivalent to 5p in today's money) for each prescription so that the rising financial demand or burden on the government can be reduced to some extent (nuffieldtrust.org.uk, 2019).
In the UK, before 1994 there was lack of presence of proper scheme for arranging availability of organs to save the lives of the people. The progressing deterioration in health leads many people in the UK to require organ donation but the lack of scheme and management of organ availability often created health service complication. Thus, the NHS in 1994 developed the NHS Organ Donor Registration that allowed ease in the availability of organ in life-threatening and deteriorated health condition for the people so that their lives can be saved (nhsgraduates.co.uk, 1994). The rise of the technology leads NHS to gradually include telephonic services to deliver non-emergency care in 1998 and 1999 so that immediate care can be offered to the increased number of patients (improvement.nhs.uk, 2019). The rising complication of heart diseases, cancer, diabetes and others lead many people in the UK to face deteriorated health condition. The NHS to resolve the rising deterioration of health invested increased amount for updated research to develop new ways of treatment for improving the health outcome of the people. The NHS to eradicate infectious and deadly diseases as well as to meet the rising demand of the people to have improved health initiated different vaccination such as Vaccination for Flu, Rotavirus was initiated in 2013, Meningitis B in 2015, Cervical Cancer in 2008 and others (nhs.uk, 2018). In 2014, the NHS has published its Five Year Forward View to mention the nature of changes they are going to make in the next five years for ensuring better care as per the rising diamonds of the public (england.nhs.uk, 2019).
In 1948, the NHS was first launched then it was provided only £437 million that is roughly £9 billion at present to be used as funds to arrange care for the public (kingsfund.org.uk, 2019). However, in 2019-20 £139.3 billion is allocated to the NHS England alone to be spent for healthcare purpose. In 2019-20, the budget for the NHS Scotland was found to be £12.9 billion, for the NHS Ireland £13.8 billion and for the NHS Wales £192 million (kingsfund.org.uk, 2019; nhsconfed.org, 2019; audit-scotland.gov.uk, 2019). The figure on comparison to the first funding for NHS indicates that more funds are being allocated and it has impacted the NHS to create various changes as well as improvement in their services. The increased funding has affected the NHS to recruit more workforce so that workload on the existing staffs can be reduced as well as effective services can be provided by increased number of medical staffs for meeting the rising complicated demands of the UK individuals (kingsfund.org.uk, 2019).
The increased funding has affected NHS to increase the salary of NHS staffs as well as arrange incentives and improved support for them so that they are motivated and have the zeal to work with better efficiency. It is evident as in 2018, 29% hike in the salary of the NHS staffs was announced (independent.co.uk, 2018). This is because improved support makes medical staffs access help in resolving issues at work and the incentives and hike in salary help the medical staffs feel being properly remunerated for their effort, in turn, making them feel valued to provided greater effort in delivering quality care (Green et al. 2017). The improvement in funding has affected NHS to include updated medical equipment and technology in better diagnosis, treatment and healthcare services for the people with health disorder. The increased funding to the NHS has also affected them to deliver healthcare at low cost compared to various other world’s efficient healthcare system such as those established in Germany, France, Switzerland and others (england.nhs.uk, 2019). Therefore, it informs that overall improvement in the working nature if NHS is faced with the increased funds for them by the government.
The discussion mentions that social, political and ideological factors are initially responsible from the 1900 lead to the development of the National Health System (NHS) as free healthcare in the UK. The increased demands of better services have led NHS to change care support to be provided by trained staffs and with technological implementation, develop different healthcare schemes and programs, include legislations and others. The changes in funding for the NHS has affected them to create innovation and better changes in their services as well as work environment for the medical staffs to ensure quality care is delivered.
The introduction of market forces leads to competition which in turn helps to make effective management of large finances and provision for public services.
The introduction of threat of new entrants as market force leads the funds to be used in such a way so that the existing services are improved and high quality care compared to the previous existing services are provided. This is because better quality care in the medical field by the existing organisation would make the threat of new entrant to be lower as the new entrants would not be accessed by the existing patients out of their effective satisfaction with the services accessed from the existing organisations (O'Hara et al. 2017).
The introduction of threat of substitute products as market force in the medical field would lead the finances to be spent in such a way so that the existing products are improved and innovated to better quality (Pankomera and van Greunen, 2017). This is because it would lead to avoid the demand of substitute products to be avoided out of better satisfaction from the use of existing products.
The low bargaining power of suppliers as the market force would led the funds to be used in such a way so that medical resources are accessed from the suppliers who provides most-cost-effective products with high quality (Bova et al. 2019).
The low bargaining power the buyers exists in the UK healthcare industry which is going to lead the funds to be used according to the planned investment by the government to deliver healthcare services (kingsfund.org.uk, 2019).
The increased competitive rivalry as market force would lead the funds in healthcare environment to be used by assessing the quality metrics as well as clinical outcomes so that best way for delivering high-quality care can be developed to effectively satisfy the service users. The satisfaction of the service users is essential as it leads them to remain attracted to the organisation from whom they are accessing care instead of leaving them to avail care from others (Wogwu and Hamilton, 2018).
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Bova, F., Dou, Y. and Hope, O.K., 2019. Health Insurer Bargaining Power and Firms’ Incentives to Manage Earnings: Evidence From an Economic Shock. Journal of Accounting, Auditing & Finance, 34(3), pp.483-508.
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Green, M.A., Dorling, D., Minton, J. and Pickett, K.E., 2017. Could the rise in mortality rates since 2015 be explained by changes in the number of delayed discharges of NHS patients?. J Epidemiol Community Health, 71(11), pp.1068-1071.
Grimes, S.S., 2016. The British National Health Service: State Intervention in the Medical Marketplace, 1911-1948. London: Routledge.
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O'Hara, N.N., Nophale, L.E., O'Hara, L.M., Marra, C.A. and Spiegel, J.M., 2017. Tuberculosis testing for healthcare workers in South Africa: A health service analysis using Porter's Five Forces Framework. International Journal of Healthcare Management, 10(1), pp.49-56.
Pankomera, R. and van Greunen, D., 2017, May. Mitigating vulnerabilities and threats for patient-centric healthcare systems in low income developing countries. In 2017 IST-Africa Week Conference (IST-Africa) (pp. 1-11). IEEE.
Sloman, P., 2016. Beveridge’s rival: Juliet Rhys-Williams and the campaign for basic income, 1942–55. Contemporary British History, 30(2), pp.203-223.
Wogwu, V.E. and Hamilton, D.I., 2018. Reconfiguration Capability and Competitive Advantage: A Study of Port Harcourt Public Health Sector. Management, 8(2), pp.47-53.
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