Social and Economic conditions and their impact on NHS Funding

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Introduction:

In the middle ages, access to health care and sanitation facilities was only available to people belonging to a sound socio-economic background. Hill, Griffiths and Gillam (2007) state that in earlier time, even ensuring the supply of clean water and sanitation facilities was a tough task for municipal authorities. It was not until eighteenth century when provision of health services began to get recognition as government’s responsibility.

The NHS was founded in 1948 and is the currently the world’s largest health service that is publicly funded. The basic idea behind the establishment of the NHS was to ensure that people from all kinds of socio-economic backgrounds receive health facilities without any discrimination. This makes the service free for any individual who is a resident of the UK. According to the official statistics of the NHS, it deals with about 1 million patients every 36 hours. Funds for the NHS come directly from taxation. The NHS budget for 2008-2009 was more than £100 billion, which means a contribution of about £1980 by every individual in the UK.

Considering the fact that health and education are the most important public services on any government’s priority list, however the functionality of these services is directly related to the social and economic conditions. Same goes for the NHS, which has faced management crisis during times of economic austerity, both in present and the past. Although the NHS has seen a sharp increase in funding over the last few decades, however, given the current economic recession, the chances of future funding are quite uncertain. It is feared that either the NHS will go through a funding cut or the government will have to resort to tax-raising measures.

Health Care and Social and Economic Conditions:

Although good health is a need of every individual, however, the access to health care services is greatly dependent on the social and economic conditions of both the individual and the country he is residing in. An individual can either opt for a private health care service, which is subjected to his willingness and ability to pay for it, or is dependent on the services provided by the government. A large proportion of the population goes for the latter option. A poor socio-economic condition of the country means that either a person sacrifices on his health or will forgo any other of his basic needs in order to pay for medical bills. According to the Social Care Report 2008-2009 issued by the Health Committee of the House of Commons, A care gap may occur if people avoid using services wither because of affordability issues or if the services do not meet their requirement. The report also claims that the past three years have seen a significant drop in the number of people using the public sector health services, despite of the fact that the country’s ageing population have increased by 3%. This makes it apparent that either the public cannot afford to pay for the health care services or the government is finding it difficult to ensure the provision of standardized health facilities on equality basis.

At the same time, given the economic crises, the government itself also gets stingy with providing funds due to lack of resources. Consequently, the quality of service provided by the NHS is compromised. Fowler (Taylor and Field 1998, p. 158) states that lack of resources means that new hospital building would not be built advanced medical technology and equipment could not be purchased and the staff would be working under conditions that would demotivate them. This directly questions the value for money provided by the NHS services.

George and Miller (1997) state that in 1960s and 1970s politicians started to doubt the economic viability of a “universalist welfare state”. They argued that achieving economic growth is the government’s primary objective that is being sidelined due to increasing public expenditure. Consequently, they demanded a cut in public expenditure, which meant less funding for public sector health services.

Powell (George and Miller 1997, p. 8) claimed that public expenditure has overshot economic growth by a substantial margin, thus resulting in disastrous financial effects including internal inflation, external devaluation and foreign indebtedness. Lees (George and Miller 1997, p. 8) argued that medical care should be treated like any other commodity available in the private market. This will not only make the NHS more cost efficient, but will also make it less politicized and will offer more consumer choice.

Although while debating on making the public health services free at the point of use, many social scientists and economists agree that it can be easily funded by taxation, they tend to overlook other factors, which may directly or indirectly effect the NHS funding. McLeod and Bywaters (2000) argue that the inflationary pressures on the NHS funding of the pharmaceutical and medical technology industries and the continued presence of private health care services are two major constraints on measures for equitable health care. Moreover, the deteriorating condition of hospital buildings and their repair and maintenance costs also add to the financial pressures.

Funding Public Health Services:

Although the funds for the functionality of the NHS are directly acquired from taxation, however, it should be noted that all the capital works such as building hospitals are funded through Private Finance Initiative (PFI). This means that these capital works are being financed through loans raised by private sector financing institutions. According to Pollock, Shaoul and Vickers (2002) this is a very expensive way of financing the NHS. Using Private Finance Initiative requires the NHS to pay an annual fee including the cost of borrowing. Considering the fact that the NHS is a free service at the point of use, this method leads to an affordability gap for the NHS trusts. As a result, the NHS is forced to resort to external subsidies, charitable donations, sale of assets and even cuts in bed capacity and hospital staff. This in return makes the NHS questionable as the idea behind its establishment was to ensure access to health facilities to everyone without any class difference.

When a large proportion of a service is being funded by the tax payers, then the service providers are suppose to make sure that they are being cost efficient and provide the value for money. Unfortunately, this has not been the case with the NHS. Davies (2007) states that the NHS was provided with unprecedented funds, however it still overspent by a substantial amount. Moreover, clinical outcomes, waiting periods and the level of satisfaction of patients are all less as compared to that provided by private health care services. According to Davies (2007), the government argues that if the NHS manages itself efficiently, the NHS trusts can achieve significantly positive results.

Conclusion:

The problems in the health sector are similar to any other economic problem. It is facing a price hike due to gaps in demand and supply. The list of people waiting to get medical treatments is mounting up but there is a shortfall of resources to cater that list.

One suggestion given to deal with the problem is to impose user charges on the services provided by the NHS. Some critics argue that if user charges are imposed it will give two benefits. Firstly, it will generate funds for the NHS to finance the shortfall. Secondly, people will start taking care of their health and will make healthy choices in order to avoid seeking a medical care. The first argument is a socially unfair argument. The current economic conditions are such that people make sacrifices even when choosing in between the basic necessities. Imposing user charges on health means that they will start avoiding seeking medical treatment not because they do not need it, but because they cannot afford it. The second argument requires one to assume that people are aware and educated enough about what “right” choices they need to make in order to seek minimum medical help. Countries like France and Germany have already tried this approached and it only resulted in undermining the efficiency of public sector health services, rather than helping to achieve the required results. Therefore, imposing user charges for the NHS consumers should not be considered. Instead, the government and the NHS trusts should look for alternative instruments.

In order to deal with the problem the government will have to make both short term and long-term strategies. In short term, it should be ensured that the NHS becomes cost efficient and the consumers get value for their money. This can be done by minimizing dependency on the private finance initiative.

On long term basis, preventive measures should be taken and the emphasis should be on primary care. People should be educated such that take care of their health so that they are least prone to diseases.

REFRENCES

Davies, P 2007, The NHS in the UK 2007/08, London.

George, V and Miller, S 1997, Social policy towards 2000: squaring the welfare circle, Routledge, London.

Hill, P, Griffith, S and Gillam, S 2007, Public health and primary care: partners in population health, Oxford university Press Inc., New York.

McLeod, E and Bywaters, P 2000, Social work, health and equality, Routledge, London.

Taylor, S and Field D 1998, Sociological perspectives on health, illness and health care, Blackwell Science Ltd., London.

Pollock, A, Shaoul, J and Vickers, N 2002, Private finance and value for money in NHS hospitals: a policy in search of a rationale, viewed 21 October 2010,




Thomson, S, Foubister, T and Mossialos E 2010, Can user charges make health care more efficient?, viewed 21 October 2010,

2004, Health Economics, Biz/ed, viewed 21 October 2010,

How will the model support the role of the professional nurse in meeting the needs of today’s health care consumer?

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How will the model support the role of the professional nurse in meeting the needs of today’s health care consumer?

 

Delivery Care model
Innovative Delivery Care Models
This week’s readings emphasized the need for nurses to act as agents of change within their institutions. Of particular note, the globalization of the health care industry through the Internet has brought the world at large into the hospital to scrutinize how well it works. The forces of technology and politics play an equal role in shaping the face of medicine. Nurses confront the challenge of meeting both the needs of society and those of their patients.

To prepare for this Discussion, search the internet using the terms “Innovative Nursing Care Delivery Models”. Review at least two innovative models. Also review this week’s assigned readings, including ANA’s Nursing Scope & Standards of Practice as they apply to your specialty area, ANA’s Guide to the Code of Ethics for Nursing, and ANA’s Nursing’s Social Policy Statement. Then, respond to the following:
How will the model support the role of the professional nurse in meeting the needs of today’s health care consumer?
Which leadership skills are needed by the professional nurse to promote positive patient outcomes in this model?
How might this model of care change or support the role of the nurse as defined by ANA’s Nursing Scope & Standards of Practice, Code of Ethics, and ANA’s Nursing’s Social Policy Statement?
Support your response with references from the professional nursing literature.

The nurse formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate?

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The nurse formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate?

The nurse formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate?

The nurse formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate?

A. Helping the client to participate in social interactions
B. Establishing a one-on-one relationship with the client
C. Establishing alternative forms of communication
D. Allowing the client to decide when he wants to participate in verbal communication with the nurse

What effect do the nursing research priorities have on nursing researchers?

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What effect do the nursing research priorities have on nursing researchers?

Explore the National Institute of Nursing Research (NINR) website: https://www.ninr.nih.gov/ Review their publication Bringing science to life: NINR strategic plan (2011, p. 7) to identify the current priorities for nursing research. Do you agree with the priorities or would you recommend addition or elimination of some of the priorities? What effect do the nursing research priorities have on nursing researchers?
•What criteria must be met in order to consider a practice, evidence-based? Provide examples. Explain the role quality plays in evidence-based practice?
•Based on the information you’ve learned to this point, write a research proposal that relates to the topics you chose for a previous assignment. Be sure to include the following information in your proposal:
?Hypothesis
?Theory
?Design model
?Method
?Anticipated results
?Potential Dissemination Avenues

The assignment should be between 1500 and 2000 words in length and contain at least two scholarly sources, in addition to the textbook and provided material.

After reading chapters 3 and 4 in your textbook, write a 1 – 2 page paper describing what you consider to be a high-quality childcare program that would facilitate infant brain/perceptual development, and also meet their cognitive and socioemotional needs.

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After reading chapters 3 and 4 in your textbook, write a 1 – 2 page paper describing what you consider to be a high-quality childcare program that would facilitate infant brain/perceptual development, and also meet their cognitive and socioemotional needs.

Consider what toys would be appropriate for infants of different ages and decide how you would decorate the setting; also what qualities you would look for in the staff. Remember to base your paper on information from the textbook, and focus specifically on ages birth to 2 years.

After reading chapters 3 and 4 in your textbook, write a 1 – 2 page paper describing what you consider to be a high-quality childcare program that would facilitate infant brain/perceptual development, and also meet their cognitive and socioemotional needs. Consider what toys would be appropriate for infants of different ages and decide how you would decorate the setting; also what qualities you would look for in the staff. Remember to base your paper on information from the textbook, and focus specifically on ages birth to 2 years.

For the Unit VI assignment you are tasked with locating the web site of Neighborworks America (http://www.nw.org/network/) and exploring the role of the organization in regards to state and local rela

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For the Unit VI assignment you are tasked with locating the web site of Neighborworks America (http://www.nw.org/network/) and exploring the role of the organization in regards to state and local relations.

Specifically address the following:

 Mission and vision of the organization  The collaboration required to help the organization meet its vision of “strong communities.”   How the collaborations can assist with capacity building. o How does this collaboration relate to the concept of building local capacity by including non-government agencies in partnerships? o Which activities improve and enhance the organizations ability to achieve its mission and sustain itself over time?  How the partnership is impacting the community.

Your assignment must:

 Be a minimum of 700 words.  Include an introduction which summarizes the main points of the essay and identifies the relevance of the assignment to the course topic(s).  Be typed, double-spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA format.

Include a cover page containing the tile of the assignment (Unit VI-Essay), the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

Describe the potential members of the interdisciplinary team for budget development and the role of each individual

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Describe the potential members of the interdisciplinary team for budget development and the role of each individual.

 

All health care organizations have complicated budgeting policies and procedures. The more the nurse understands the process, the more effectively they can participate in the process. The budget process usually starts with an interdisciplinary approach. 1.Describe the potential members of the interdisciplinary team for budget development and the role of each individual.2.What are the specific responsibilities of nursing in the development of the budget?3.Are the responsibilities for budget specific only to the leadership of the nursing department or are they found throughout the organization? Citations should conform to APA guidelines.

Cognitive Approach to Improving Auditory Comprehension

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Cognitive Approach to Improving Auditory Comprehension

Aphasia is a communication disorder that results from damage to the portions of the brain that are responsible for language. It usually impairs the expression and understanding of language as well as reading and writing at different levels. Aphasia is most commonly characterized by the area of lesion, however, regardless of its localization and severity, auditory comprehension is always impacted to some degree. The biggest variables that impact sentence comprehension are sentence length and syntactic complexity (Brookshire & McNeil, 2015). Other than therapy being targeted to specifically improve auditory comprehension, it has been proven that when speakers slow down their rate of speech and add emphatic stress it can improve the individuals with aphasia comprehension abilities.

Nancy Helm-Estabrooks, Sc. D., CCC-SLP, the researcher that will be discussed, is a distinguished professor in the Department of Communication Disorders and Science at Western Carolina University in North Carolina. Among her awards are the Honors of the American Speech and Hearing Association and of the Academy of Neurologic Communication Sciences and Disorder, the Frank R. Kleffner Lifetime Clinical Career Award, and the Edith F. Kaplan Award for Invaluable Contributions of the Field of Neuropsychology. Her publications include over 100 peer-reviewed articles, seven books, 25 chapters, and seven standardized tests.

The traditional approach used to remediate auditory comprehension difficulties is the linguistic stimulation approach. It was first noted by Schuell, Jenkins, and Jimenez Pabon in 1964 which requires the patients to point to items by name, follow commands and respond to yes/no questions. The effectiveness of this approach is not well established because it suggests that underlying linguistics difficulties are the basis of auditory comprehension deficits. If this were the case, it would explain why patients can understand some stimulus and not others, but it does not. Since the linguistic stimulation approach has inconsistencies, Helm-Estabrooks and Albert conducted a study in 2004 to investigate the cognitive approach to treat all areas of auditory comprehension that the traditional approach cannot. The cognitive approach takes into account that effective language cannot take place without adequate attention, memory, executive function, and visual-spatial skills. However, in order to apply this approach clinicians have to determine the patients overall cognitive status to identify how it relates to the treatment outcomes.

This approach was inspired by the Attention Process Training Program created by Sohlberg an Mateer in 1986 to improve auditory comprehension in those with traumatic brain injuries. Since their program had great results, Helms-Estabrook created a similar program catered to those with aphasia. In the pilot study, the patient participated in a cognitive treatment titled Cognitive Linguistic Task Book that addressed attention, concentration, visual memory, counting, number facts, judgments, estimations, visuoperception, construction, and semantic/conceptual knowledge. The treatment consisted of 10 one-hour sessions that resulted in the participant’s auditory comprehension improving from the 37

th

percentile to the 95

th

percentile. Later studies with other participants with different severity levels of aphasia also demonstrated significant improvements leading Helm-Estabrooks and other researchers to believe that attention training alone might be an effective approach to treating auditory comprehension.

This treatment addresses the handicap of aphasia because auditory comprehension deficits is the disadvantage that arises after the diagnosis of aphasia. Without adequate auditory comprehension it impacts communication skills, the effectiveness of communication and the overall quality of life. Considering most individuals are not aware of what aphasia is and the setbacks that it comes with, if an individual is having difficulty understanding a message and cannot respond accordingly it is going to lead to people avoiding interactions with them. Even if an individual’s output may not be fluent or complete, if they can understand the message they can use other compensatory strategies to respond accordingly like an augmentative alternative device. Although several researchers support this strategy, the cognitive approach to improving auditory comprehension still needs further research and investigation to determine its efficacy on all the aphasias their possible severities.  The details of the current approach and the step-by-step procedures of the treatment can be found in the Manual of Aphasia and Aphasia Therapy, 2

nd

Edition.

References

  • Brookshire, R., & McNeil, M. (2015).

    Introduction to neurogenic communication disorders

    (8

    th

    ed.). St. Louis, Missouri: Elsevier.
  • Helm-Estabrooks, N. (2011). Treating attention to improve auditory comprehension deficits associated with aphasia.

    Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders,21

    (2), 64. doi:10.1044/nnsld21.2.64
  • Pearson. (n.d.). Nancy Helm-Estabrooks, ScD, BC-ANCDS. Retrieved from https://www.pearsonassessments.com/professional-assessments/products/authors/helm-estabrooks-nancy.html
  • Schuell, H., Jenkins, J., & Jimenez-Pabon, E. (1964),

    Aphasia in adults.

    New York, NY: Harper & Row.

What Is Ethics in Research and Why Is It Important?” Focus on the expectations of ethics for the scientific community, how results are used in the real world, and related ethical issues.

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What Is Ethics in Research and Why Is It Important?” Focus on the expectations of ethics for the scientific community, how results are used in the real world, and related ethical issues.

 

Review Chapter 1 of the course text, Social Psychology, focusing on research bias and research ethics.
•Watch the “Research Methods” video from the Contemporary Videos in Social Psychology DVD. Focus on the various problems that can be associated with different types of research.
•Read the online article, “What Is Ethics in Research and Why Is It Important?” Focus on the expectations of ethics for the scientific community, how results are used in the real world, and related ethical issues.
•Select one of the following articles from this week’s Learning Resources: ?”Intervening to Decrease Alcohol Abuse at University Parties: Differential Reinforcement of Intoxication Level”
?”An Attitude-Behavior Model of Salespeople’s Customer Orientation”
?”Prosocial and Antisocial Behavior in Preadolescence: Teachers’ and Parents’ Perceptions of the Behavior of Girls and Boys”
?”The Self-Protective Altruist: Terror Management and the Ambivalent Nature of Prosocial Behavior”
?”A Cross-Cultural Study of Environmental Motive Concerns and Their Implications for Proenvironmental Behavior”

•Read your selected article thoroughly and think about the following questions: ?What was the purpose of this research study?
?How were the participants selected?
?What kind of design is the study? (correlational or experimental)
?How was data collected?
?Where might bias exist in the study and for how was it controlled?

?What might be the implications of bias in this study? In other words, if the results of this study were applied in real life and bias was indeed present, what might be the results?

?Was the study conducted ethically? If so, what strategies did the researchers use to assure that the study was conducted ethically? If not, what could they have done differently?
The assignment

•Analyze the article you selected by responding to the following questions: ?Briefly, what was the purpose of the study and what were the main findings?

?Where could bias exist in the study design, in the conduct of the study, in the behavior of the study subjects as they participate in the study, or the interpretation of results? Did the research do anything to help control for bias? Explain. If there is potential bias in the study, how might this impact the use of the study results in the real world or in future research? If the researchers controlled for bias, what might be the results if they had not controlled for bias?

?Was the study conducted ethically? Explain in terms of the information you learned in the assigned readings. Would you implement additional strategies to assure an ethical study? Explain.

Assignment: Professional Construction Industry

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Assignment: Professional Construction Industry

Assignment: Professional Construction Industry

Assessment No 3 [70% of overall]
This assignment is relevant to the following Learning Outcomes:

2. Discuss effective leadership, motivation and communication in the construction industry

3. Read and interpret technical literature used in the construction industry.

Answer all questions.

LO 2 – Discuss effective leadership, motivation and communication in the construction industry

You are the Managing Partner of a quantity surveying practice that is based in Tauranga, New Zealand. Your company is growing fast with recent proposed housing developments in the area. Your company has decided to hire five more junior estimators to assist with the current workload. (This scenario is applicable to Q1 and Q2)

1. Discuss five (5) of your own personal leadership attributes that would help you to run your business successfully. (10 marks)

2. (a) Discuss three (3) motivational factors you will implement for the above scenario in order to achieve a high performing team (6 marks) Hint: key motivators that influence a person to achieve desired goals.

(b) Discuss one leadership style that will be suitable for the scenario in Q 1 to achieve effective leadership (2 marks)

(c) Discuss two (2) advantages of the leadership style you have chosen in Q 2(b) (2 marks)

3. (a) Communication can flow in different directions within hierarchical levels in an organisation. One of the communication flow direction common to Managers is downward. Discuss three (3) advantages and two (2) disadvantages of downward communication flow within organisations. (5 marks)

(b) Site meetings are important in the successful management of construction projects. Regular site meetings between different stakeholders on a project can help facilitate better communication and a shared sense of purpose, making it more likely that the project is completed successfully. You are required to send an email as a Site Manager to invite all stakeholders to your monthly meeting. Discuss any five (5) key items that will be included in your email to make it a concise, clear, professional invitation (5 marks).

LO 3 – Read and interpret technical literature used in the construction industry

4. Quantity surveying practice in New Zealand is guided by a Professional Code of Conduct which is produced by the NZIQS.

(a) Explain three (3) types of ethical problems that a practicing Quantity Surveyor or Estimator may face in the construction industry (6 marks)

(b) The professional code of conduct for Quantity Surveyors specifies several competencies and client care requirements of its members. Provide your own interpretation of any two (2) competences and client care requirements within the professional code of conduct. (4 marks)

5. SiteSafe and WorkSafe are the two key organisations involved in the provision of Health and Safety training and management within construction businesses in New Zealand.

(a) Discuss two (2) important roles of SiteSafe New Zealand in ensuring the health and safety of construction employees (2 marks)

(b) Discuss two (2) roles of WorkSafe in the health and safety of construction employees (2 marks)

(c) The primary responsibility of an employer is to provide safe working environments. Explain three (3) responsibilities that Employers are expected to perform under the Health and Safety at Work Act, 2015. (6 marks)

6. The extract of the drawing provided gives a list of specification (General notes) to a proposed residential building in Auckland. The specifications have been categorised under the following:

 Plumbing notes  Drainage notes  Timber notes  Glazing requirement  Insulation

In your own words, interpret the significance of two (2) specification items under each category (10 interpretations in total) (10 marks)

7. The GIB Site guide is an installation manual for GIB Boards in New Zealand residential and commercial buildings. A copy has been provided to you for this question. Using your own words you are required to interpret five (5) key steps within section 4.2 (General Installation Technique) of the installation manual (10 marks).

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