National Healthcare Services Management Essay Example | Topics and Well Written Essays - 2250 words

National Healthcare Services Management - Essay Example It provides comprehensive health care universally on the basis of need, and is financed out of general taxation and national insurance. It is one of the largest employers in the country, and is a major consumer of public expenditure. In UK, NHS undergoes drastic changes which have a great impact on the structure, functions and effectiveness of healthcare delivery. These failures are caused by lack of strategic vision and lack of budgeting, inadequate structure of NHS and inability to meet coming changes. The main problem of the strategic level is lack of coherence and consistency in planning process and goals. Government agencies seek to achieve their goals by attempting to build political consensus, and by incorporating key strategic actors in the creation and execution of policy. Thus, public administration cannot provide the co-optation of all institutions and groups, and state policy (in education, health, welfare and so on) and collaboration between producers and consumers. The problem is that "organizations fail to respond to requirements for engaging community in planning and development" (Publications and Reports NHS 2007). During the last five years, the politics of the NHS have varied in their intensity and nature, and conflicts have developed around a diversity of issues at different times (Moran 1999).. These have included the possibility of devising planned programs for specific health-care needs; the balance between acute medicine and care of the elderly, mentally ill and mentally handicapped; the organization of acute medical care; the national and regional redistribution of resources to equalize facilities and services; the scope of private medicine in NHS hospitals; the co-ordination of statutory agencies; tiers of administration and types of management; working conditions and pay levels for NHS staff; and cost-containment. Failures in NHS policies are cause by the fact that "NHS bodies on the patch do not have the commitment or the plans in place to ensure financial balance is achieved" (Publications and Reports NHS 2007). Ever since the inception of the NHS there were problems in identifying and measuring costs within hospitals, but by the late 1990s the measurement of costs and efficiency became a major source of concern for government. David Cameroon comments: "His (Gordon Brown's) great experiment in tax and spending has failed. He is an out-of-date politician wedded to state control. The question everyone is asking is, 'Where has the money gone" (Russel 2007). As central government attempted to contain health-service spending, tighter controls were applied to local Health Authorities; special emphasis was given to improvements in efficiency, and healthcare services were required to make 'efficiency savings' in their budgets (Petit-Zeman, 2005). Cost improvements or efficiency savings in the clinical sphere have not, to date, been established, but there have been systematic attempts to devise techniques for measuring and evaluating medical output, and intensive efforts to develop better accounting, budgeting and costing procedures. A major and long-standing difficulty in the NHS, largely due to the absence of market pressures, is that clinical costs were rarely the subject of detailed