How Social Policy Had An Impact On The Nhs Social Work Essay

How Social Policy Had An Impact On The Nhs Social Work EssayThis essay is a discussion of how Social Policy had an usurpation to the National wellness Service (NHS) the essay will pace the discussion in the context of some of the economic, political and complaisant concepts that influence the education of favorable indemnity in the NHS. It also discusses the impact of the social policies in relation to social exclusion, in comparison and/or poverty. While evaluating the effectiveness of these policies, it will explore the relationships among the varied agencies involved in social welfare provision.Social policy is aimed to break human welfare and meet human needs (Ken 2007 pg 1). During the 1942 Beveridge report on social security, it was recommended that a comprehensive national dish up should be developed to combat ill health after the Second World War. In 1944 proposals were brought up for the development of the NHS, legislation was passed in 1946 and in 1948 NHS started its operation after the National Health Act (1946). It provided a comprehensive service to the whole population at a relatively low cost. It was to be run nationally and mainly financed from taxation and a small token from National Insurance Fund and was substantially bump at the point of sales talk Howard (2000). All citizens had to be registered with a family doctor in order to receive give up treatment for miner illness and be referred on to infirmarys for those conditions that the General Practitioner (GP) could not treat. The NHS had popular support in the 1940s and in 1944 Henry Willink the standpat(prenominal) Minister of health, described the health proposals as representing the very root of national vigour and national enterprisethe biggest single advance ever made in this country. Webster (1988), Howard (2000 pg98).Despite its achievements and popularity since the mid-eighties, the NHS has come under increasing extort and strain from the conservative judicatures whi ch shake seen it as a burden on the economy. It has come under intensive criticism for being professionally dominated, unresponsive to consumers and internally inefficient and ineffective in the use of resources. And as a result in the 1990s the NHS and community Act come in to force and introduced changes that have been seen as the most radical since the 1946 Act that created the service. Though the NHS remained tax funded at the point of delivery, this Act recommended the basis of an internal or quasi market and the introduction of a split of the NHS budget between those who purchased the services for their population and those who provide the services. The command and control model of the NHS with the Top-down directives was replaced by a system where the topical anaesthetic purchasers negotiated contracts with the providers also emphasis was placed on introduction of audit system and better monitoring of performance. Purchasers (the districts) determined what services they wa nted and who they should be bought. This means that the concern costs were a priority for the purchasers than the quality of the services. The aim of the conservative government in introducing the markets was to drive up standards and increase accountability (Enthoven, 1985).The conservative government came into exponent in May 1979 strongly influenced by the political philosophy of the New Right government policy in general strongly promoted business and mystical enterprise and sought to discourage individuals and families from succumbing to welfare dependency. Reliance on the market (not the state), increased the competition and to a greater choice for individuals- consumer sovereignty- were the principles which underpinned a plethora of policies during the 1980s and 1990s. Individualism was lauded over collectivism Dorey (2005p.104). Thatcher applied policies of Milton Friedmans monetarism (1980) that aimed at controlling ostentation by reducing government borrowing and subsi dise industries through privatisation. This involved exchange government funded services to companies and individuals who had property to invest Jenkins, (1987). The main aim was to raise money and pay off the government debts and to improve efficiency of nationalised industries. The National Health Service was not privatised but was reorganised into parts, the medical which was dealt with by the government while the ancillary was privatised to competitive tenders from private companies (cheap bidders win). It was assumed that competition would increase efficiency, sign costs, create social justice in order for everybody to get equal treatment and discipline medical behaviour. But all this did not work place as planned. For example infirmarys were not properly cleaned leading to an increase of infections like Methicillin Resistant Staphylococcus Aureus skin infection (MRSA) and Clostridium Difficile (CDF).It can be concluded that the Thatchers politically influenced policy bet ters were aiming at privatisation through the creation of market which is contrary to the foundation principles of NHS which are free at the point of delivery. This argument leads one to question whether Thatcher had prepared the NHS for these radical reforms. But also one wonders if the government had planned how the poor would access NHS services without being excluded on financial merit.King (2005) asserts that there was no immediate overhaul of the NHS in order to render it compatible with and complementary to these new values as it encouraged greater use of private health trouble while from 1983, health authorities were required to contract out domestic, catering and laundering service. In relation to poverty and inequality, it can be argued that this policy created unemployment for those who lost their jobs during the privatisation and also those who could not afford to pay for private health care they were excluded from accessing the services.However, Haus argues that Marga ret Thatcher saved the British economy by bringing both the inflation and unemployment under control and by creating a much dynamic private sector they called a third way that combines the best aspects of the socialist commitment to equality and market economy. But to her opponents, Haus says that they viewed her policies as new problems and exacerbated existing ones by widening the gap between rich and the poor and by allowing public services to degenerate (Haus 2009).Much as the privatisation policy appears controversial from Haus perspective, the element of controlling inflation and saving the British economy from the 1980s depreciation implies that there were economic drivers that influenced Margaret Thatcher to reform the policies. This argument is supported by Alcock. He states that social policy development is also closely dependent upon the economic structure of the clubhouse and upon the economic outgrowth within it (Alcocks 2008 p.198).One of the new crunchs main obje ctives when elected in 1997 was to make significant improvement in the NHS and in line with that the NHS was to be rebuilt. The government personate forward its plans in a White paper. (The new NHS Morden dependable Department of Health 1997).Following the publication of the white paper on the NHS in 1997 and a various other consultation document, wide ranging health reforms were discussed which led to the Heath Act 1999.This Act brought key changes in the NHS. The internal markets which were introduced by the Thatcher government in the 1990s were replaced by a new policy which encouraged co-operation and partnership between health services and between the NHS social services and other care providers.In 2001 primary care groups were established in every area of England with the aim of running the health services. The primary care groups were formed by topical anesthetic groups of doctors and nurses, theses organisations were to oversee the delivery of primary health care to the t opical anesthetic community through family doctors. They also directed resources available to the NHS trust and other health service organisation (Blackmoore, 2003).The health Act 1999 together with the health Act 2001 led to the introduction of the Primary Care Trusts which were meant to run health and social service jointly. gibe to Downey ( 2001 p 34) the health and social Act of 2001 led to a radical shake up of the social service never seen in three decades. The Labour government under Tony Blair made significant changes to the doctors contracts due to economic factors, mainly limitations of the capitation system in GP funding. Instead it introduced what was termed as modern contracts for GPs and hospital doctors. The contracts were to be quality based and doctors were paid on condition upon reaching certain performance targets. GPs were required to meet specified improvements in preventative care as well as quality of their services to patients. The General Practitioners (GP s) were budgeted and were expected to work within those budgets to meet the needs of their patients. They were rewarded if they managed to work within their budgets and given additional money for running health promotional clinics. They were to shop around for the cheapest provider for their patients. However as they were reluctant to accept patients who would drain on their budgets thus care for the throng who needed it most in most cases suffer. Shaun et al (2001).Inspection of the health service was introduced together with the central regulation. This meant that the health care standards and health service delivery were to be monitored by an organisation known as the national institute for clinical excellence. This body was to decide which drugs and new treatments are to be available to patients free on the NHS.In line with the above, another regulatory body was set up. It was known as the Commission for Health Improvement (CHI). This body was to inspect the standards of hospit al and primary care. In fact this body was meant to act as Ofsted in providing confederation tables of schools and colleges but for CHI it created hospital performance league tables by publishing patients survival rates after various hospitals and operations.In contrast however, the publication of league tables with ranking of performance, create negative impact to the primary care trusts and hospital located at the bottom of the table that they provide worst services. It also creates negative impact on the public trust and professional moral because module may be demoralised in reaching its maximum potential for better services if their hospital is considered to be under performing. Again the use of league tables do not really reflect the quality of hospital treatment, because they include a small number of key clinical areas and doubt go into fact around the process of care. What they really show is the effectiveness of trusts management team rather than standard of clinical care. More so, even if patients are aware of their local hospital performance, they have no choice about where to get better treatment because hospital referrals are decided by GPs.In 1997, the labour government under Blair recommended a welfare review. However, there was no attempt to reverse the changes made by Thatcher and accepted that there can be no turn back to the Golden Age. The main welfare provision that Labour introduced is called WELFARE TO WORK, A NEW DEAL. It was aimed at helping groups especially young, lone parents and long-term unemployed who desire on benefits, to find work and support themselves. Labours approach was to find a third way between the Golden Age welfare state and the conservative changes. The government introduced a minimum wage to make-work more attractive than claiming benefits. The Blair government did a lot to improve the NHS and in 2002 Blair staked the future of his government to improve the NHS.The distribution of wealth in Britain saw a nu mber of arguments, which were about equality, and the impact of welfare state on various sectors in society.Capitalist do not fund welfare systems as the workers pay for it through direct taxation they pay for their own health. Poor people carry far more of the tax burden in real terms than the wealthy because the cost of the indirect tax such as VAT on items such as beer and cigarettes take a large portion of their income (Shaun et al, 2000) the wealthy benefits more the welfare state than do the poor such as tax relief on mortgages.Socialist. The socialists argue that the welfare of individuals is the responsibility of the state. They argue for redistribution of income through taxation so that the rich can fund the welfare of the poor. They wish to change the structure of the society to benefit the poor and bridge the gap between rich and poor. The socialists argue in favour of universal access to welfare and are opposed to targeting benefit.Liberals. They argue that welfare is ne eded to support capitalism and to support the poor. Writers such as Anthony Giddens, suggest that the state cannot leave some of the problems to market forces to solve because these problems are too big or too complicated .The liberals sort out problems as they arise without either looking for them or allowing any rigidly held views influencing common moxie views of the events.In conclusion welfare state developed due to a number of factors contributing poverty, sickness, high levels of unemployment after the Second World War. The recommendations of the Beveridge report about the five evil giants influenced the government to introduce the welfare state and to the subsequent changes to the NHS.