Search

The authors assess the health care reform proposal of the new British government for the National Health Service (NHS) in 2010. Accordingly, the government aims to promote the involvement of public sector in influencing public health policy. They explain the advantage of placing public health directors and their teams in the council architecture. For comparison, the authors reference the health care reform efforts in the U.S.

The remit of the National Institute for Health Research Public Health Research (PHR) Programme is to evaluate public health interventions, providing new knowledge on the benefits, costs, acceptability and wider impacts of interventions, set outside of the National Health Service, intended to improve the health of the public and reduce inequalities. This paper illustrates how the PHR Programme is providing new knowledge for public health decision makers, based on the nine key areas for local authority public health action, described by the King's Fund. Many funded PHR projects are evaluating interventions, applied in a range of settings, across the identified key areas for local authority influence. For example, research has been funded on children and young people, and for some of the wider determinants of health, such as housing and travel. Other factors, such as spatial planning, or open and green spaces and leisure, are less represented in the PHR Programme. Further opportunities in research include interventions to improve the health of adolescents, adults in workplaces, and communities. Building evidence for public health interventions at local authority level is important to prioritise and implement effective changes to improve population health. [ABSTRACT FROM AUTHOR]

Many scholars have argued that social programs are marked by a logic of 'increasing returns' that makes change difficult. Yet over the past decades, reformers across industrialized countries have introduced substantial administrative reforms in these services, even as entitlement reform remains politically difficult. This paper explains these shifts by breaking apart the logic of 'increasing returns' into three distinct 'costs to change': technical, political, and expectations. Decreases in a particular type of costs produce different logics of institutional change-back end, informal, and front end-that privilege the state, professionals or private, or political actors in distinct ways. I support these claims by reexamining three cases that were considered exemplars of stability but that ultimately had major entitlement reform: health care in the United Kingdom and United States and welfare programs in the United States. I show that even before radical reforms occurred, reformers introduced distinct logics of administrative change that underpinned later changes. [ABSTRACT FROM AUTHOR]

This paper compares the development of genetic testing for breast cancer (BRCA testing) in the USA and the UK. It argues that national political cultures played an important role in how these genetic testing technologies were shaped, and that the shapes of these technologies had important implications for the users of these systems. In order to demonstrate the roles of national social and political elements in the development of new genetic testing technologies, I introduce the concept of a technology's architecture, which is made up of component and the specific ways in which these components are assembled to fulfill particular functions. In the USA, four very different BRCA testing systems initially emerged. However, one biotechnology company, Myriad Genetics, eventually used its legal and economic position to become the sole provider of testing. It offered BRCA testing the way many other laboratory tests were provided in the USA, available to anyone through any physician. The shape of this testing service had important implications for its participants, defining the client as a consumer who could demand access to any of Myriad's laboratory services, but could not choose among testing systems. In the UK, the government-run National Health Service provided testing through regional genetics clinics, using family history information to assess risks and triage care. Clients in the UK were defined as citizens and patients, who had the right to equal access to the testing system but could not demand any specific services. [ABSTRACT FROM AUTHOR]

President Clinton recently announced his reform plan for health care in the United States. The United Kingdom, along with other countries, has already enacted reforms in an effort to overcome the basic problem of having insufficient funds to provide a health service to meet modern demands. This paper briefly describes the recent health reforms in the United Kingdom and highlights some lessons for the United States, which include the need to choose procedures that should be universally provided. Health reforms that involve some fundamental restructuring need to be evaluated everywhere and agreed to by the staff in advance. [ABSTRACT FROM AUTHOR]

The capacity to provide satisfactory nursing care is being increasingly compromised by current trajectories of healthcare funding and governance. The purpose of this paper is to examine how well Marxist theories of the state and its relationship with capital can explain these trajectories in this period of ever-increasing austerity. Following a brief history of the current crisis, it examines empirically the effects of the crisis, and of the current trajectory of capitalism in general, upon the funding and organization of the UK and US healthcare systems. The deleterious effect of growing income inequalities to the health of the population is also addressed. Marx's writings on the state and its relation to the capitalist class were fragmentary and historically and geographically specific. From them, we can extract three theoretical variants: the instrumentalist theory of the state, where the state has no autonomy from capital; the abdication theory, whereby capital abstains from direct political power and relies on the state to serve its interests; and the class-balance theory, whereby the struggle between two opposed classes allows the state to assert itself. Discussion of modern Marxist interpretations includes Poulantzas's abdication theory and Miliband's instrumentalist theory. It is concluded that, despite the pluralism of electoral democracies, the bourgeoisie do have an overweening influence upon the state. The bourgeoisie's ownership of the means of production provides the foundation for its influence because the state is obliged to rely on it to manage the supply of goods and services and the creation of wealth. That power is further reinforced by the infiltration of the bourgeoisie into the organs of state. The level of influence has accelerated rapidly over recent decades. One of the consequences of this has been that healthcare systems have become rich pickings for the evermore confident bourgeoisie. [ABSTRACT FROM AUTHOR]

The article compares the health care system of Great Britain and the U.S. It is based on a series of three British-American medical sociology conferences, the most recent of which was convened in Boston, Massachusetts. It is stated that for most Americans, health care is procured through employer-sponsored group insurance plans. Whereas, in Great Britain medical is governed by the National Health Service (NHS).

This article presents information on various developments related to nursing in Great Britain and the U.S. The American Association of Critical-Care Nurses has announced the establishment of the Stanley Johnson Memorial Award for Creativity in Critical Care Nursing. Psychiatric nurses smoke more than their colleagues in other parts of the British National Health Service, while community nurses smoke less. This is one of the findings from a research project backed by the Health Education Council and based in the Universities of Hull, Manchester and Surrey. The project is designed to discover how many nurses smoke and why, and to look at the part nurses can play in smoking education. Linda Thomas, previously a nursing officer in the Geriatric Unit, Guy's Hospital, London, has been appointed the new nurse adviser of the RCN Society of Geriatric Nursing.

A letter to the editor is presented in response to the article "The NHS five year forward view: lessons from the United States in developing new care models" in the April 21, 2015 issue.

Interest-based arguments do not provide satisfying explanations for the surprising reticence of major US employers to take a more active role in the debate surrounding the 2010 Patient Protection and Affordable Care Act (ACA). Through focused comparison with the Bismarckian systems of France and Germany, on the one hand, and with the 1950s and 1960s in the United States, on the other, this article concludes that while institutional elements do account for some of the observed behavior of big business, a necessary complement to this is a fuller understanding of the historically determined legitimating ideology of US firms. From the era of the "corporate commonwealth," US business inherited the principles of private welfare provision and of resistance to any expansion of government control. Once complementary, these principles are now mutually exclusive: employer-provided health insurance increasingly is possible only at the cost of ever-increasing government subsidy and regulation. Paralyzed by the uncertainty that followed from this clash of legitimate ideas, major employers found themselves unable to take a coherent and unified stand for or against the law. As a consequence, they failed either to oppose it successfully or to secure modifications to it that would have been useful to them. [ABSTRACT FROM AUTHOR]

The article discusses the significance of the patients' medical history that is a necessary part of the holistic management for which the dental team is responsible. It also includes two tables such as American society of Anaesthesiologists' health categorisation and another table includes the website providing medical guidelines relevant to dentistry. It briefly describes several emerging pressures that challenge dental team while providing medical care.

Comparative histories of health system development have been variously influenced by the theoretical approaches of historical institutionalism, political pluralism, and labor, mobilization. Britain and the United States have figured significantly in this literature because of their very different trajectories. This article explores the implications of recent research on hospital history in the two countries for existing historiographies, particularly the coming of the National Health Service in Britain. It argues that the two hospital systems initially developed in broadly similar ways, despite the very different outcomes in the 1940s. Thus, applying the conceptual tools used to explain the U.S. trajectory can deepen appreciation of events in Britain. Attention focuses particularly on working-class hospital contributory schemes and their implications for finance, governance, and participation; these are then compared with Blue Cross and U.S. hospital prepayment. While acknowledging the importance of path dependence in shaping attitudes of British bureaucrats toward these schemes, analysis emphasizes their failure in pressure group politics, in contrast to the United States. In both countries labor was also crucial, in the United States sustaining employment-based prepayment and in Britain broadly supporting system reform. [ABSTRACT FROM AUTHOR]

Infectious diseases are a long-standing and continuing threat to health and welfare, with their containment dependent on national disease surveillance and response capacities. This article discusses infectious disease surveillance in the United States and the United Kingdom, examining historical national traditions for identifying and controlling infectious disease risks and how globalization and technical advances have influenced the evolution of their respective approaches. The two systems developed in different but parallel ways. In the United States, surveillance remained quite localized at the state level until the early twentieth century and still retains many of those features. The U.K. approach became centralized from the latter part of the nineteenth century and has principally remained so. In both cases, disease surveillance was traditionally conceived as a public good, where national or local authorities held sovereign rights and power to protect public health. With the increasing globalized nature of infectious disease, such notions shifted toward surveillance as a global public good, with countries responding in turn by creating new global health governance arrangements and regulations. However, the limitations of current surveillance systems and the strong hold of national interests place into question the provision of surveillance as a global public good. These issues are further highlighted with the introduction of new surveillance technologies, which offer opportunities for improved disease detection and identification but also create potential tensions between individual rights, corporate profit, equitable access to technology, and national and global public goods. [ABSTRACT FROM AUTHOR]

In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery-system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism. [ABSTRACT FROM AUTHOR]

We are at the beginning of an era in which the pressure to secure the biggest possible "bang" for the health care "buck" is perhaps higher than it ever has been, on both sides of the Atlantic, and within the health policy discourse, incentives, for both professionals and patients, are occupying an increasingly prominent position. In this article, we consider issues related to motivating the professional and the patient to perform targeted actions, drawing on some of the evidence that has thus far been reported on experiences in the United Kingdom arid the United States, and we present an admittedly somewhat speculative taxonomy of hypothesized effectiveness for some of the different methods by which each of these two broad types of incentives can be offered. We go on to summarize some of the problems of, and objections to, the use of incentives in health and health care, such as those relating to motivational crowding and gaming, but we conclude by positing that, following appropriate consideration, caution, and methodological and empirical investigation, health-related incentives, at least in some contexts, may contribute positively to the social good. [ABSTRACT FROM AUTHOR]

The social science literature on the comparative history of the welfare state offers conflicting accounts of the relationship between the United States and the United Kingdom. At first blush, the comparative history of health care policy in the United States and the United Kingdom seems to affirm the dominant view that the U.S. and U.K. welfare states have diverged substantially during the twentieth century. A comparison of U.S. and U.K. health policy, however, suggests that there are more parallels and points of tangency between the two systems than are readily apparent. The comparative history of health policy over the past century reveals common political and policy challenges and frequent interchanges of policy ideas, and helps uncover the political dynamics behind the development of health policy in the two countries, which can, in turn, help illuminate the contemporary politics of reform in both countries. [ABSTRACT FROM AUTHOR]

The article presents a comparison of the legal status of the embryo and the associated restrictions on abortion between the U.S. and Great Britain. It discusses efforts of the National Health System (NHS) in providing assisted reproduction services and regulating the genetic testing under the provisions of the Human Fertilization and Embryology Act of 1990. It discusses the judicial decision of the U.S. Supreme Court in the case of Roe v. Wade regarding the abortion law in the U.S.

Aim To test a priori hypotheses concerning client–treatment matching in the treatment of alcohol problems and to evaluate the more general hypothesis that client–treatment matching adds to the overall effectiveness of treatment. Design Pragmatic, multi-centre, randomized controlled trial (the UK Alcohol Treatment Trial: UKATT) with open follow-up at 3 months after entry and blind follow-up at 12 months. Setting Five treatment centres, comprising seven treatment sites, including National Health Service (NHS), social services and joint NHS/non-statutory facilities. Treatments Motivational enhancement therapy and social behaviour and network therapy. Measurements Matching hypotheses were tested by examining interactions between client attributes and treatment types at both 3 and 12 months follow-up using the outcome variables of percentage days abstinent, drinks per drinking day and scores on the Alcohol Problems Questionnaire and Leeds Dependence Questionnaire. Findings None of five matching hypotheses was confirmed at either follow-up point on any outcome variable. Conclusion The findings strongly support the conclusion reached in Project MATCH in the United States that client–treatment matching, at least of the kind examined, is unlikely to result in substantial improvements to the effectiveness of treatment for alcohol problems. Possible reasons for this failure to support the general matching hypothesis are discussed, as are the implications of UKATT findings for the provision of treatment for alcohol problems in the United Kingdom. [ABSTRACT FROM AUTHOR]

Part one of this two part article explores the factors contributing to errors during the administration of medicines through a detailed literature review. Medication incidents cause serious harm to patients. In a typical NHS hospital approximately 7000 medication doses are administered daily (Audit Commission, 2002a). The costs of errors to patients, practitioners and the NHS are significant. While some errors can be prevented, it is unlikely that they will ever be eliminated as they arise from human nature (Kohn et al, 2000). There is a lack of strong evidence in the literature about what nurses feel the factors contributing to medication errors are. The majority of studies were carried out in the USA and tended to be carried out by non-nurses with the exception of those by Gladstone (1995), Hand and Barber (2000) and King (2004). Gibson (2001) felt that nurses' experiences and knowledge appear to be under-valued. [ABSTRACT FROM AUTHOR]

Focuses on the way the National Health Service (NHS) creates and manages legitimacy in Great Britain. Use of complex processes of human interaction to deliver health care; Performance of managerial duties by doctors; Problem of sourcing, building and maintaining legitimacy in the NHS.

The article discusses the decision of the British government to make fundamental changes in the British National Health Service (NHS), introducing ideas adapted from the U.S. It says that a market system into the supply of free health care for all residents of Great Britain was introduced by the government. It adds that the reconciliation of its own role with the essentially market-driven issues is the fundamental problem struggled by the government. Moreover, the features underlying the NHS are also discussed.

Most governments devote considerable resources to the provision of private goods such as health, housing, and education. Moreover many such schemes are universal in the sense that everyone is eligible and provision is free. In Great Britain, for example, the National Health Service (NHS) offers free health care to all citizens, while; in the U.S. the public school system provides free high school education. The purpose of this article is to point out that such universal provision schemes can redistribute income: from the rich to the poor, even if they are financed by a head tax. The key to this argument is a discrete-choice model between private and public sector consumption in which individuals demand at most one unit of the publicly provided good while caring about its quality. This seems reasonable for a number of cases. Parents want their children to have a high school education, and individuals' health care needs are manifested in the form of a demand for a particular course of treatment. It is typically neither desirable nor even possible for a child to attend two schools at once or for an individual to receive health care from two different sources simultaneously.

This article reviews and contrasts the manner in which the British have coped with various problems in health care that are of increasing concern in the United States: primary health care, distribution of health personnel, division of medical functions, and the like. It is generally concluded that the National Health Service demonstrates the possibility of providing "reasonable" care to an entire population, within a limited budget, in terms of need rather than the ability to pay. Various problems in the National Health Service are reviewed, and the implications of British medical care practices for the United States are explored. [ABSTRACT FROM AUTHOR]

This section offers medicine-related news briefs as of March 2016. Topics covered include the question raised by Royal College of Physicians president Jane Dacre on the unfilled consultant posts to meet demands in patient care, the protest held by junior doctors in response to the government's handling of its dispute with the profession and the conduct of a study of women infected with the Zika virus in the first trimester of pregnancy.

The author focuses on the importance of conducting a visit to the U.S. among doctors undergoing medical training in Great Britain. Topics mentioned include the incorrect notion that belief in a successful approach in one culture can be transferred to another with similar results, research published in the journal "Lancet" in October 2015 on the results of the government program "Family Nurse Partnership," and importance of focusing on local assets instead of imposing external solutions.

The article provides information about several websites or online information resources for the health care industry. They include the Medline Plus news service provided by the U.S. National Library of Medicine and the National Institute of Health, the Australian website Media Doctor that aims to improve the journalism standards in the coverage of new drugs and treatment, and an information service funded by the National Health Service in Great Britain.