Healthcare in the United Kingdom: Difference between revisions
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=== Cost recovery === |
=== Cost recovery === |
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Each NHS system reserves the right to claim compensation for treatment required as a result of the negligence of others, such as when compensation is received from motor insurance companies through the Injury Costs Recovery Scheme following the determination of fault in motor accidents. |
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=== Dentistry === |
=== Dentistry === |
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Revision as of 16:04, 27 July 2008
Healthcare in the United Kingdom is mainly provided by four publicly-funded health care systems: the National Health Service (that covers England), NHS Scotland, NHS Wales and the Department of Health, Social Services and Public Safety that provides public healthcare in Northern Ireland. Each system has in common that it provides healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation. However, healthcare is a devolved matter and there are significant and growing differences between the systems.[1][2] In addition to the public NHS systems (which dominate healthcare in the UK), private healthcare and a wide variety of alternative and complementary treatments are available.
For details of healthcare provision in each of different countries of the United Kingdom, see;
Similarities between public systems
Advice services
Each NHS system runs 24 hour confidential advisory services: NHS Direct provides a telephone-based service for England and Wales while Scotland has a similar system, called NHS24.[3]
Ambulance services
Each public healthcare system provides free ambulance services for patients facing life-threatening emergencies or if ordered by hospitals or GPs where patients need the specialist transportation only available from ambulance crews.
Cost recovery
Each NHS system reserves the right to claim compensation for treatment required as a result of the negligence of others, such as when compensation is received from motor insurance companies through the Injury Costs Recovery Scheme following the determination of fault in motor accidents.
Dentistry
Each NHS system provides dental services through private dental practises and dentists can only charge NHS patients at set rates (though the rates vary between countries.) Patients opting to be treated privately do not receive any NHS funding for the treatment. About half of the income of dentists comes from work sub-contracted from the NHS[4]. Not all dentists choose to do NHS work and there is a trend of movement from the NHS to private dentistry.
General practitioners
General practitioners are qualified doctors, typically working in business practices that deal exclusively with NHS patients and receive fees based on the number of patients and the different services provided by the practice under the GP contract. Doctors are not allowed to charge for services provided as part of the contract, which almost all care is. All people are eligible for registration with a GP, usually of the patient's choosing, though the GP must be local to the area in which the person lives. GPs can only reject patients in exceptional circumstances.
The role of the GP is to be the primary carer for the patient and to make referrals to other specialist NHS services as necessary, whether for tests or treatments. Test results are returned to the referring doctor who may then prescribe drugs. GPs do not usually follow their patients into hospital for elective treatment as is the practice in some countries. The GP will follow the patient's progress from treatment to recovery and will be involved in the drawing up of a care plan for a patient before discharge if the patient has special care needs. All treatments given at hospitals are reported back to the home GP, so there is a single record of a patient's medical history.
If patients are unable to get to the doctor or clinic because of illness or because the case is urgent and the surgery is closed, they may be seen at home by the GP or a doctor acting as locum for the GP. Home visits can be provided by District and Community Nurses as part of continuing care following discharge from hospital.
Pharmacies
In all countries of the UK, pharmacies are privately owned but have contracts with the relevant health service to supply prescription drugs. Pharmacists bill the relevant health service for the costs of prescriptions less any fees received from the patients.
Differences between public systems
Cost control
Each constituent part of the NHS (e.g. a trust or GP practice) is responsible for overall control of costs within its area of operation.
The National Audit Office reports annually on the summarised consolidated accounts of the NHS, and Audit Scotland performs the same function for NHS Scotland [5].
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. In Scotland, the Scottish Medicines Consortium performs a similar function. However, the Scottish system makes some new drugs available for prescription more quickly than in the rest of the UK which has led to complaints.[6]
Prescriptions
In England, patients under 16 years old (19 years if still in full-time education) or over 59 years will get the drug for free. There are also exemptions for people with certain medical conditions, and those on low incomes. Prescribed contraception is also issued free of charge (e.g. contraceptive pills). Otherwise, as of April 2008, a fixed charge of £7.10 is payable per item.
In Northern Ireland, patients under 16 years old (19 years if still in full-time education) or over 59 years will get the drug for free. There are also exemptions for people with certain medical conditions, and those on low incomes. Prescribed contraception is also issued free of charge (e.g. contraceptive pills). Otherwise, as of April 2008, a fixed charge of £6.85 is payable per item.
In Scotland, patients under 16 years old (19 years if still in full-time education) or over 59 years will get the drug for free. There are also exemptions for people with certain medical conditions, and those on low incomes. Prescribed contraception is also issued free of charge (e.g. contraceptive pills). Otherwise, as of April 2008, a fixed charge of £5 is payable per item with the intention is to phase out prescription charges before 2011.
In Wales, prescription charges have been abolished and all prescription drugs are now dispensed without charge.
Role of private sector in public healthcare
Whereas the UK government is expanding the role of the private sector within the NHS in England[7][8], the current Scottish government is moving in the opposite direction, actively reducing the role of the private sector within public healthcare in Scotland[9] and planning legislation to prevent the possibility of private companies running GP practices in future.[10]
See also
Footnotes and references
- ^ NHS now four different systems BBC January 2 2008
- ^ A four-way split on the NHS BBC News, July 4, 2008
- ^ NHS24, About Us
- ^ "Call for dentists' NHS-work quota".
{{cite web}}: Text "BBC" ignored (help) - ^ NAO report (HC 129-I 2007-08): Report on the NHS Summarised Accounts 2006-07: Achieving Financial Balance
- ^ Call for quicker drug decisions BBC News, January 10, 2008
- ^ Private firm to carry out surgery BBC News, August 5, 2007
- ^ £64bn NHS privatisation plan revealed guardian.co.uk, June 30, 2006
- ^ Plans to end private cash for NHS BBC News, 21 June, 2007
- ^ Sturgeon to end privatisation of GP practices Sunday Herald, June 8, 2008
External links
- Common questions about NHS services and Treatments(only applies to NHS in England)