Amazon health and personal care

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Amazon health and personal care
Amazon health and personal care

Amazon health and personal care

Amazon health and personal care
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Health care facilities and personnel increased substantially between the early 1950s and early 1980s, but because of fast population growth, the number of licensed medical practitioners per 10,000 individuals had fallen by die late 1980s to three per 10,000 from the 1981 level of four per 10,000. In 1991 there were approximately ten hospital beds per 10,000 individuals.

Primary health centres are the cornerstones of the rural health care system. By 1991, India had about 22,400 primary health centres, 11,200 hospitals, and 27,400 dispensaries. These facilities are part of a tiered health care system that funnels more difficult cases into urban hospitals while attempting to provide routine medical care to the vast majority in the countryside. Primary health centres and sub-centres rely on trained paramedics to meet most of their needs.

The main problems affecting the success primary health centres are the predominance of clinical and curative concerns over the intended emphasis on preventive work and the reluctance of staff to work in rural areas. In addition, die integration of health services with family planning programmes often causes the local population to perceive the primary health centres as hostile to their traditional preference for large families. Therefore, primary health centres often play an adversarial role in local efforts to implement national health policies.

according to data provided in 1989 by the Ministry of Health and Family Welfare, the total number of civilian hospitals for all states and union territories combined was 10,157. In 1991 there was a total of 811,000 hospital and Amazon health and personal care health care facilities beds. The geographical distribution of hospitals varied according to local socio-economic conditions. In India’s most populous state, Uttar Pradesh, with a 1991 population of more than 139 million, there were 735 hospitals as of 1990. In Kerala, with a 1991 population of 29 million occupying an area only one-seventh the size of Uttar Pradesh, there were 2,053 hospitals. In light of the central government’s goal of health care for all by 2000, the uneven distribution of hospitals needs to be re-examined. Private studies of India’s total number of hospitals in the early 1990s were more conservative than official Indian data, estimating that in 1992 there were ^300 hospitals. Of this total, nearly 4,000 were owned a1(d managed by central, state, or Amazon health and personal care local governments. Another 2,000, owned and managed by charitable trusts, received

partial support from the government, and the remaining 1,300 hospitals, many of which were relatively small facilities were owned and managed by the private sector. The use of state-of-the-art medical equipment, often imported from Western countries, was primarily limited to urban centres in the early 1990s. A network of regional cancer diagnostic and treatment facilities was being established in the early 1990s in major hospitals that were part of government medical colleges. By 1992 twenty-two such centres were in operation.

Most of the 1,300 private hospitals lacked sophisticated medical facilities, although, in 1992, approximately 12 per cent possessed state-of-the-art equipment for diagnosis and treatment of all major diseases, including cancer. The fast pace of development of the private medical sector and the burgeoning middle class in the 1990s have led to the emergence of the new concept in India of establishing hospitals and health care facilities on a for-profit basis.

By the late 1980s, there were approximately 128 medical colleges—roughly three times more than in 1950. These medical colleges in 1987 accepted a combined annual class of 14,166 students. Data for 1987 show that there were 320,000 registered medical practitioners and 219,300 registered nurses. Various studies have shown that in both urban and rural areas people preferred to pay and seek the more sophisticated services provided by private physicians rather than use free treatment at public health centres. Indigenous or traditional medical practitioners continue to practice throughout the country.

The two main forms of traditional medicine practiced are the ayurvedic (meaning science of life) system, which deals with causes, symptoms, diagnoses, and treatment based on all aspects of well- being (mental, physical, and spiritual), and the unani (so- called Galenic medicine) herbal medical practice. A vaidya is a practitioner of the ayurvedic tradition, and a hakim (Arabic for a Muslim physician) is a practitioner of the unani tradition. These professions are frequently hereditary. A variety of institutions offer training in indigenous medical practice. Only in the late 1970s did official health policy refer to any form of integration between Western-oriented medical personnel and indigenous medical practitioners. In the early 1990s, there were ninety-eight ayurvedic colleges and seventeen unani colleges operating in both the governmental and non-governmental sectors.

The Indian constitution charges the states with ‘the raising of the level of nutrition and the standard of living of its People and the improvement of public health’. However, many critics of India’s National Health Policy, endorsed by Parliament in 1983, point out that the policy lacks specific measures to achieve broad stated goals. Particular Problems include the failure to integrate health services With wider economic and social development, the lack of Nutritional support and sanitation, and the poor participatory involvement at the local level.

Central government efforts at influencing public health have focused on the five-year plans, on coordinated planning with the states, and on sponsoring major health programmes. Government expenditures are jointly shared by the central and state governments. Goals and strategies are set through central-state government consultations of the Central Council of Health and Family Welfare. Central government efforts are administered by the Ministry of Health and Family Welfare, which provides both administrative and technical services and manages medical education. States provide public services and health education.

The 1983 National Health Policy is committed to providing health services to all by 2000. In 1983, health care expenditures varied greatly among the states and union territories, from Rs.13 per capita in Bihar to Rs.60 per capita in Himachal Pradesh, and Indian per capita expenditure was low when compared with other Asian countries outside of South Asia. Although government health care spending progressively grew throughout the 1980s, such spending as a percentage of the gross national product remained fairly constant. In the meantime, health care spending as a share of total government spending decreased. During the same period, private sector spending on health care was about 1.5 times as much as government spending.

In the mid-1990s, spending on health amounts to 6 per cent of GDP, one of the highest levels among developing nations. The established per capita spending is around Rs.320 per year with the major input from private households (75 per cent). State governments contribute 15.2 per cent, the central government 5.2 per cent, third- party insurance and employers 3.3 per cent, and municipal government and foreign donors about 1.3, according to a 1995 World Bank study. Of these proportions, 58.7 per cent goes toward primary health care (curative, preventive, and promotive) and 38.8 per cent is spent on secondary and tertiary inpatient care. The rest goes for non-service costs.

India is a pluralistic, multi-lingual and multi-ethnic nation which accounts one-sixth of the world’s population occupying less than 3% of the world’s area. In India, since the last 10 years considerable work has been undertaken related to health and hospital sector reforms, which has involved various government, worldwide multilateral agencies and other stakeholders. Delivering affordable health care to India’s billion plus people presents enormous challenges and oppturunities for the medical community. The practice of medicine is becoming increasingly complex and time consuming. Political ideologies play a major role in determining the health policies of the country through decisions on resources allocation, choice of technology, human resources policy and degree to which health services are to be made available to the population.

No health care system in the world is stable. To start with health care sector has to become the priority sector for the government of india.The Indian health care sysyem must have a broader scope and biggert purpose.The government of india has taken a smart fight against HIV, T.B, Tobacco.The launch of massive programmes like The National Rural Health Mission (NRHM) and National Urban Health Mission(NUHM) by the government of india and ban on smooking in public places is a proof that Indian government is committed to health care of its population.

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To start by the fact that higher spending does not mean better health care . We have the case of America where 17% of the GDP goes on health care , still 77% of Americans have at least one chronic disease(1 out of 2 americans have a chronic disease and 7/10 people die of chronic disease).So we must not pursue wrong goal of just doubling the health care spending as a percentage of GDP. India is a young nation with 60%of its population below 40 years of age therfore We need a system that is outcome driven.Its high time that we converte our slogan from food, clothing and shelter to food, clothing and health care.

According to WHO, India has 14% of its population suffering from arthritis(approx 140 million), 10% suffering from Hypertension(approx 100 million).Accroding to international iabetes federation, approximately 5% of Indian population suffers from diabetes(50 million) and elderly people in india accounts about 150 million.

I believe that we have been already been late for this generation but we must build a robust healt care model for coming generation.We need to bring change in government policis,medical curriculum and channels to delivery of care across health care spectrum.

Constraints and challenges in health care sytem

Problem of distribution

India has a serious problem with focus and allocation of health resources, we are quite urban centric. Asurvey by Indian medical society had found that 75% of the qualified consultant doctors practice in urban centers , 23% in semi urban ares and only 2% in rural urban ares(where 65% of the toatal population live)

Preventaive care

The problem of not adopting a preventive health care is that aging population requires more health care treatments with lower earning and paying capacity. Earnings reduces with age but health care problems increases and this will put young nations of today into serious economic and developmental crisis in the next 20 years.

Financial constraints

Health expenditure was 5.9% of the national budget in the year 2009 compared with 7.6% in 1990 and 8.4% in 1985. The running cost of extensive health care infrastructure is high and can not be met with the current level of expenditure. Moreover Investment in medicine and human being support is required to fortify national capacity for first-class manufacturing practices in order to produce essential drugs, vaccines and medical supplies. Health is largely financed by the private sector. Per capita public health expenditure is nearl20 Intl.$ per annum. Due to inadequate budget and pressure to achieve targets, several states upgraded two-roomed sub-centres to full PHCs. With limited space for laboratory, examination, pharmacy, etc., many are not fully functional. Location also is a problem. Nearly 25% of the people in Madhya Pradesh and Orissa could not access medical care for locational reasons.

Expertise and other physical constraints

After 62 years of independence essential expertise such as handling medical emergencies , complications of pregnancy and childbirth, treatment of acute and severe infection in children and In aged patients , injuries and acute surgery, are sometimes compromised because in India, a basic medical degree without a specialization is of not much use and there are so few graduate specialization seats that competition is fierce. In addition, the problem is getting worse day by day : expertise in India are leaving medical schools for better-paying jobs in private hospitals and in the biotech and pharmaceutical industry, forcing the medical schools to cut the size of their programs. And students who would have studied medicine a generation ago are pursuing more lucrative careers in the technical sector. Hospital infection control procedures require strengthening and even Work place wellness (Occupational health) is not established in india.

New paradigm of health care

Government action

We need a central health authority along with state authority in every state to focus n Health Risk Managemant., Health awareness, Mother and child care , Occupational health and Disease management.Government should hold the sole responsibility for awareness creation about wellness and disease sepeartely and both should be handled by different departments .

India also need an epiddemological survey as wee need to be more scientific in whatever we do to have an outcome.Moreover all the admissions after high school should have a basic health check up as prerequisite and marriage certificate should only be issued after comprehensive risk management.Furthermore government should start a 24 hors health channel Day acre centers for minor surgeries.

Chronic disease

Chronic disease cannot be controlled by prescription alone.I t involves behavioral and life style change and this calls for counseling. Moreover doctors, Pharmacists and Nurses should be trained in the treatment and dealing of chronic diseases. In addition to that patient’s family should be involved and government should immediately start a Central/State disease registry so that patients must be registered under the same by path lab itself.

Finacial incentives in health Crae

Telemedicine hold a promise when it comes to health care delivery in more than 3billion villages. Appolo hospitals just launched a telemedicine service , a combination of technology, telemedicine , preventive health care , training of the district health care workers and their doctors by going out , travelling overnight by train or by car in the rural area , conducting free medical camps and voluntary organizations , operating in theaters over there or doing consultations .Such companies and hospitals should be given tax rebate and health professionels working in rural india should be given 50 or 100% tax free income based on the regional disparities. Pharmaceutical and other biotech companies that sponsor health checkups in the communities should be given 50% tax rebate.

Medical curriculum

Far reaching requires changes even in medical curriculum.The government should not allow MBBS doctors to do post graduation till they spend 2 months each in rural health, Panchayat health centres and pharmacies. Moreover doctors going in rural area should be given loans at cheaper rate .

Public private parternship(PPP)

Public –private cooperation should be made at secondary and tertiary care. The effort to cure infectious diseases that kills millions of people around the world require both a push and pull mechanism to engage the private sector with government in sustainable solutions. Government can provide some money to “push” discovery and development of various drug and vaccines in India that biotech and pharmaceutical firms would otherwise tend to disregard and overlook. However companies necessitate to recognize that they will be awarded if effective treatment or cure is acknowledged. The “pulls” can be generated through a number of public private paternships that seek new behavior to create viable markets for pioneering health care services and products. This will provide scientific creditability, optional solidity and stability , Finacial feasibility and political viability.

New models

The government must ideate and try new low cost models where the primary preventive care can be availed at Rs 2(INR) per day.Imagine , if we get 5000 people to pay Rs 2 a day, we can achieve Rs 3 lacs per month per facility and this can be used to have two full time doctors, two nurses and two counselors to provide basic care to the population of 5000 people around the clock.

Therefore we need to find new models and steps for inclusive growth in health sector in India. very minority number of hospital groups are economically smart and overseas direct asset is going into every other sector in india and not so much in healthiness care.We have to decentralize the key element of reform process and set in motion the concept of PPP into newer magnitude by receving Pollicy attention in a major way. Today’s sculpt of health care are not solutions for tomorrow’s health care troubles. Private sectors should be seen as a national assest and alternate service delivery systems should be considered.

A healthy nation they say is a wealthy nation. Healthcare is important to the society because people get ill, accidents and emergencies do arise and the hospitals are needed to diagnose, treat and manage different types of ailments and diseases. Many of people’s aspirations and desires cannot be met without longer, healthier, happy lives. The healthcare industry is divided into several areas in order to meet the health needs of individuals and the population at large. All over the world, the healthcare industry would continue to thrive and grow as long as man exists hence forming an enormous part of any country’s economy.

Healthcare is defined as the diagnosis, treatment, prevention and management of disease, illness, injury, and the preservation of physical and mental well-being in humans. Healthcare services are delivered by medical practitioners and allied health professionals (http://en.wikipedia.org/wiki/Health_care).

The National Health Service (NHS) is the provider of healthcare to all permanent residents in England. The services provided by the NHS are free at the point of use and paid for from general taxation. Although, there are charges associated with other aspects of healthcare such as eye tests, dental care, prescriptions, and many other aspects of personal care. The NHS is guided by series of policies as outlined by the Department of Health from time to time. All Health policy in England and the rest of the UK rests on the National Health Service Act of 1946 which came into effect on 5th July 1948, launched by Minister of Health, Aneurin Bevan during the opening of Park Hospital in Manchester.

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In this write-up, I would be analysing healthcare policy, provision and funding in England. I would also assess and evaluate the impact that culture and the society has on healthcare as well as the people’s attitude towards healthcare.

The role of public health and health promotion in the provision of healthcare services can not be over emphasized. I would also assess national and international socio-political issues in the promotion of public health, an analysis of the impact of international campaigns and national policies on the demand for healthcare would be done. I would also evaluate the role of health promotion in determining healthcare service demand in England.

Contemporary issues affecting healthcare in England would be identified and an evaluation of their impact on national and international policy as well as practical responses to these issues would be done.

The World Health Organisation (WHO) defines health policy as decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. The aim of health care policies is to define a vision for the future which in-turn helps to establish targets and points of reference for the short and medium term. It also outlines priorities and the expected roles of different groups; and it builds consensus and informs people.

Policy governs and informs the planning and implementation of both strategies and projects, and provides a framework for the professional development of the workforce (Porter and Coles, 2011). However, polices can take on different forms and may be communicated in different ways.

Culture is a way of life; it is the way we do things. It is defined as the way of life of a particular society or group of people; it includes the patterns of thought, beliefs, behaviour, customs, traditions, rituals, dress, language, art, music, as well as literature (Webster’s New World Encyclopedia, 1992).

Culture as defined by dictionary.com is the behaviours and beliefs characteristic of a particular social, ethnic, or age group. It is a group’s shared set of beliefs, norms, and values.

The cultural differences and way of life of people have a great impact on the way they assess their health and well-being as well as their attitude towards healthcare. It affects their attitude and understanding of the cause of an illness and how to manage them as well as the consequences of medication and medical treatments. This also has an effect on people’s expectations on healthcare delivery.

There are diverse groups of people living in England as a result of migration and they are diverse in the fact that they are of different age, sex, gender, race, ethnic background, colour, religion, beliefs as well as cultural background. It is important for health and social care practitioners to understand and cope with all these differences as it affects the way people react to healthcare provision.

In England, every resident have access to free healthcare provided by the NHS. However, people can still go to private hospitals if they wish to but they have to pay for the medical services they receive by themselves or by their health insurer.

For religious reasons people also have different beliefs and how they perceive healthcare delivery and sometimes how they react to medical practitioners. For instance, Muslim women do not allow male medical practitioners to attend to them especially when it has to do with the exposure of their private parts. Jehovah’s witnesses do not consent to the use of blood transfusion.

Using the PEST analysis, I will be assessing how several factors have influenced people’s attitude towards healthcare in England.

Political factors: a new government with new agenda and mission to fulfil their manifestos pass new laws about health and health reforms. With the government of the day wanting to cut cost; so many benefits of the citizens has been drastically reduced. These include a cut in energy allowance for the elderly, cut in healthcare allowance and so on.

Economic factors: the global economic downturn has made the government of the day to cut cost and introduce policies and agenda which has made people loss job and become unemployed. How well the government of the day react to these issues will determine the extent to which the health and well-being of its entire populations are protected. During these times, some people may become depressed, and become mentally ill.

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Social factors (inequalities, discrimination): for instance, when people become depressed and mentally ill during recession, they become discriminated upon by colleagues, friends and sometimes close family members. The loss of a job too makes people to socialise less often and prefer to live in isolation most times and this can have a great impact on their health.

Technological advancement: this has drastically affected healthcare delivery in recent times. Diagnosis and treatment of diseases with the use of technological equipment have gone a long way in making things easier and faster for healthcare professionals and the patients as well. Treatment can be done faster and accurately too. For instance, the use of radiotherapy in the treatment and control of cancer. However, such treatments are sometimes rejected by the patient due because of the after effects it will have on them. A recent example is Sally Roberts who resisted radiotherapy being done on her son who has brain tumor (the guardian news UK).

Environmental factors: a change in the weather e.g. snow, heavy rainfall and flooding also affect people’s attitude and spending towards healthcare. Many become very ill, catching a cold, having flu and fever in cold temperatures, making them to visit their local G.Ps more frequently, and spending more on medication as well. The government tend to spend more and healthcare professionals tend to be more engaged during these periods. Emergency services work round the clock saving people.

HISTORY OF THE NHS

Healthcare in England would not be complete without taking a look at NHS, its history and how it has evolved over time. NHS is the major provider of healthcare in England as earlier mentioned in the introduction. For this purpose of this assignment, I would be analysing only the major events that happened in the NHS decade by decade.

The Second World War ended in 1945 leaving many soldiers dead and lots wounded who needed quality healthcare and some suffering from post war depression and all other kinds of ailments and diseases. Right after the war, there was heavy storm and flooding in the following year causing destruction, industrial and economic breakdown. With no money to spend on proper and balanced diet, people are left with malnutrition and became prone to various infectious diseases and so on.

This led to the government wanting to create a system whereby good healthcare can be available to all regardless of wealth and to bring all healthcare professionals under one umbrella, hence the creation of the NHS. Before the start of NHS, access to healthcare in England was funded by each individual that needs healthcare services. There are also fewer hospitals and fewer Doctors.

After the creation of the NHS in 1948, there have been lots of innovations, inventions and discoveries through the use of research.

In the early 1950s, one shilling (5p) and £1 respectively for prescription charges and dental treatment was introduced, however the prescription charges was abolished in 1965 and later re-introduced in 1968. This was followed shortly by the revelation of the DNA (deoxyribonucleic acid) structure by two scientists, James D. Watson and Francis Crick. The DNA is a material that makes up the gene and passes hereditary characteristics from parent to child. This allows the study of diseases caused by defective genes, hence allowing doctors and clinicians to easily identify diseases and know how to treat them on time without wasting money and resources. It also helps in the Amazon health and personal care prevention of hereditary diseases.

In the mid 50s, Sir Richard Doll published his finding of a research he carried out in the 40s about the link between smoking and cancer. He was able to found out that smokers are more likely to die of lung cancer than non-smokers. Shortly after, there was an introduction of daily hospital visits for children because before then, parents were only allowed to visit their kids for one hour each on Saturdays and Sundays.

By 1958, polio and diphtheria vaccinations were launched as there has been an epidemic just before that year. The vaccination programmes ensures that children of 15years and below were vaccinated; leading to an immediate and dramatic reduction in the diseases. Hence, the promotion of good health by the NHS and not only the treatment of illnesses and diseases. This however formed a good part of the NHS plan.

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In the 60s, contraceptive pill was made widely available, initially to married women, until 1967 when it was relaxed. The pill suppresses fertility with either progesterone or oestrogen or a combination of both and it plays a major role in women’s liberation.

A report (Porritt Report) was published in 1962, which results in Enoch Powell’s Hospital Plan. The medical profession calls for unification of the NHS after criticizing its separation into – hospitals, general practice and local health authorities. The Hospital Plan approves the development of district general hospitals for population areas of about 125,000. The 10-year programme happens to be the new territory for the NHS.

In the same year, the first hip replacement was carried out by Professor John Charnley in Wrightington Hospital.

The Salmon Report was published in 1967. It sets out recommendations for the development of senior nursing staff and the status of the profession in hospital management. The Cogwheel Report considers the organisation of doctors in hospitals and proposes that medical practitioners be grouped according to area of specialisation. The report also acknowledged how complicated the NHS is and the fact that change needed in order to meet future needs and demands.

The Abortion Act was introduced and became law on April 27 1968. Abortion became legal up to 28 weeks if carried out by a registered physician and if two other doctors agree that the termination is in the best mental and physical interests of the woman. By 1990, the time limit is lowered to 24 weeks.

On the 2nd of October 1968, a British woman gave birth to sextuplet after receiving fertility treatment. In the same year,

In 1972, Computer tomography, CT scans was introduced and it transformed the way doctors examine the human body. CT scanners have developed enormously over time, but the principle remains the same.

Another major discovery of the 70s was the world’s first test-tube baby, Louise Brown, who was born on July 25th, 1978 as a result of in-vitro fertilization. This new technique developed by Dr Patrick Steptoe, a gynaecologist at Oldham General Hospital, and Dr Robert Edwards, a physiologist at Cambridge University found a way to fertilize the egg outside the woman’s body before replacing it in the womb. Shortly afterwards in 1979, the first successful bone marrow transplant on a child takes place. The operation was performed by Professor Roland Levinsky at the Great Ormond Street Hospital for Children.

Magnetic resonance imaging- MRI scans was introduced in the 80 to provide more information about the body e.g. prove more effective in providing information about soft tissues, such as scans of the brain. It is particularly useful for finding tumours in the brain, for detecting multiple sclerosis and the extent of damage following paralysis.

The first keyhole surgery was performed in the 70s using a telescopic rod with fibre optic cable to remove gallbladder.

The Black Report commissioned by the then secretary of state, David Ennals, aimed to investigate the inequalities of healthcare i.e. differences between the social classes in the usage of medical services, infant mortality rates and life expectancy. The Whitehead Report in 1987 and the Acheson report in 1998 reached the same conclusions as the Black Report.

The 1981 Census shows that 11 babies in every 1,000 die before the age of one. In 1900 this figure was 160. Childhood survival has been revolutionised by vaccination programmes, better sanitation and improved standards of living, resulting in better health of both mother and child. Increased numbers of births in hospital has meant that where unexpected problems do occur, medical help is on hand.

In 1986, the public health campaign was lunched to educate people about the threat of Aids as a result of HIV. This is done in order to keep with the NHS’s original concept that it should improve health and prevent disease, rather than just offer treatment. In the following year, the first heart, lung, and liver transplant was carried out at Papworth Hospital in Cambridge by Professor Sir Roy Calne and Professor John Wallwork.

A comprehensive national breast-screening programme was introduced in 1988 in order to reduce breast cancer deaths in women over 50. This project is launched with breast-screening units around the country providing mammograms that takes an X-ray of each breast to show changes in tissue that might be otherwise undetectable. This will make any abnormalities show up as early as possible, making treatment more effective.

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NHS and Community Care Act was introduced in 1990 and the first trust established in 1991. This means health authorities manage their own budgetsAmazon health and personal care  and organisations will become NHS Trusts.

The National register for organ donation was set up in 1994 to co-ordinate supply and demand after a five-year campaign. Organ donation is needed as demand outstrips supply and this register ensures that when a person dies they can be identified as someone who has chosen to donate their organs.

NHS Direct, a nurse-led advice service which provides people with 24-hour health advice over the phone was launched. It is the start of a growing range of convenient alternatives to traditional GP services – including the launch of NHS Amazon health and personal care walk-in centres, which offer patients treatment and advice for a range of injuries and illnesses without the need to make an appointment.

The NHS walk-in centres was established in year 2000 to offer convenient access, round-the-clock, 365 days a year and are managed by Primary Care Trusts. The services are available to everyone without making an appointment or requiring patients to register.

In 2002, Primary care trusts are set up to improve the administration and delivery of healthcare at a local level. The primary care trusts oversee 29,000 GPs and 21,000 NHS dentists. The trusts are in charge of vaccination administration and control of epidemics also controls 80 per cent of the total NHS budget. They also liaise with the private sector when contracting out of services is required. As local organisations, they are best positioned to understand the needs of their community, so they can make sure that the organisations providing health and social care services are working effectively.

In 2004, all patients waiting longer than six months for an operation are given a choice of an alternative place of treatment. Everyone who is referred by their doctor for hospital treatment is given a choice of at least four hospitals. Nowadays you can choose where and when to have your treatment from a list including local hospitals, NHS foundation trust hospitals across the country and a growing number of independent sector treatment centres and hospitals that have been contracted from the private sector. You can choose according to what matters most to you: waiting lists, MRSA rates, bus routes and so on.

Robotic intervention was launched in 2007 with the aim to performing operations to treat patients for fast or irregular heartbeats.

Free choice is introduced on April 1 2008. Patients can choose from any hospital or clinic that meets NHS standards. Patients who are referred by their GP for their first consultant-led outpatient appointment can choose from any hospital or clinic that meets NHS standards. You can choose a hospital according to what matters most to you, whether it’s location, waiting times, reputation, clinical performance, visiting policies, parking facilities or patients’ comments.

On July 5 2008, the NHS celebrates its 60th birthday. Local events take place across the country, and NHS staff and patients celebrate at Westminster Abbey and 10 Downing Street.

HPV vaccination programme was launched a few months after the 60th anniversary of the NHS. The aim is to vaccinate girls aged 12 and 13 against the human papilloma virus (HPV) is launched to help prevent cervical cancer. A three-year catch-up campaign is also introduced, which will offer the HPV vaccine, also known as the cervical cancer jab, to girls who are 13 to 18 years old.

The NHS Constitution is published on January 21 2009 and sets out people’s rights as an NHS patient. For the first time in the history of the NHS, the Constitution brings together details of what staff, patients and the public can expect from the NHS. It aims to ensure the NHS will always do what it was set up to do in 1948: provide high-quality healthcare that’s free and for everyone. Also, the New Horizons programme was launched to improve adult mental health services in England followed by the launch of NHS Health Checks for adults in England between the ages of 40 and 74. Primary care trusts begin implementing the NHS Health Check programme in April 2009. It has the potential to prevent an average of 1,600 heart attacks and strokes and save up to 650 lives each year. It could prevent over 4,000 people a year from developing diabetes and detect at least 20,000 cases of diabetes or kidney disease earlier, allowing people to manage their condition better and improving their quality of life.

NHS Choices 2010

By the end of 2009, a five-year plan to reshape the NHS to meet the challenge of delivering high quality health care in a tough financial environment was developed. The report describes practical measures to meet the demands of an aging population and the increased prevalence of lifestyle diseases. The vision is for an NHS that is organised around patients whether at home, in a community setting or in hospitals. There will be a renewed focus on prevention with the ambition of delivering cost-effective high quality care across the service.

Health insurance

In healthcare, there are several barriers and obstacles that prevent people from accessing needed healthcare in the society. Migration is a natural phenomenon, England and the whole of the UK at large has experienced a new wave of migration in recent years. This is due to the fact that the European Union (EU) has expanded and people have immigrated into England to make a living; students come in to study and people come for different other reasons such as tourists, for greener pastures and so on.

The barriers being created as a result of migration include cultural barriers and illiteracy, as well as language barriers. The UK which England is part of is the only country in the whole of Europe where English is spoken as a first language; hence some of the migrants from the EU countries and others from countries where English is not widely spoken face the problem of accessing basic healthcare. As a result of lack of interpreters, it is often difficult for them to give the required information to their local surgeries when they go for registration.

Personally, I have experienced a long time appointment wait recently for a referral and this has prevented me from accessing healthcare as at when needed.

For personal reasons, when some people fall ill, the fear of taking time off work, losing their jobs or working for fewer hours with less pay prevents them from visiting the G.P when the need arises and hence not having access to basic health care needs.

Environmental barriers such as snow and extreme weather conditions also prevents people from going to G.Ps or prevents emergency rescue teams from reaching them on time.

Black and Minority Ethnic (BME) Groups in England also suffer economic disadvantages hence an increased risks of ill health (The Independent, 1995).

Another barrier is perception and lack of understanding of immigration laws on the part of the local surgeries staff, hence preventing people from registering with local G.Ps. Very recently, students studying in England are being refused registration with the G.P because their visas do not show any work hours, the surgeries claimed that it means the students are not contributing through general taxation towards healthcare and do not deserve to benefit from the services being offered by the NHS.

Undocumented, irregular and illegal migrants for fear of being detected and arrested by law enforcement agents do not visit and access healthcare.

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